Permit c .
if.
C ITY OF TIGARD MECHANICAL PERMIT
�; DEVELOPMENT SERVICES PERMIT #: MEC2003 -00583
�` ��JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/1/03
PARCEL: 2S111 CA -11200
SITE ADDRESS: 09532 SW SATTLER ST
SUBDIVISION: LAKESIDE PLACE ZONING: R -7
BLOCK:. LOT: 003 JURISDICTION: TIG
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:
OTH 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:
OTHER UNITS:
FURN > =100K BTU: < =10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of wood fireplace insert.
Owner: FEES
FREAD, JAMES R + DEBORAH J Description Date Amount
9532 SW SATTLER ST [MECH] Permit Fee 10/1/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 10/1/03 $5.80
Phone: 503- 620 -7951 Total $78.30
Contractor:
MORTON ENTERPRISES
803 NE 122ND. AVE.
VANCOUVER, WA 98684 REQUIRED INSPECTIONS
Phone: 360 - 904 -9285 Woodstove Insp
Final Inspection
Reg #: LIC 122159
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 -00
Issued By: 411110 _ y=
, 410 / �L Permittee Signature: ,
Call (503) 639 -4175 by 7:00 P.M. for inspections nee.e' the next business day
i
Mechanical Permit Application FOR OFFICE USE ONLY
Received p Mechanical
Date/By: / ' /0 3 613 Permit Nolyi b2 0, — sg3
City of Tigard Planning Approval Building
y g Date/By: Permit No.:
13125 SW Hall Blvd. RECEIVED Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 -639 -4171 Faxo�3 -59 v c, Post - Review Land Use
°6'' �� 1 1 �(t t 3 �nrrd 9' C ontac t Case No.:
Internet: www.ci.tigard.or.us . • Contact Juris.: ® See Page 2 for
24-hour Inspection Request: 503 -639 -4 LL75 Name/Method:
CITY OF TI i �C Supplemental Information.
BUILDING DIVISION
- TYPE OF WORK . .. . COMMERCIAL FEE* SCHEDULE - USE CHECKLIST -
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
. ' CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
® 1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning•• 14.00
Job site address: R53D Sty) t3 *- 4l - S t- Gas heat pump 14.00
Suite #: _ Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Cross street/Directions to job ( ob site: (oridenfor radiator or hydronic system) 14.00
'k APcL Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
_ Subdivision: I Lot #: Repair units . 12.15
Tax map/ parcel #: Other Fuel Ap liances
ax ma
P P Water heater 10.00
DESCRIPTION OF WORK . . Gas fireplace 10.00
I Kr5•114Lc.- 4.a °•A — CCU pA i r € v-i- Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
. Wood fireplace /insert_ / 10.00
Chimney/liner /flue/vent 10.00
,PROPERTY OWNER : ' I ❑.TENANT - Other: 10.00
Environmental Exhaust & Ventilation
Name: .3 pt yyx s . G-�,w Range hood/other kitchen equipment 10.00
Address: qs 3 .5 S Pr't .ct--
Clothes dryer exhaust 10.00
City /State /Zip: �
L Z z c f
s a� 7 Single duct exhaust
Phone:S-b3- ((„)d- / ' Fax: (bathrooms, toilet compartments,
- ❑ APPLICANT ' . ❑ CONTACT PERSON utility rooms) 6.80
Name: Atticicrawl space fans 10.00
Address: Other _ 10.00
Fuel Piping
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Furnace, etc. ' ••
Phone: Fax: Gas heat pump '•
E -mail: WalUsuspended/unit heater ••
CONTRACTOR Water heater ••
Business Name: (V4, ,ricvi GlU „ 3Vt 6,,, Fireplace ••
Address:4 3 N f = 1 ^.� / Range ••
City/State /Zip: Va c - , % $-, e ., - , c . oy A 1 gp ,,e ty Clothes dryer (gas) ••
Phone:340-s'7 (. Sa Fax: Other: ••
CCB Lic. #: (2 -2- 51' 5791° 5 Total:
Mechanical Permit Fees*
Authorize. Subtotal: $
Si 1
Minimum Permit Fee $72.50 $ ��;! - ice
Date:/0Y r v -� 7a T. 5-e `� � - J Plan Review Fee (25% of Permit Fee) $
J St ate Surcharge 8% of Permit Fee) S W
(Please print name) ( ) $
TOTAL PERMIT FEE $ 'fig, 30
Notice: This permit application expires if a permit is not obtained within •Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
A
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 $1 0,000.00 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. •
$100,001.00 and up $1,396.50 for the first $100,000.000 and
$1.10 for each additional $100.00 or fraction
thereof.
All New Commercial Buildings require 2 sets of plans.
•
r '
is \Building \Permit Forms \MecPermitAppPg2 09- 01- 03.doc
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION f Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / AM PM BUP
Location q S �� thl a"/ S • Suite 3-- oO 5 $3
Contact Person � ^1 R9 a..01 Ph ( ) spa- -D — 79• 7 PLM
Contr- ar Ph ( ) SWR
B ILDING Tenant/Owner ELC
F.'oting
ELC
F•undation
Access:
g Drain ELR
rawl Oral
lab Inspection Notes: SIT
'ost &B =:m
hear A hors
xt She. th/Shear
t She. h/Shear
rmin (11 C64-e— i I i' Ala L S I • ��LA -7
nsulat'•n
ryw -.I Nailing
irewpl
• ire '•prinkler
- *re Alarm
S -.•'d Ceiling
R• •f
dir
'AS PART FAIL
• LUMB G
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
FAIL
- -am
Rough -In
Gas Line
S • e Da' pers
P PART FAIL
LECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 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 35(
ADA a_j ,
Approach/Sidewalk Date 3 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24- Hour -
BUILDING Inspection Line: (503) 639 -4175 -
INSPECTION DIVISION ' Business Line: (503) 639 -4171 MST
BUP
Received Date Requested D 3 PM BUP
Location 9 Sc 4p.✓ Suite g` 3 - 0052
Contact Person Ph ( ) - 79 SI PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear d �G e-56AG c-y � C y ' Mil
Framing
•
Insulation
Drywall Nailing I,
(/�(}
Firewall \ 1 O k\ O MIT 6 CJs \ c; N r 5-
Fire Sprinkler J ' `►
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 FAI
MECHANICAL TL
Post & Beam, b y) 0
Rough -In y • • _ A "
Gas Line ,G
Smoke Dampers
IWO
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for eins• ection RE: Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk Date /"
PP —.NIL Inspecto / �. i . #r Ext
Other:
Final DO NOT REMOVE this Inspection record rom the jo ' - Ite.
PASS PART FAIL
11:1-f3111\