Permit t" a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00164
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/27/2007
PARCEL: 2 S 102 AB - 02200
SITE ADDRESS: 12525 SW MAIN ST ZONING: CBD
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT: 015 JURISDICTION: TIG
PROJECT: STONE GALLERY
Project Description: TI - Install vent fan, gas fireplace, gas piping for fireplace and future bar b - que. Project Value: $2,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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: 1
> 10000 cfm:
GAS OUTLETS: 2
Owner: FEES
JIM TOMA Description Date Amount
26431 S BARLOW RD
CANBY, OR 97013 [MECH] Permit Fee 3/27/2007 $72.50
[TAX] 8% State Surcha 3/27/2007 $5.80
Total $78.30
Phone:
•
Contractor:
SUNSET HOMES INC
26398 SW LABROUSSE RD
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 313 -2599
FAX 503- 825 -1684
Reg #: LIC 91700
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.
- sued By: L 0 / j L ' Permittee Signature:
Al
Call 503.639.4175 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 • Fo►z oii IC1•: fist ONLY
-r ,r' • City of Tigard Received e
q 13125 SW Hall Blvd., By Permit No.: ' /'
d, Tigard, OR 97223
i1 r ` AI r „ � ,, ' ,0 v/ 6
; C Plan Review Other Permit:
503.639.4171 Fax: 503.598.1960 Date/By
T I C A It D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method �jD Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
• Mechanical permit fees' are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
performed Indicate value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, lab r, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $•
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 and 2 dwelling Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi family 0 Master builder ❑ Other: . .
Description I Qty. Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / Air conditioning or heat pump
/ z�9 S � �A ,...1 5 T (requires site plan showing placement) _ 14.00
City /State/ZIP: 77 "- Furnace 100,000 BTU (ductslvents) 14.00
Furnace 100,000+ BTU (doers/vents) 17.90
Suite/bldg. /apt. no.: Project name: STGJ1 ,4„/Ze/Y' 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 '
• i .
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00 •
Subdivision: Lot no.:
_ Other: 10.00 '
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK . Water heater 10.00
/ Gas fireplace / 10.00 •
571 // ..400 S • /l'el4GG dirt - /J r Flue vent for water heater or gas
W 5 p •p � eS , 2 1 fireplace / 10.00
�l / � � 7 fits/! Log lighter (gas) 10.00
Wood/pellet stove 10.00
•
Wood fireplace/insert 10.00
PROPERTY OWNER I ❑TENANT Chimney liner /flue/vent 10.00
r Other: 10.00
1
Name: 'i• / _.T4-�'�� Environmental exhaust and ventilation
Address: 2 / / L ���L�� Range e hood/other kitchen
G / equipment 10.00
y /state /ZIP: L4_rtGL 4 . 3 Clothes dryer exhaust 10.00
/ f iax:( Single -duct exhaust (bathrooms,
Phone: (So,) G S/ -- ys ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
'� // Other: 10.00 •
Business name 5 4 . 05e 71- /'t+9'�` F piping
Contact name: / `o , / . x.4
Address: $5.40 for first four; $1.00 for each additional
2G ,3• 7 ! s ' —� Furnace, etc.
�f sr S� Gas heat pump
City / State/ZIP: 5 L , fw d d q 7 WalUsuspended/unit heater
Fireplace 1
Phone: (Sf l / 3 --�- I ($(J� �J� / �� heater ` / Fax:
E -mail: Z4/4 L • /Z > L /Z . e-g•pot< .•S 7 •Ji G % 1
Range
. CONTRACTOR Barbecuet/O /
Clothes dryer (gas)
Business name: S�riG � A1 .
Other:
Address: MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee)
CCB Iic.: G, j '7 6 / .,/ -7 State surcharge (8% of permit fee)
/ ` �y TOTAL PERMIT FEE
y, This permit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete.
I - Print name: 4 "37 �� , I Date: 3/L3`t77 • Fee methodology set by Tri- County Building Industry Service Board
I:\Building\PertnitAMEC -Penni pp.doc 09/06106 440-4617T(11/02/COM/WEB) •
Mechanical Permit Application - City of Tigard • -,. ,
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$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.
1: \Building\Permits MEC- PermitApp.doc 12/30/05 2 •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007- 00164
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/27 /2007
Phone: (503) 639 -4171 4pgg
Inspection Requests (24 Hrs.): (503) 639 -4175 'I L.
INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 79
SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK:
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 016 TYPE OF USE:
PROJECT NAME: STONE GALLERY
DESCRIPTION: TI - Install vent fan, gas fireplace, gas piping for fireplace and future bar- b-que. Project Value:
$2,000
OWNER: TOMA, JIM PHONE #:
CONTRACTOR: SUNSET HOMES INC PHONE #: 503 -3'1 :3 -2599
•
Inspection Request Scheduled For: Date: 7/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
/
699 ii Mechanical
final 053024 -01 5033/32599 N
Corrections /Comments /Instructions:
ib '-'
tiff) 1
( . 1 .7,
j /
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \A (/Z" Date: 'e ?/ ;k (6 Phone #: (503) 718-
y `-4
CITY OF TIGARD - -- ,
BUILDING DIVISION PERMIT #: MEC2007 -00164
13125 SW Hall Blvd., Tigard, OR 97223 _ - DATE ISSUED: 3/27/2007
Phone: (503) 639 -4171 di;
Fi l l tl
Inspection Requests (24 Hrs.): (503) 639 -4175 - _
INSPECTION WORKSHEET FOR DATE: 7/26/2007 TIME: 7:03AM PAGE: 23
SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK:
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE:
PROJECT NAME: STONE GALLERY
DESCRIPTION: TI - Install vent fan, gas fireplace, gas piping for fireplace and future bar- b-que. Project Value:
$2,000
OWNER: TOMA, JIM PHONE #:
CONTRACTOR: SUNSET HOMES INC PHONE #: 603 313 - 2699
Inspection Request Scheduled For: Date: 7/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 052814 -01 503 - 313 -2599 N
Corrections /Com -nts /Instructions:
,./ 6 Ct.r - (,-- ti...-12
41 I
.1vv.p....,--) sift- 5 SLiii O (:)--• `- C)
0 Al--e - ANA--12-i■- -1/■)
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FA ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \/L. Date: `i ( 6 ?hone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00164
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3127/2007
Phone: (503) 639-4171
_ .e N l IC
Inspection Requests (24 Hrs.): (503) 639 -4175 ± __Si- IL.
INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7:01AM PAGE: 21
SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK:
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE:
PROJECT NAME: STONE GALLERY
DESCRIPTION: TI - Install vent fan, gas fireplace, gas piping for fireplace and future bai-b-que. Project Value:
$2,000
OWNER: TOMA, JIM PHONE #:
CONTRACTOR: SUNSET HOMES INC PHONE #: 503-313 -2599
Inspection Request Scheduled For: Date: 4/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 046625.05 503. 313 - 2599 N
Corrections /Comments/ Instructions:
Ifl ( Cf 11 1/ iipzio q
❑ PASS ❑ PARTIAL APPROVAL J►l CANCEL ❑ NO ACCESS
❑ FAIL % V ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' ell■ � =� Date: � �A 7 Phone #: (503) 718- �,V
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: MEC2007 -00164
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/27/2007
Phone: (503) 639 -4171 4 + N d 1 i
Inspection Requests (24 Hrs.): (503) 639 -4175 I 1
INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7:01AM PAGE: 22
SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK:
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE:
PROJECT NAME: STONE GALLERY
DESCRIPTION: 11 - Install vent fan, gas fireplace, gas piping for fireplace and future bar - b-que. Project Value:
$2,000
OWNER: TOMA, JIM PHONE #:
CONTRACTOR: SUNSET HOMES INC PHONE #: 503-313-2599
Inspection Request Scheduled For: Date: 4/17/2.007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 046625 -04 503-313-2599 N
•
Corrections /Comments /Instructions:
i'kWO V L 1{/7/0 7
❑ PASS / PARTIAL APPROVAL El NO ACCESS
III FAIL % FOR INSPECTION " ADDITIONAL FEES ASSESSED
Inspector: _ - - ' ate: ,/ /7/9 2 Phone #: (503) 718-
•
CITY OF TIGARD
,
BUILDING DIVISION PERMIT #: MEC2007 -00164
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/27/2007
Phone: (503) 639 -4171 Ar
Inspection ( ) ection Requests (24 Hrs.): 503 639 -4175 . ' `'I L.
INSPECTION WORKSHEET FOR DATE: 4/12/2007 TIME: 7:00AM PAGE: 6
SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK:
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE:
PROJECT NAME: STONE GALLERY
DESCRIPTION: TI - Install vent fan, gas fireplace, gas piping for fireplace and future bar- b-que. Project Value:
$2,000
OWNER: TOMA, JIM PHONE #:
CONTRACTOR: SUNSET HOMES INC PHONE #: 503-313-2599
Inspection Request Scheduled For: Date: 4/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas lire 04640402 503 - 2599 N
Corrections /Co ments /Instructions:
' ?) 1' rNe � /J.
K PASS 1,I APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL % ' LL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: - — ■�� Date: �Z D Phone #: (503) 718 - Z97
i
CITY OF TIGARD , . •
BUILDING DIVISION PERMIT #: MEC2007 -00164
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/27/2007
Phone: (503) 639 -4171 / w
Inspection Requests (24 Hrs.): (503) 639 -4175 Rijl
__..
INSPECTION WORKSHEET FOR DATE: 4/12/2007- TIME: 7:OOAM PAGE: 5
SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK:
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE:
PROJECT NAME: STONE GALLERY
DESCRIPTION: TI - Install vent fan, gas fireplace, gas piping for fireplace and future bar - b-que. Project Value:
$2,000
OWNER: TOMA, JIM PHONE #:
CONTRACTOR: SUNSET HOMES INC PHONE #: 503-313 -2599
Inspection Request Scheduled For: Date: 4/17J2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 046404 -03 503-313-2599 N
Corrections /Comments/ Instructions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ± ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� Date: /E- O� Phone #: (503) 718- Z� � i'�