Permit CITY OF TIGARD MECHANICAL PERMIT
a.. , COMMUNITY DEVELOPMENT Permit #: MEC2010 -00049
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 2S110AC01000
Jurisdiction: Tigard
Site address: 11545 SW BEEF BEND RD 62
Subdivision: WELLINGTON ESTATES APARTMENTS Lot: 0
Project:
Project Description: Replace gas furnace.
Owner: FEES
FERN VALLEY PROPERTIES LLC Description Date Amount
BY CAMBRIDGE REAL ESTATE SERVICES, PO Furnaces < 100K BTU 02/03/2010 $46.75
BOX 2968
12% State Surcharge - Mechanical 02/03/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 02/03/2010 $43.25
Contractor:
ROBBEN & SONS HEATING INC
2214 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 233 -5841
FAX: 503 - 238 -8849
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
or direct que ' ns to 00 C b .fling 503.246.6699 or 1.800.332.2344.
Issued y: # /I" ii � Permittee Signatu .
Call 503.639.4175 by 7:00 a.m. for an Inspection 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.
Feb. 2. 2010 10:32AM Robben & Sons Heating Inc. No. 6707 P. 1
rri Mes cal Permit Application I on It I. t Si, (1\1.\
City of Tigard (+ 1 d Dete
Received , L'e No.: , i / • ,13 4 13125 SW Hall Blvd., Tigard, OR 97273 ..x ` ( Plan Review Other Permit:
Phone; 503.639.4171 Fax: 503.598 b 121 .L960 -O (O Daterhyr
Ins ection Line: 503.639.4175 pale Ready/By: See Page 2 for
I' 1 c A Il U p ®
Internet: www.tigard-or.gov Notified/Method. Supplemental information
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� y" ` "� i ' 4{ ; : ` ": ` r ` F ] Mechanical permit fees* are based on the value of the work
❑ New construction 23 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition ❑ Other: mechanical materials c'ul.men labor overhead end .rofit.
;. , �,� - - _,.•, -,:_ - ,,; _y , ;:' {:� ;s alu S 51,550.00
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El 1 and 2- family dwelling ❑ Commerciltlflndustrial ❑Accessory building For special information use checklist.
0 Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. 1 Total
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Air conditioning 46.75 •
lob site address: 11545 BEEF BEND RD ues she .fan sho laeetnent
City /State/ZIP: TIGARD , OREGON 97224 Furnace 100,000 BTU (duets/vents) 1 46.75
Furnace 100,000 BTU (duets/vents) 54.91
Suite/bldg. /apt. no.: , z Project name: WELLINGTON ESTATES Heat . , 61.06
Cross street/directions to job site: Duct work _ 23.32
Hydronic hot waters stem 23.32
Residential boiler (radiator or
hydronic) 11 23.32
• Unit heaters (fuel -type, not electric),
in -wal in -du sus, ended etc. 46.75
Flue/vent for any of above Il 23.32
Subdivision: Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel a .. liances
..ar:.� 1, - :r_.._- ,,.,,•- , :,;_.�,� Water heater 2332
6-, . r, t � ,r., 11 1 ,i .- e, R zti_ ,, _ ~ _. _,.. . ? .< <i_ 1., G as p
t5.�; u� „;�.�.r�:,."�a! � � <���+•�..«� ., �i .....,, . , � - fireplace 33.39
REPLACE GAS FURNACE Flue vent for water heater or gas
fireplace - 23.32
Lo: li :.ter (:as 23.32
Wood/. =llet stove - 33.39
Wood fire ■ lace/insert 23.32
:-.,-.-e.:54.-:, f - . - 23.32
I a i a • �vz -`�'-, r • � j� y l
l +ir _.a , ; ,� 23.32
�.+��t �`�� -.e:: ��:., r .,: );..>,r •�. .. . .,, fir.. _ 5 r ..r...r .�, , . Other: � .
Name: WELLINGTON ESTATES Environmental exhaust and ventilation
Range hood/other kitchen
Address: 11545 BEEF BEND ROAD e' ui' ment 33.39
City/State/ZIP: TIGARD , OREGON 97224 Clothes dryr exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)620 -5088 Fax: ( ) toilet co jnrtmenls, utility rooms) 23.32
<,�,;� - , r.,. _:.c_- :, _ -. "• -' -�.j 2332
+ `r' E o e r r =w._ Attic/crawls.acefans
Ekiel:vi T trAT.:, '.:; V' %y 41 .in,: 'r,; ._ y c , �. `._... : ��: � k .: 3Z3 n/ II :5._ a der: 23.32
Business name: ROBBEN AND SONS HEATING Fuel .1.In
Contact name: SARAH ROBBEN $14.15 for first four; $4.03 for each additional -
Furnace etc.
Address: 2214 SE 8TH A Gas heat um •
City /State/ZIP: PORTLAND , OREGON 97214 Wall/sus. nded/unit heater
Phone: (503) 233 -5841 Fax: : (503) 2384849 Water heater
• Fireplace
E -mail: sarah ®robbenandsons.com Ran :e
P [�I�)7Ii:�h Irh�� y�1�41K�� �rr wv{� �(Illi l�I jCl s t a r t M I +t Barbecue
lik.},'�.i].tEfiL'y:n11r'>:.c? 1 , +:�la�' :>R . n., t• : ,:� r._,�G::i ,i iR7...�_r c
Business name: ROBBEN AND SONS HEATING Clothes dryer (gas) .
Other: •
Address: 2 1 SE r: -f e�>. ii •"? 1 ' y=;=7
2 4 8� " A VE €6::-4;',ai z
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City/State/ZIP: PORTLAND, OREGON 9'7214 Subtotal 99.76
• Minimum permit fee (590.00)
Phone: (503) 233 -5841 Fax: (503) I -8849 plan review (25% of permit fee)
CCB lit.: 1884 State surcharge (12% of permit fee) 11.98 ,
TOTAL PERMIT FEE ` 7
1 This permit application aspire, If a permit is not obtained within 180
Authorized signature: � ', 1 ,. days after i1 has been accepted OS complete.
Print name' a . r 1W1P �ll Date: ! J (V • Fee methodology set by Id- County Building Industry Service Board
I:\ Building \penniiMEC- ecrnriIApp.doe 10/01/09 a0.4617r(I1/07/COM/WLEB) ,') vi •