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Permit CITY OF TIGARD MECHANICAL PERMIT M DEVELOPMENT SERVICES PERMIT #: MEC2004 -00609 J� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/13/2004 PARCEL: 2S111 CC -20600 SITE ADDRESS: 15640 SW GREENLEAF CT SUBDIVISION: SUMMERFIELD NO.5 ZONING: R -12 BLOCK: LOT: 263 JURISDICTION: TIG CLASS OF WORK: OTR 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: 1 DOMES. INCIN: • LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: _ GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: 2 Remarks: Replace water heater, furnace & A/C unit to gas. Install gas piping to fireplace and BBQ. Owner: FEES GILSTRAP, THOMAS Description Date Amount 15640 SW GREENLEAF CT [MECH] Permit Fee 9/13/200 $72.50 TIGARD, OR 97224 [TAX] 8% State Surchar€ 9/13/200 $5.80 Phone: 503 624 - 6746 Total $78.30 Contractor: REQUIRED INSPECTIONS Phone: Gas Line lnsp Heating Unt Insp Reg #: Cooling Unt lnsp Final Inspection 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. 1 Issued By: Permittee Signatu • Alt" � � r.�-- Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application • • F FFICE USE ONLY ` I . , CIS of TI and •r } ' Received Permit No„ c /I Y g Date/By � /' y QV t% t 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit 503.639.4171 Fax: 503.598 1960 O p aN�,� i I N � Date/By. Inspection Line: 503 639 4175 , -a1,1. CI I i Date Ready/By: Juris E7 See Page 2 for ci.tigard.or.us Internet: www ci.ti W. g Notified/Method rib- Supplemental Information o-!^.. ,N =t- +p z 'C' °'' p ue . - .'€7� a m`=" *•_''itzD '• . *.e l iif `rt'; r: .. , ..*. - 'w ti " ;;' f- .' ' ; C'P , -. . ,, WOR'I�: 4 " >x _ ��',� °'� `t:J:: sri"``� -= �, "`%=; � ,� h ;. , , .�,. ,.��� �, E '„ r ��,.r, =;� >- ,,,,a e��M:,° . � +COMMERGIAZ✓ .EF3E .SCFIED.LJ�E: - '•CJSE CHECKLIST' Mechanical permit fees* are based on the value of the work ❑ New construction Addition/alteratio replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit 41. <;, 9 . ,' -w.., ;_._, Value: $ %�,��`. �' ; ° ` �� ' �° �` R. OF"" �QPIS' fRUC� :�� „�:�;- ��� - F � :: i ii ' ,.,:Z.N..,,,. 1 „ „ = . r. ..;& ',$„:.7 ..,x,' �,,,. x.,....- ^•aa tz:t%;. ».,,...,.,,t- ,,r ,..= ,,,,,. •..:..,..,< >.,. . n „ »- th - :,s - ,. N „ , ° , . - 7 RE S ID ENTJ L °E QU IP MET /,SYS>TEMS:FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist (Multi family ❑ Master builder ❑ Other Description Qty Ea Total :_ m , '.= a i " , j4 TO B SI , TI .Z. 4 .E ORNiATIO- . = 1V,,'r ArTD I OCAT.I©NF ; °• = .*-,,, - , ', 44 ;:;. ;5 _ ,” ,., Heating cooling 1 -i: ':e�':z�s., e» „�s�” ;�'J 3: 3� �s�.. ..n- r;•;�. -.° y� =� . °,,,ASS t„aa - ,,. �„ rs. <„�. - � - _, - � ” � • Job site address: S b 1j �-1�.� ��``20.� c Air conditioning or heat pump (requires site plan showing placement) 1 14 00 14 00 City /State /ZiP: Cp � - 0 \ it O p../ cn 22 Furnace 100,000 BTU (ducts/vents) _ ` — `J � 1 V 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: Tk) Sk.& fir.., -e\i— r .Q \ A Duct work 14 00 Hydronic hot water system 14 00 C \r"Oc +A GA NIS till C & - 1 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 ;:.. , k °:. •, <. _, a, g; � 7 ._ > Y thl ;• :; _ • , u k`3 ,: i - n -, ;.; Water heater 4 10 00 , , -, r. z�: ®Fs ; .Y , A . , ° `.. l 10 00 ' = , -:.. "a lt ' ., °. -Y :. -';; :„ `...,... ' : :: Gas fire lace 4 R-E e � 0. \'r- 1 - k`e�� e ‘ , ��`c1N0. Flue vent for water heater or gas ` .. t C - O K A �; D � � � 4.3 0.S � \ Ik fireplace 10 00 E}- ` 'r\ Log lighter (gas) 10.00 i_) 0 \ C1` `�- nk) RC� / Wood /pellet stove 10 00 Ge ! 0 `. N $ FT v- kc ., ,. � S? Wood fireplace /insert 10.00 ,,, � s , � ^ b„ . „ - , I^ l ..:; , , Chimney /liner /flue /vent 10 00 ,i'V : °. I tM O O , E R2 , li , , ; r,,; , ' , 71 . 0 . fE A 1Y° . ..v« : , �:,;.. _' ., s.,�.a� �.•,,�.��� i• • .. .� �.'n »° :4 „ >•.,.��.; ..r. �,u= ,'',.'s a 4 Other. 10 00 °!. Name: r - . • Environmental exhaust and ventilation - Address: '� () �”‘ ., — �ke, N - fp`r- C � -- Range hood /other kitchen `I equipment 10 00 City/State /ZIP: ) .i (( c'("tk 1 ©t( '' 1 .7Z 2 ]" Clothes dryer exhaust 10 00 (::0.... ��� � / ! Single-duct exhaust (bathrooms, Phone. (55 L, Fax: ( ) toilet compartments, , utility rooms) 6 80 ;; �`-_ h 41 ,r ' l Attic/crawlspace fans 10.00 ,a ;. '; '. ' 1 %AP,Pw-, A 1 : e tl - ;s ' C ®NT ACTT PERSON` =w' ~: - p ,?=.: nit" -., ,-,:. ..� M , ,» r •, -,� ,,,,v,----; �,,,,,,,.,••a,„r. w�,,'= ,•c,�a:..•,�. =v- 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 Phone: ( ) Fax : ( ) Water heate , Fireplace E -mail: Range i;,. -, ,K � ? ,a,",#-,�; . . .. �`'. °1 %}, i O ;. ,t= rx� •a, �'.} . .,•_�;,•_ -,, 'j•'vi,' i,` 4 ?'', • ,,,, . . , _ $• .s, '; �i ge �,, C. T RA CTOR f , r t• <,;,: ,, - r ' ` ; _ 4 _ ., . , Barbecue ,.,.3` - .,u, _$;N,,i.,:t 0 `1 ; iz- -` ,.,,. ,-, -, ? -. t c t..6,,:. : ,v •i" . 2.. . <.. _,tr., -k, „„ . .,,a; ; 4 ' y ' - e� ,....'7,1Z. ,L. Business name: 0 w bo -R y---- Clothes dryer (gas) Other Address: 7" ''' -':' •MECHANICALi:P- ,ERMITFEES* City/State /ZIP: Subtotal Phone: ( ) Fax ( ) Minimum permit fee ($72 50) 7 .,2_dl Plan review (25% of permit fee) CCB lie.: r - ' State surcharge (8% of permit fee) •y- TOTAL PERMIT FEE 'nf` 6 Authorized sit This permit application expires if a permit is not obtained within 180 `sLa�Jr „� days after it has been accepted as complete. Print name:" s (2 , G--‘, I ' 1., ( Date' t, / ` b t j * Fee methodology set by Tn- County Building Industry Service Board i \Buddmg\Perntts \MEC- PerrrutApp doc 12/03 440 -4617T (I I /02 //COM/WE13) Mechanical Permit Application - City of Tigard _ Page 2 - Supplemental Information Commercial Fee Schedule: TotaI aluafion >: a, Permit 1?ee� .;.. $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. 1 $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\Pemuts\MEC- PertmtApp.doc 12/03 2 CITY OF TIGARD 24 -Hour 7 / BUILDING Inspection Line:' , .(5,03) 639741>75 MST INSPECTION DIVISION Busi ss Line: (503) 639417) 4 Received B CA- S, .) ------ UP Date Requested -3 AM PM / � 1 2 4 s'' BUP Location / Sip V �✓�.�► l-e-ct 1 Suite ,;-'6Q V 66 6 d , Contact Person 7� Ph(S C 2 ? — " 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing -- --- ELC Foundation - - Ftg Drain Access: -� ELR Crawl Drain -- --- Slab Inspection Notes: S Post & Beam 7/ Shear Anchors (( /ge r Os- Z/Y1 Lr■ /� Ext Sheath /Shear Int Sheath /Shear \\� Framing _, __ - Insulation - - -- -- -- -� Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof n Other: Final I \ PASS PART FAIL //) ) // �� 1 \\ PLUMBING (4 Post & Beam // K---- c il ) J Under Slab - Rough In /1 L ( �� ---;,/ C Water Service / Sanitary Sewer J / \ 1 /I" 1 U) U O l Rain Drains /1 i f .J/) /, Catch Basin !Manhole Storm Drain Shower Pan `( /1 // ,, 7', Other: �.-/ n �� / Final PASS PART FAIL MO �/ HANIL" L \ ` Post & Beam v /,'% Rough -In Gas Line //' Smoke Dampers 1 (Final ART FAIL RICAL - Service Rough -In UG /Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line l , � / , ADA Date q )3 / Inspector Ext Approach /Sidewalk Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL