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Permit ' R CITY TIGARD MECHANICAL PERMIT i+� DEVELOPMENT SERVICES PERMIT #: MEC2006 -10015 ;;'�,��li; DATE ISSUED: 3/7/2006 ^ 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 CB -02300 SITE ADDRESS: 14885 SW 100TH AVE ZONING: R -3.5 SUBDIVISION: MURDOCK HILL LOT: 004 JURISDICTION: TIG Project Description: Gas to boiler, WH and 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: 1 DOMES. INCIN: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 3 Owner: FEES MARILYN WEBER Description Date Amount 14885 SW 100TH AVE TIGARD, OR 97224 [MECH] Permit Fee 4/1/2006 $72.50 [TAX] 8% State Surcha 4/1/2006 $5.80 Total $78.30 Phone: 503- 968 -3204 Contractor: ABC CONTRACTING SERVICE 11945 SW PACIFIC HWY. TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS Contact #: FAX 503- 620 -4790 PRI 503- 620 -4757 Reg #: LIC 162558 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: en _ / , , Permittee Signature: 0)/ #ee 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. s .s. - t + T" 7 i 1 r - ri tv 4. kr , echa!Iical Permit Application ; �• �' ''' " , 1 � „ ,t . -�► (�)li: � " I_) ' r .41 1 ,; I:z � =' E aIVii;�4 City of Tigard . = . Received 1 Date/By 'ill ob Q Permit No.: B� aoo� ! / 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 1001 Other Permit. Inspection Line: 503.639.41751 ;hl I D ate /By. -- Date ReadyBy: luris: El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: �(,, Supplemental Information ' TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction %Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL-EQUIPMENT / SYSTEMS FEES* [1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. Total JOB SITE INFORMATION AND LOCATION, Heating/cooling ( €3p w \ ©U +� I Air conditioning or heat pump Job site address: (requires site plan showing placement) 14.00 City /State /ZIP: r ki (0..V C) CDS .e 9 0 tJ Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project namee: ` � z b .t Gas heat pump 14.00 Cross street /directions to job site: M C_ C)t) NA \ / S (A 100 /1U Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) i 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 10.00 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK • Water heater ( 10.00 �r '� Gas fireplace 10.00 L7 .-- O . �'v '-c_ \6: e. J Flue vent for water heater or gas . 1\_) L U c c G ( b V--J ^T v 'c ( ?t fireplace 10.00 .1\_) ��� ` Log lighter (gas) 10.00 N C_,%..J L 0 C. C A ■ (> •_,) '*0 ON Wood /pellet stove 10.00 d •r__ V--‘.. c_,...;....-Li 3 LA-) / I-t r Wood fireplace /insert 10.00 . ;a PROPERTY 'OWNER ! - I ❑ TENANT Chimney /liner /Flue/vent 10.00 Other: _ 10.00 Name: c1/4.v i . / �/ C \ j Environmental exhaust and ventilation Address: \1/4.A 6 B 5 5.0 ( 0 ,& V� Range hood/other kitchen J equipment 10.00 City /State /ZIP: 1 .` (jc - c) C�k/ z i 0 C-C_! Clothes dryer exhaust 10.00 /2 Single -duct exhaust (bathrooms, Phone: (56 q b J - 3Z dy Fax: ( ) toilet compartments, utility rooms) 6.80 . ❑ APPLICANT I'CONTACT PERSON " Attic/crawlspace fans 10.00 1 �, N j F u e l 10.00 Business name: A- J o '7` V s C ,.._,c-, 5 v c/ t.. e -c Fuel Piping Contact name: 3 Cir >` co S 72-- $5.40 for first four; $1.00 for each additional Address: 1 \ Ci (-t . r t c . l 4 i C 14� 3 Gas Fumace, heat etc. Gas heat pump City /State /ZIP: r t (( (be 61/41 < ')7 7 Wall /suspended/unit heater Phone: (9 L.( 31 - b( 3 Fax: : (503) 62 d r (.{7 Yt7 Water heater I Fireplace E -mail: Range CONTRACTOR • Barbecue Business name: /� J v •� r Clothes dryer (gas) /t �13c C C�t�1 ' i h 5 C A ( ta. ,. v Lit . Other: Address: L (q Li 5 --- 3 <. L ' c'.. ,. � � y j SC-6 MECHANICAL PERMIT FEES* • City /State /ZIP: r1^'(' c 4.1.i 0 ? 72 Z Subtotal _ Minimum permit fee ($72.50) 9�, 5 Phone: (,go) 6Z0 . 4? 5-'7 - ) C Z ;` ro Plan review (25% of permit fee) CCBIic.: 1 0 . 255 8 e.Xi - 7 JkjpB '7/04P6 State surcharge (8% of permit fee) 5,140 TOTAL PERMIT FEE Is', 3v �% It t e s.,... This permit application expires if a permit is not obtained within 180 Authorized signatur• L ...�. _ days after it has been accepted as complete. Print name: p, 2. S (/ ` .,,,.. e j Date: 7 - 0 , , * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Pennits\MEC- PermitApp.doc 12/03 440.4617T(1I /02/COM/WEB) ' 2(" 6 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. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 CITY OF TIGARD >� , i /OUI� i BUILDING DIVISION PERMIT #:a 006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:. C4. ' rr � (, Phone: (503) 639 -4171 �'a�l��g " i( t Inspection Requests (24 Hrs.): (503) 639 -4175 .�' .. --- i0`k-. II INSPECTION WORKSHEET FOR DATE: TIME: ,Et g 0nE:--' /t) oAS-- SITE ADDRESS: l % �Y R r / d C " - \ CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 -- / 3 - 6 a Pour Time: Code # Inspection Description . Confirm # Contact # Message ._ - 6(0 6 j fie /- O/ 3 Z- P Corrections /Comments /Instructio s: e _/// 1 2 I A I �` , .1 f ' _ \1q111111.111 l 6 /io (() • ' (_„471tEr_l_e) A / 401,1/14 r:41: - 7 , - c 2 - - 5- 7 .° 36 7 .. . . 6 to f.. AP4wd 1 [PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - Date: �? Pho #: (503) 718 -���