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CITYOF TIGARD i MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00395
1125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/30/02
PARCEL: 2S1 14BA-Oo6OO
SITE ADDRESS: 09775 SW COOK CT
SUBDIVISION: COPPER CREEK ZONING: R-4.5
BLOCK: LOT: 008 JURISDICTION: TIG
CLASS OF WORK: 01-R FLOOR FURN: EVAP COOLERS:
-i YPE OF USE: SP UNIT HEATERS: IGEN r FANS:
OCCUPANCY GRP: 123 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSOR_SHOODS:
_ FUEL TYPES 0 - 3 14P: _ DOMES. INCIN:
LFC� 3 15 HP: COMML. INCIN:
MAY. INPUT: BTU 15 -310 HP: REPAIR UNITS:
FIRE' DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS P^ESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: A AIR HANDLING UNITSOTHER UNITS: 1
FURN >=100K BTU: <= 10000 Cfm7 GA:i OUTLETS: 1
> 10000 cfm:
Remark:,: Installation of gas logs an(' gas piping.
Owner: _ FEES _
MALONE, PATRICIA M + Type By � Date i Amount Receipt ^
MCDONALD, MARY JAMIE PRMT CTR 8130/02 $72 50 272002000C
9775 SN COOK CT 15PCT CTR 8/30/02 $5.80 27200200011
TIGARD. OR 97224 -- -
L Total $78.30
Phone:
Contractor:
T + K MECHANICAL
2.0565 SW TV HW Y#346
ALOHA,OR 97006 _ — REQUIREINSPECTIONS
Gas Line Insp
Phune:503-357-4614 Mechanical Insp
Reg#:LIC ;21'165 Final Inspectio,r
This permit is issued subject to the regulations cortained in the .i igard 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
Wility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-0-0 1-0080. You may ohtain copies of these rules or direct questions to OUNC by calling
rc;nI»ar,_Qi AQ
Issurn By: --1. chi l ; Permittee Signature: –
��"
Call(503)639.4175 by 7:00 P.M. for inspections needed the next business day
Mechanical PeriTilL_�'�p :)� ication 7Received a Mechanical``,.i``,,
tc/B : 'r 'L' C' �..'-4 I'ermtt No.:
i. Planning Approval Budding
City of TigardTest Farm Date/By: Permit No
13125 SW Hall Blvd. / Plan Review other
Tigard,Oregon 97223 Date/By: I Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Re.,ew Land Use
i Date'H : Case No.:
Internet: www.ci.tigard.or.us Conwct Juris.: WSce Page 2 for
24-hour Instiection Request: 503-6;9-4175 Nome/Method: supplemental Irrormation.
TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
New construction _ Demolition Mechanical permit foes'are based on the total value of the work
JUAdditiotr/alteration/replaeement _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 dwellingCommercial/Indusirial— value: $ _ See Page 2 for Fee Schedule
Accf,sso Building nn Multi-Fami1V __RESIDENTIAL EQUIPMENT/SYS rEMS FEE*SCHEDULE
_ �_.—� !-� -
Description I Qty I Fec(ca.) Tolal
Master Builder El Other: --_ Hestln Conlin
---JOB S'TE INFORMATION and LOCATION Furnace-add-on air conditioning 14.00
Job site address: 11-1 `S S LA,�J �cr�k-_ Gas heat um 14.00 _
Suite#: —_ Bldg/A t.#: Duct work 14.00
Project Name: H dronic hot water stem 14.00
Residential boiler
Cross street/Dircctions to job site: for radiator or hydronic system) 14.00
Unit heaters(fuel,not,' -tric)
in wall,in-duct,suspended,etc.)_______14.00
- Flueivent for any of above) _ 10.00 _
Subdivision: i Lot#: Repair units _ _12.15
_Other Fuel Apprioncei _
Wax ma i/parcel #: _ _� Water heater-- 10.(11 _—
DESCRIPTION OF WORK Gas[truce—_ 10.00.-------
C, -fuc
0.00 -__ -
fue vent water hcater/gas Fm_nlace 10.00 _
Lu li litergasL__ 10.00 _
--- Wood/Pellet stove _ 10.00
Wood fire lace/insert 10.00 --
Chimney/liner/fbte/vent 10,00
14OPERTY OM'NERTENANT Other: o-Jic < _ 10.00
t nvitonmentsl Exhaust&Ventilation
Name: _1 } C (���L_ Range hood/uthcj hilchcn equipment 10.00
Address: �� 1 5t✓.:�1X�k- L_� Clothes dryer exhaust 10.00
Cit /State/Zi rCk C)"e-
--��--- Single duct exhaust
Phone: 4;3( �I Fax__ (bathrooms,toilet compartments,
APPLICANTCUN_TACT_PERSON utility rooms) 6.80
Namc: '�� �� >1 r') t?_ _ Attic/crawl space fans 10.00
ess' (,}� c, -T- �� t+t Other: — _ I0.U0
Addr
—_�_�L - -��y Fuel Plning
Cit /State/Zip: a�(1�� r C� __SS5.40 for Ont 4,$1.0_0 each additional••
Furnace,etc.
Phone: ��")- �11Q l� Fax: C�ci,'�- `6 �5� Gas heat pump -_---_ '•
E� nail' Wall/suspended/unitheater _ _ •' _-
_�— CONTRACTORS _ Waterhuatcr '• _ __
Buriness Name: Fireplace
Range
Address: 5�� SLI '�`- BB _ ••
Cit /StateiZip: LIf Clothes dryer(gas) '•Phot,-. LLLOther:Fax: - S — Other: Ior'4,�__---- ..
CCB Lic. #: a 1 1 _ Total`
`•� Mechanical Permll Fees• _
Subtotal: $ ;71A.. I!d(
—
Authorized Minimum Permit Fee ) $ _.
Signature: Date: 1, ���"� Plan Review Fee 25"/.of Permitit Fee) $
11-- State Surcharge °u of Permit Fee $
--TOTAL PERMIT FEE S
(Please print nam ) Notice: This permit application expires If a permit Is not obtained within
180 days after It has liven accepted ns complete.
"Fee methodology set by Tri-County Building Industry Service Board.
Mechanical Permit Application - City of'Cigard
Page 2 - Supplemental Intormatiou
Commercial Fee Schedule: _ _
Total_ValueFe
tlon: _ _Perrnit e
$1 00 to$5,000.00 _ Minimum fee$72.50
$,"nl(I I.00 to°10,(N)0.00 $72.50 fo: .hc first$5,000.00 and$1.52
for each additional$100.00 or fraction
_ thereof to and including$10,000.00.
Si0,00i.Of)to$25,000.00 5148.50 for the first$10,000.00 and
51.54 for each additional 5100.0 or
fraction thereof,to and including
$25,000.00.
525,001.00 to$50,000.00 $379.50 for the first$15,000.00 and
$1.45 for each additional$100.00 or
fraction thereof,to and including
_
$50,000.w. _
S50,001,00 and up $742.00 for the first$50,000.00 and
$1.20 for cech additional$100.00 or
fraction thereof _
Assuitied Valuations Per Appliance:
Value. Total
lkacnjttion: t _ (ru) _Amount
Furnace to 100,000 BTj,including 955
duels&vents __,--•-
Fumace>100,000 BTU including ducts 1,170
&vents
Floor furnace includin&vent
Suspenj..0 heater,wall heater or floor 955
mounted heater
Vent not included in appliance omit 445
Rr air units _ 805
< t hp;nosorb.unit, 955
to 100k BTU
3-15 hp;rNsorb.unit, 1,100
101k to S L►T
15.30 hp;absorb.unit,501k to 1 mil. 2,310
BTU _
30-50 hp;absorb.unit, 3,400
1-1.75 aril.BTU
»0 hp;absorb.uni!, 5,725
21.75 mil.BTU __
Air handling unit to 10,000 cfm 656
Air hand HE&unit>I0,0( cfm, 1,170
Non- oruublc cvagorate cooler 656
Vent fan cotme(ted to a single duct 446
Venn systern not included in appliance 656
ermit_ _
Hood served by mechanical exhaust 656 _
Damestie incinerator 1,170
Commercia;or indushial incinerator 4,590
Other unit,including wood stoves, 656
inserts,etc.
Gas piping i-4 outlets _ 360 _
Each additional outlet 63
TOTAL C7MMERCIAL °.
VALUATION: ___
CITY OF TIGARD 24-Flour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Rbceived __ __Date Requested --5 -__- _ ____ AM—_ PM- - __ BUP
Location __7ZLr -5'w. CdG �_C� _ — -- Suite— _ MEC
Contact Person _ --_____— Ph( ) ��s,y� PLM
Contractor_._ ---- Ph SWR —_--- - -__—
BUILDING Tenant/0wner -_ _ -- ---__-- ----.—__. ELG
Footing —
Foundation Access: ELG _----_--- --------- - --
Ftg Drain G�n eh �� EL.R
Crawl Drain ✓ _ __--_------ -
Slab Inspection Notes: SIT
Post Beam i
Shear
A..-hors -- - - - --- ---- -
Ext Sheath/Shear
Int Sheath/Shear
Framing --
Insulation
Drywall Nailing -- — --- �`
Firewa!I
Fire Sprinkler - — — -
Fire Alarm
Susp'd Ceiling -- -- —-- --
Roof
Other: - ------- - -
Final
PASS PART FAIL - - -- — — --
PLUMBING
Post& Beam
Under Slab 1
Rough-In
Water Service - - —
Sanitary Sewer
Rain Drains - - - --
Catch Basin/Manhole
Storm Drain --- ------ — ----- —
Shower Pan
Other: --
Final —
PAS ART FAIL
Post& Beam
Rough-In -
Ras Line
Smoke Dampers - - -
Fina
0SSTRICAL
PART FAIL
Service - ----------- — - -
Rough-In - _ —
UG/Slab
Low Voltage
Fire Alarm —
Final Reinspection fee-if$� __ _ _ required before next inspection. Pa at Ci 13125 SW Hall 13W.
PASS PART FAIL L_I P� q p y City
SITE _ Please call for reinspection RE:-. — __ Unable to inspect-no access
Fire Supply Line
ADA 11,771/1
Approachlcidewalk Daly ,��'" Insprertor —. Ext
Other: _
Final DO NOT REMOVE this Inspection) retard from the job site.
L PASS PART FAIL