Permit 4' \
CITY TIGARD MECHANICAL PERMIT
°' COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00473
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/22/2008
PARCEL: 1 S125DA -04201
SITE ADDRESS: 06820 SW WALNUT TER ZONING: R -4.5
SUBDIVISION: KINGS VIEW LOT: 027 JURISDICTION: TIG
PROJECT: CLAYTON
Project Description: Installation of gas fireplace.
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
STEVE CLAYTON Description Date Amount
6820 SW WALNUT TERRACE
PORTLAND, OR 97225 [MECH] Permit Fee 9/22/200€ $72.50
[TAX] 12% State Surch 9/22/200€ $8.70
Phone: 503- 244 -7341
Total $81.20
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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 d' ns to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss ed By: 0 0 ; Permittee Signature:
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.
r M echanical Permit Application FOR OFFICE USE ONLY
City of Ti and ( � n L- � Received �y
g \mil U Date/By 9 ff or Permit No )44 Z /, 3
13125 SW Hall Blvd , Tigard, OR '97223'
'' II II Phone 503 639 4171 Fax 503 598 1960 Plan Review
, n Date/By Other Permit
�
Inspection Line 503.639 4175 S I- -) /+ °%
T I GA R D Date ReadyBy lur � ® See Page 2 for
Internet www tigard -or gov Notified/Method / e" Supplemental Information
CITY OF T0GARL
TYPEIW ARifiM-. l !!S!ON COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
ID New construction - ° lddition/alteration/replacement
performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ,Other: — S cc.s S - OJ-L mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
'i1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
Multi-family ❑ Master builder ❑ Other: Description Qty Ea I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 6 2 ,2 O 5 t-4_) \A)pt 1 vi u # '-g V• (requires site plan showing placement) 14 00
City /State /ZIP: ■ J -4 , U Q F 2 2 3 Fumace 100,000 BTU (ducts /vents) 14 00
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 10 00
I ` � Q r Hydronic hot water system 14 00
$ 6 411 LAJc VLU{ Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 14 00
Flue /vent for any of above 6 80
Subdivision: Lot no.: Other 10 00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10 00
� n I _ Gas fireplace / 10 00
in 5l-ct � 1 t g,t) o c) q 4 1 V r 5let VWtl ✓L& 1(L5 54-DJ Flue vent for water heater or 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
KPROPERTY OWNER ❑ TENANT Other 10 00
Name: 54,e/eke K C I c ut( J � Environmental exhaust and ventilation
Address: , Range hood/other kitchen
bEQO 5 Lt) vi ( " ( e h • equipment 10 00
City /State /ZIP: 1 114trj 0 Q GI '7 Z L3 Clothes dryer exhaust 10.00
!! I Single -duct exhaust (bathrooms,
Phone: (9b3 ) ?.4.(,', . 3 4_ ( Fax: ( ) toilet compartments, utility rooms) 6 80
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10 00
Business name:
\ Other ] 0 00
Fuel piping
Contact name: 54. C lS41-1-vK- $5.40 for first four; $1.00 for each additional
Address: 6 820 5 u1 u,(kuu -t (-6 . Fumace, etc
Gas heat pump
City /State /ZIP: .1 A 4 rcl 1 (7. CO L 23 Wall /suspended/unit heater
Phone: (5 2,444 - -7 34 ( Fax:: ( ) Water heater
ac
E -mail:
Range
CONTRACTOR Barbecue
Business name:
Clothes dryer (gas)
P Other
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fcc ($72 50) 0 91- 5
Phone:
( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee) �j, 70
TOTAL PERMIT FEE ''1, 91, Authorized signature: This p ermit a expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: S 4 h_' yL G C La y L si Date: ? - 2- - og • Fee methodology set by Tri -County Building Industry Service Board
\ M
1 \BuddingPermits'EC- PermnApp doc 01/19/07 6 440-4617T (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 01/19/07 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MFC2008 00)473
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2212000
Phone: (503) 639- 41719i�1
Inspection Requests (24 Hrs.): (503) 639 -4175 ., J.— °:_.. •
INSPECTION WORKSHEET FOR DATE:' 10/16/2008 TIME: 7:01AM PAGE: 26
SITE ADDRESS: CLASS OF WORK:
06020 SW WALNUT TER
SUBDIVISION: KINGS VIEW 027 #: 027 TYPE OF USE:
PROJECT NAME:
CLAYTON
DESCRIPTION: Installation of gas fireplace.
OWNER: CLAYTON, STEVE PHONE #: 503 -244 -7341
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 076793-01 603 -244 -7341 N
Corrections /Comments / Instructions:
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL U CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e r Date: Phone #: (503) 718- Z -
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r ,