Permit 71 CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00277
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/3/2008
PARCEL: 2S 114BA -15400
SITE ADDRESS: 16085 SW COPPER CREEK DR ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 4 LOT: 119 JURISDICTION: TIG
PROJECT: WASHINGTON
Project Description: Replacing existing wood stove.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
WOODSTOVES: 1
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
KEVIN WASHINGTON Description Date Amount
16085 SW COPPER CREEK DR
TIGARD, OR 97224 [MECH] Permit Fee 6/3/2008 $72.50
[TAX] 12% State Surch 6/3/2008 $8.70
Total $81.20
Phone: 503- 635 -8515
Contractor:
EVERGREEN GAS INC.
PO BOX 388
WEST LINN, OR 97068 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 407 -9542
FAX 503- 344 -6289
Reg #: LIC 158031
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
�-
Issued B • . ` _ ��./ � Permittee Signature:
1)a
Call 50 •.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Foil OFFICE USCONLY
y g �
eCit of Tigard iiIi `� R B V� 1 ��� / - 4 �/W O nnitNo.: gyp, +—OC
n 13125 SW Hall Blvd., Tigard, OR 9 t •.
.11 ` c� r �QO Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JV \ VN o J Date/By:
Other Permit:
T I G AR D Inspection Line: 503.639.4175 a p ate Ready/By: 0 See Page 2 for
Internet: www.tigard- or.gov � otified/Method: Supplemental Information
WO
CAIN
0 *SCHEDULE — USE CHECKLIST
TYPE OF ,�
COMMERCIAL FEE
❑ New construction ® Addition /alterati Mechanical per it fees *are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑Other:
Description Qty. Ea. Total
ITE INFORMATION AND LOCATION Heating/cooling
Job site address sw copper creek dr
Air conditioning heat pump
(requires site plan showing wing placement) 14.00
City/State /ZIP: tigard oregon 97224 Furnace 100,000 BTU (duets/vents) 14.00
S ! j Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldg./apt. no.: Project name:
C VA /i f� () Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
I Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
�! Gas fireplace 10.00
take out 0 � 0 wood stove and replace with new - reconnect vent Flue vent for water heater or gas
A fireplace 10:00
� Log lighter (gas) 10.00
• Wood/pellet stove 1 10.00
Wood fireplace /insert 10.00
® PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10.00 •
Name: kevin washington Environmental exhaust and ventilation
Address: 16085 sw copper creek dr Range hood /other kitchen
equipment 10.00
City/State /ZIP: tigard oregon 97224 Clothes dryer exhaust 10.00
• Single-duct exhaust (bathrooms,
Phone: (503)635 -8515 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Fax: Phone: ( ) ( ) Water heater Fireplace
E -mail: Range
CONTRACTOR Barbecue •
Business name: evergreen gas inc Clothes dryer (gas)
Other:
Address: po box 388 MECHANICAL PERMIT FEES*
City/State /ZIP: west Jinn oregon 97068 Subtotal
Minimum permit fee ($72.50) ''la•.5t2
Phone: (503) 407 -9542 Fax: (503 -) 344-6289
Plan review (25% of permit fee)
CCB lie.: 158031 State surcharge (12% of permit fee) t.70
TOTAL PERMIT FEE '/,
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: william belden Date: june 4 200 * Fee methodology set by Tri- County Building Industry Service Board
I:\ BuitdingWermits \MEC- PecmitApp.doc 01119107 440-4617T (11 /021COM/WEB)
.
CITY ®F TIGARD
BUILDING DIVISION PERMIT #: IMMEC2008 -00277
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/3/2008
Phone: (503) 639 -4171 a a ggiiulP�`li
Inspection Requests (24 Hrs.): (503) 639 -4175 �_`
INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:01AM PAGE: 47
SITE ADDRESS: 16085 SW COPPER CREEK DR CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 119 TYPE OF USE:
PROJECT NAME: WASHINGTON
DESCRIPTION: Replacing existing wood stove.
OWNER: WASHINGTON, KEVIN PHONE #: 503- 635 -8515
CONTRACTOR: EVERGREEN GAS INC.. PHONE #: 503- 407 -9542
Inspection Request Scheduled For: Date: 6/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 0709G9 -01 503.6338515 Y
Corrections /Comments /Instructions:
ASS (i PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ---6 —a 8 Phone #: (503) 718- --"Z1-4-5----
CITY OF TIGARD
BUILDING G DIVISION PERMIT #: Mf 20081 C1' 77
'I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 6/312008
Phone: (503) 639 -4171 @� , A
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' ' �..
INSPECTION WORKSHEET FOR DATE: 6/4 /2008 TIME: 7:01AM PAGE: 22
SITE ADDRESS: 16085 SW COPPER CREEK DR CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 119 TYPE OF USE:
PROJECT NAME: WASHINGTON
DESCRIPTION: Replacing existing wood stove.
OWNER: WASHINGTON, KEVIN PHONE #: 503 - 635
CONTRACTOR: EVERGREEN GAS INC. PHONE #: 503 - 407 -3542 • Inspection Request Scheduled For: Date: 6/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 070836-01 603.407 -9542 N
Corrections /Comments /Instructions:
/n
V
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL O ACCESS
I l FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 6 --4--- Phone #: (503) 718 - '----