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16260 SW COPPER CREEK DR
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CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES
PERMIT#: MEC2001-00026
13125 SW hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED:PARCEL: 2S 1 25/142001
BA-1390Q
SITE ADDRESS: 16260 SW COPPER CREEK DR
SUBDIVISION: COPPER CREEK STAGE 4 ZONING: R-7
BLOCK: LOT: 104 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: 1
STORIES: _ BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: i
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas fireplace insert and gas piping
Owner: FEES _
SORENSON, GREG A + BAMBI L Type By Date Amount Receipt
16260 SW COPPER CREEK DR Pr�MT CTR 01/23/20( $72.50 272001000C
TIGARD, OR 97224 5PCT CTR 01/23/20( $5.80 2720010000
Phone:
Total $78.30
-- --- —
Contractor:
ANCHOR FIREPLACE PRODUCTS INC
14175 SW GALBREATH DR
SHERWOOD, OR 97140-9170 REQUIRED INSPECTIONS
Gas Line Insp
Phone:925-8888 Mechanical Insp
Reg #:LIC 102814 Final Inspection
This permit is issued subject to the regulations contained in the Tig'.ird Municipal Code, State �.f Ore
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080
You may obtain c w s of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: Permittee Signature: c7✓.��f/'L i C'¢i`7C'� M`�4 -'
Call (503) 639 4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Datc received:, .a3 C, Permit no.:
_
City of 'Tigard ProjecUappl.no.: Expire date:
Llkj6ess: 13125 SW Ilall Blvd,Tipard, W 97223
Ciryrf"ri r �' Date issued: Icy' Kec_etptno.:
Phone- X503) 639-4171 �__ _
Fax':1(1403) 598-1960 Case file no.: Payment type
Lanq Mppproval: _.� Betiding permit no.:
crit ty„ — ---
)L4,&2 family dwelling or accessory U Commercial/industrial U Multi-fancily U Tenant improvement
U New construction U Addition/alteration/replacement U()ther:
COMMERCIAL VALUATION SCIFEDULT,
Job address: 777, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit,Value$
Lot: Block: Subdivision: 'See checklist for important application information and I
Project name: juri:;(fiction's fee schedulC for residential permit Fee
City/county: � ZIP:
Des,:riHiion and IoAtion of wor n premises:
129 Pce(ea.) Total
Est.date of completion/inspection: V Dewription ---(NY.. Res.only Res.only
Tenant improvement or change of use: I A
Is existing space heated or conditioned'?U Yes U No Air handling unit
Is existing space insulated?U Yes U No Air conditioning(site p an-T requireTAlteration of existing H VAC system
oiler compressors -- -
Business name: State boiler permit no.:
Y' �C HP Tons BTU/II
Address: _ — — ---
Fire/sntokc damper�s duct smo a electors
~ c -�— -- - ---
1
Cily: State: ZIP: U eat pump(site plan required)
Phone: ' �C-- j VG' I Fax: S-_O$'L) E-mail: nsta rep ace furnac umcr
CCB no.: I O �-
Z g �( Including due(work/vent liner U Yes U No
Instal rep ac re create eaters-suspended,
City/tett,t lie,no.: (p ( g wall,or floor mounted
Name(pl-ase print): `,�,� r ent for lance other than furnace --
e r gerat on:
A:.corptionunits _ BTUM
Name: � r 1/�� Chillers _. HP
Address_ Sf�YI� - Compressors-_ 1{I'
nv ronmenta ex est an vent at on:
City: State: ZIP: Appliance vent I O,p
Phone. a,S''Q, Fax: _•- (' nwil rycrcx--taut ----
o s, Type I/res.kitc� azmat
hood fire suppression system
Name: yi Y ,�y c Exhaust fan with single duct(bath fans)
Mailing ad cess: ��� t-y�� :x gustsystem apart 'rot eatingor AC
City: -- - State: 7.IP: Fuelpiping a dist ut on(up to outlets)
'type: LI'G -�_NC oil L4 la
Phone: Fax: _ 1 m,tii Fuel piping each additional overout ets -
rocesspiping(sc ematicrequire ) _
Natne: Number of outlets
Other lifled app ante or equipment:
Address: - Decorative fireplace
City: State: ZIP: I nsert-type
Phone: Fax: I E-mail: Woodstovelpellet stove
Applicant's signature A Ot cr.
Date: p tet
Name (print): c vt,,,r ,
Not ell jutwiction
rain cmlit carte,please call Juriadkuon for tae infatnatian. Permit fee.....................$
❑Visa ascerCard --- Notice: This permit application Minimum fee................$ _ Z
-^ expires if a permit is not obtained
Credit card Hamner _. / / Plan review(al �) $
Expires within d a days after it has been State surcharge(8%)....$ �_
-- or cardholder u rnoWn n cera _"- accepted as rnncplete.
s TOTAL $
C'erdholdersignature Amoum
140J617(WWOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Table 1A n: Price Total
$1.00 to$5,000.00 Minimum fee$72.50 `_ Table na Mechanical Code _ Qy (Ea) Arnt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and Incl1) Furnace to 100,000 BTU
$1.52 for each additional$100.00 or Furnace
ducts&vents 14.00
fraction thereof,to and including 2) Furnace 100,000 BTU+
_ $11000.00. Including ducts&vents 17.40
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or including vent v 14 00
fraction thereof,to and including 4) Suspended heater,wall heater
$25,000.00. r Moor mounted heater 14.00
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or 6.80
fraction thereof,to and Including 6) Repair units
$5000000,. 12'5 -_
$50,001.00 and up $742.00 for Ills first$50,000.00 and Check ail that apply: Boller Heat Air
$1.20 for eal1h additional$100.00 or For Items 7-11,see or Pump Cond - -
fraction thereof, footnotes below.
7)<3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: fo 3-15 HP;
_ 14 00
8)3-15 absorb
Value 0181 unit 100k to 500k BTU 25.60
Descdpflon: O E_91- Amount 9)15-30 HP;absorb
Furnace to 100,000 BTU,including 355 unit.5-1 mil BTU - 3500
ducts 8 vents 10)30-50 HP;absorb
Furnace> in
100,000 BTU ctuding 1,170 unit 1-1.75 mil BTU 52.20 _
ducts 6 vents 11)>50HP:absorb
Floor furnace Including vent 955 unit>1.75 mil BTU 87.20
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not Included In applicance 445 13)Air handling unit 10,000 CFM+
ermit17.20
Repair units 805 14)Non-portable evaporate cooler
<3 hp;absorb.unit, '- 955 1000
to 100k ETU --- 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 ; 680----
101k
80101k to 500k BTU 16)Ventilation system not Included in
15-30 hp;absorb.unit,501k to 1 2,310 appliance permit 10.00 I$�
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00-----
1-1.75
0.00 __1-1.75 mil.BTU - 18)Domestic Incinerators
>50 hp;absorb.unit, 5,725 17.40
>1.75 mil.BTU 19)Commercial or Industrial type Incinerator
Air handlingunit to 10,000 cfm _ 656 6995
Air handling unit>I0,000 cfm_ 1,170 20)Other units,Including wood stoves
Non- ortable eva orate cooler_- _ _ 656 _ -__ 1000
Vent fan connected to a single duct 446 21)Gas piping one to four outlets
Vent system not Included in 656 - 540
appliance permit -- -. 22)More than 4-per outlet(each)
Hood served by mechanical exhaust 656 _ _ too _
Domestic incinerator -1,170 Minimum Permit Fee$72.80 SUBTOTAL: $
Commercial or industrial incinerator 4,590 _
Other unit,including wood stoves, 656 - 8%State Surcharge _ $
inserts,etc. _ _
Gas piping 1-4 outlets 360 _ - - 25%Plan Review Fee(of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL- _ $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION: -
Othgr Inspections and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72 50 per hour
2 Inspections for which no fee Is specifically indicated (minimum charge-hall tour)
$72 50 per hour
3 Additional plan review regoir 4y changes,additions or revisions to plans(minimum
charge-one-half hour)$72 L 1 .r hour
"State Contractor Boller Certification required for imfti>200k BTU.
"Resrdontial A/C requires site plan showinq placement of unit.
i'\dsts\formsVnech-fees.doc 10i11100
CITY OF TIGARD BUILDING INSPECTION DIVISION
2441our Inspection 'Liner: 639-4175 Business Line: 639-4171 MST
BUP
_Date Requested_`_ Y AM PM
BLD
Location� 2- �C ��✓ �G, h 1 CLQ Ile �r� Suite __ _� MEC
Contact Person N Ph -�� Z117 51' PLM
Contractor _ Ph, V `+� SWR —
BUILDING — -- Tenant/Owner -+Yr() ELC
Retaining Wall ELR
Footing Access-
Foundation FPS
Ftg Drain -
Crawl Drain Inspection Notes: SGN
Slab --- — ---- —�__ -- - SIT
Post& Beam -- -- _
Ext Sheath/Shear
Int Sheath/Shear --- - -
Framing
Insulation
Drywall Nailing
Firewall __—_------------.--_--_--------
Fire Sprinkler
Fire Alarm --- - ----- --
Susp'd Ceiling
Roof ----_.------__---------------------- _.--__
Misc
Final ----- ---------_- - - —_- -�.- --__
PASS PART FAIL - - ------ - --------- -- --- --- - -----
PLUMBING
Post& Beam
Under Slab
Top Out - - - - ---- - — _ -_._..- ----- -------
Water Service
Sanitary Sewer
-- - -T._..----- -- ---- --
Rain Drains
Final - - - ----- - -.._--- ----- -- --- -
TFAIL
Post& Beam
0Rou h In ��r r Apt;t. �t� r"�----- __- _- ------------------ -
a
.rnokg Dampers
PAS PART FAIL
TRICAL --- -- —
Service
Rough In - _. --- - - - -- —
UG/Slab
Low Voltage - _---------- ------ -
Fire Alarm
F-final --- - --- -- - --- - ------------
PASS PART FAILSITE
Backfill/Grading - - -- --
Sanitary Sewer
Storm Drain ] Reinspection fee of$ _ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line J Please call for reinspection RE: _ _ - [ )Unable to inspect- no access
ADA
Approach/Sidewa�k Da _ / l l
Other w C Inspector —_— ''� _ Ext
Final
PASS PART -FAIL DO NOT REMOVE this inspection record from the job site.