Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00134
�•��� DATE ISSUED: 3/22/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103AC 08900
SITE ADDRESS: 12835 SW FONNER POND PL
SUBDIVISION: ON FONNER POND TOWNHOMES ZONING: R -4.5
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Add additional line for cook top & fireplace
Owner: FEES
cy fiyu .3-/Lez-vt-c-a— Description Date Amount
a 3 Si) ° -' F- lL1 [MECH] Permit Fee 3/22/04 $72.50
� 4
6."1,6 / i 97/ 3 [TAX] 8% State Surchar€ 3/22/04 $5.80
Total $78.30
Phone: 52 — g 7<�
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone: Gas Line Insp
Reg #: rar OEM
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 thr gh OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions to O NC by calling
(503)246-6699.
Issued By: Permittee Signature:
Call (5 3) 639 -4175 by 7:00 P.M. for inspections n ed the next business day
Mechanical Permit Application FOROFFIICE USE ONLY
City of Tigard
2 EC Y®' {® IV ® Received
Date/By: Permit No __ 13125 SW Hall Blvd., Tigard, OR 97 Plan Review
Phone: 503.639.4171 Fax 503.598.1960 //t 4rHl�yi �r I iii Date/By Other Permit
Inspection Line: 503.639.4175 MAR 22 2004 ,_,x, a! I� lures
®
.+even W
Date Ready/13y See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TIGARD
4! "- r`„Yd. ";Ir'i"; "3 >_,��e.ASi �arp3., �
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._ ". a;.' ,ik >,, , }:; :. ':t ! Ef.ON, :G"(3 C'I� : ..,, 1 ` ri ' ° ":' „,•,-.,; , }CO�IVIIVI "IAL' ;FEE* =S -SE,CHECK
UL'IST
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Mechanical permit fees* are based on the value of the work
❑ New construction IS. Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
` ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
i`, ""' i to "''' ''- 4'' " wq -- ",= CATEGORY OF; COIVSTRUCI'•IOIV ”" --.'-''''''''''',:74:"' " Value' $
.L;, �r.r_ p l;' ' -. .. ; r ,
, '. RESIDENTIALrEQUIPMENT'/ SYSTEMS FEES*
`k 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty Ea Total
„ -;. _;z. l ;,JOB;.'SITE. b„..,,„_RIVIATION'AD "'L'.00AThON'r =' r;. . `.i,,._..1, _ .
',,;; Heating/cooling
�n,,,'.wet "`r;i� F; »r�s. t',�'d..'i6a= .K ;y.� s.� „,,,„i„„- x.;, _s: _ ,„ .,s-' Chw>>vu
Job site address: / Za3 � (i3 n w\t.c (?gv PL- Air conditioning or heat pump
(requires site plan showing placement) 14.00
Furnace 100,000 BTU (ducts /vents) 14.00
City/State /ZIP: T 1 ��� O q:--- Z Zit
i Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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. 10 00
Subdivision: Lot no.: Flue /vent for any of above 10 00
Other: 10 00
Tax map /parcel no.: Other fuel appliances
,,: =,` f S ; . . - . W spa - „1 TI , ; r$ - 6 + ;_., ..,,; . -ti i ; :r.3 il, .r,I ; <: l Water heater 10 00
s� > ,s ?y: ssi . t c •'; ; ° �'.;.r � DESC T IO 1V: tOFj_ , � 1.-^,1-,
;�._ ... a.`�.. e=�:a:�.�r x..r��i. -, . =;mow€ _:ter._, .�h,.. ,...� sr_ :�s�. ,,.,.:.ft ��;3. "• ,, d.�..,.a .�._ ... ' _.
Gas fireplace / 10.00
/t- ",i Ctkit to^ J t' 5 L 114 Cto!( *OA -1 4a3 Flue vent for water heater or gas
}� fireplace 10.00
F74.-.1. e 'Pi c-.- Log lighter (gas) 10 00
Wood /pellet stove 10 00
Wood fireplace /insert 10 00
Chimney /liner /flue /vent 10.00
ii:` "'`3�::¢+`�"n':', § ... ,., e -r., ».s - - ;e s ` ' �;;,k ' ;p� , ;a :, k .,.:._.-.a^, , Y Sr � Y
i., tC,r 1K1 , . r'. r? siiek: _> _ ,` afii, :TN'ANT'S ....,i.,�,,,:d
�.aa.,a�x'�' >e,�.,�e.. =_.ter �.��,,.," �.•,..... __ :: Other• G ,s 6'00IL'�w0 10.00
Name: �fny _ __ Environmental exhaust and ventilation
Address: lam. S-00 , SLhLJ ) L S . c), Range hood /other kitchen
l equipment 10.00
City/State/ZIP: \\.. --e-T0 O ,P.__., RA't;"_3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: Q1,3) 1/4s 7 Z -9 8-� Fax: ( ) toilet compartments, utility rooms) 6 80
V i, 4 ;,. - ,^, „n . :yt ,*,t a ' ; -_ . _, , _ • F' Attic /crawlspace fans 10 00
i ,E _ `j yYt, t ' _ APRL3CAlVT ` ,. e" t 4i ` 4 = 7:Q . ..t ; t - ,. P ERSON' J - - i; . : ' y
Other: 10 00
Business name:
Fuel piping
Contact name: Jptr_) �f01 NC $5.40 for first four; $1.00 for each additional
C / a Furnace, etc.
Address:
23 )� S co Loi s k Y t Gas heat pump
City/State /ZIP: i't,(t(1(YL0 OP- Ct' ( Z3 Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
`'S;:rS,;t ''"`'1fOlt i „ , i, .:,. : s,. ; :mnw, ii r uj�Y�` ° sI2 =[ [ d•''i�r�.`Nr_ '' S'' ;S a''.'s
!z }r. 7 z . .1 ;:. .CONTRACTOR x- - 4 , . rip ,,
. ��s, t,! � ` >W�rd,'�'ttest� �:�ds;�' = ;��� _.,�,_ .<< ���._� _mom_ . >:a =�� =���'�;'� =• ;�''��. - �;:�p .,, '� Ie; " .� Barbecue
-C , w Ps --- Clothes dryer (gas)
Business name:
j i wt Other:
Address: - s' ;f4`'-'` .mr. MECHANICAL`PERMIT,FEES*
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72 50) 7,7 • _V.
Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee) 5 g0
TOTAL PERMIT FEE 7a
This permit application expires if a permit is not obtained within 180
Authorized si ture: days after it has been accepted as complete.
Print name: _____---- 1 h Date: 3 - Z7 , O f( * Fee methodology set by Tri- County Building Industry Service Board
i \Building\P is \MEC- PermnApp.do 12/03 440 -4617T (I I /02 /COM /WE
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
:t, ">+; k " S LV, . alu�aton ri ';: k` i: ;,", ;:,��,
Tota:;
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2 •
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received . Date Requested '- - °Z AM PM BUP
Location / a RS3•5 - • / +P1_Suite E� g— ( /
Contact Person ` "''�' Ph ( C-e-e �7a` / q TD6 - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC L - DO //S
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab InspectionNotes'' SIT
Post & Beam CA- J I �- ` /
Shear Anchors 2 f / `-
Ext Sheath/Shear
Int Sheath /Shear et.; - (J fr
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
"itIOHANIQW '
Post & Beam
ough -I
Gas ine
•yoke Dampers
• •I.
•n'T FAIL
' ICAL
Service
UG751ab
Low Voltage
Fir- Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
11 1:11 .4 . 11111 ft PART FAIL
SITE Please call for reinspection RE: I Unable to inspect — no access
Fire Supply Line
ADA `"Q
Approach/Sidewalk Date �� Inspector , l L " J Ext
Other:
Final DO NOT REMOVE this Inspection record f one the jo n - ite.
PASS PART FAIL