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Permit , ,' .:,. ,,,,,.._. i CITY TI® MECHANICAL PERMIT ��+ DEVELOPMENT SERVICES PERMIT #: MEC2006 - 10030 I DATE ISSUED: 3/15/2006 .,41.- ; ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 102 D C - 01700 SITE ADDRESS: 09200 SW EDGEWOOD ST ZONING: R - 4.5 SUBDIVISION: EDGEWOOD LOT: 014 JURISDICTION: TIG Project Description: Relocate gas line for new meter. CLASS OF WORK: OTR 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: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Owner: FEES GEORGE TENY Description Date Amount 9200 SW EDGEWOOD ST TIGARD, OR 97223 [MECH] Permit Fee 4/4/2006 $72.50 [TAX] 8% State Surcha 4/4/2006 $5.80 Total $78.30 Phone: 503- 970 -1811 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 direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: . y Permittee Signature: - _e_e 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. . a x o, .; - as i Mechanical Permit ti'---- Er At e : .„. .'': h( ,,IZ@h11���,,,sl c� l:�: '� City of Tigdrd nattaBy. .7 /� -o ( Permit No. ( . 6 „ c „.. 20 �` // U 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ! / r yr�y , � Date/By. Other Permit: pp Inspection Line: 503.639.4175 MARJ { �� DateReady/By: 1uri: ® See Page 2for Internet: www.ci.tigard.or.us L� Notified/Method: -' /'! Supplemental Information CITY O �, y il g ; 6Y t RK%' ' COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction 0 C Addition/alterdtion rrepla'cement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ El 1 - and 2 dwelling RESIDENTIAL EQUIPMENT /SYSTEMS FEES* y g ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. 1 Total `JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: _() ©p Si= �cl'r OC, Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State /ZIP: '7; y q roe cb /Z 9 7o 62 . Fumace 100,000 BTU ( ducts/vents) 14.00 Fumace 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 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK _ Water heater 10.00 //�� Gas fireplace 10.00 C &l�70de `r4 f mei �2. 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 1 PROPERTY OWNER , - ❑ TENANT Chimney /liner /flue/vent 10.00 • Other: 10.00 Name: 4 €C,e4 � %.. /V Y Environmental exhaust and ventilation Address: V00 S i c'eige tk vfzl Range hood/other kitchen i J equipment 10.00 City /State /ZIP: 7l C Cj lip/ 0/2- 9 70 6—Z_ Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( 3 -03) yT � /g // Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT • ❑ CONTACT PERSON Attic/crawlspace fins 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Fumace, etc. Gas heat pump City /State /ZIP: WaIl/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CONTRACTOR _ Barbecue Business name: Clothes dryer (gas) Other: Address: , MECHANICAL PERMIT FEES* .. ' City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) r Z � TOTAL PERMIT FEE Authorized signature: ` - 7 �� y This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ate: j `/ - -(76 * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits\MEC- PamitApp.doc 12/03 440 4617T /02/COM/WEB) .1 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 $1 0,000.00. $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. i:\ Building \Permits\MEC- PermitApp.doc 12/03 2 CITY OF TIGAR® c_ BUILDING DIVISION PERMIT #: 0 /0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 AVOilA � Inspection Requests (24 Hrs.): (503) 639 -4175 A .. lill) INSPECTION WORKSHEET FOR DATE: TI . i llt ill 'il PAGE: SITE ADDRESS: q9` ,DO c. t� � ev O a S— CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: i n PHONE #: 3 -- 3.09-.2.,5 - CONTRACTOR: L.__ PHONE #: Inspection Request Scheduled For: Date: °.-- / 7— £ Pour Time: Code # Inspection Description Confirm # Contact # Message 6iu cL. Comic LL Corrections /Comments/ Instructions: TO i 2ocr4 -7/0 J o` 4'43 h/fMne ' WO .e , feu -re-r cvs Pi ' - 5 x-rzour? -) 3 /lG- -w 5:� • C ) n , eZd .uZ - cg - E9 > Lei 5i7 -1- c/1- -5 C 1 di e .. iAl S - LC / lG '5 �L c c I' _ Xi L ity ,,9 nJ .�� c�� , 1' - S c.r�hh1 �7yii PLC /) 2 ) �Z--5 = -Z (- i- ,_E" f/r- /S Ji4 i .1c/7 () 14 L L 6 E ;/X 41c� PASS l PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL /CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1-17--- Phone #: (503) 718- 2-/- -3