Permit 0 41' CITY OF TIGARD
MECHANICAL PERMIT
� ; COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00029
,� t DATE ISSUED: 1/12/2007
"TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
��rn� g PARCEL: 2S110AC -01000
SITE ADDRESS: 11545 SW BEEF BEND RD 1 ZONING: R -40
SUBDIVISION: WELLINGTON ESTATES APARTMENTS LOT: JURISDICTION: TIG
Project Description: Gas furnace replace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PRINCETON PROPERTIES Description Date Amount
783 SE LAKE RD.
PORTLAND, OR 97268 [MECH] Permit Fee 1/12/2007 $72.50
[TAX] 8% State Surcha 1/12/2007 $5.80
Total $78.30
Phone: 503- 794 -9004
Contractor:
ROBBEN + SONS HEATING
2214 SE 8TH AVE
PORTLAND, OR 97214 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 233 -5841
FAX 503- 238 -8849
Reg #: LIC 1884
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: /4 4 4., Permittee Signature: r/
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.
° Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ' ' ' Received Permit No.
13125 SW Hall Blvd., Tigard, OR 7 3 Date/By:
Rev //.2` /� g m _07 -- 00 a,R
Phone: 503.639.4171 Fax: 503.598 " Plan Review Other Permit:
Inspection Line: 503.639.4175 Y• Date Ready /By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us JAN 1 9 200 Notified/Method: Supplemental Information
an 1179 . COMMERCIAL', FEE * = SCHEDULE -' USE CHECKLIST
❑ New construction glinqdr"iPalllaneFinffIrtt 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: $
RESIDENTIAL 'EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB 'SITE INFORMATION AND LOCATION Heating/cooling
•
Job site address: 7 /` /sir L/ Air conditioning or heat pump
/ I�`� S f / (r �� I "/ 7 (requires site plan showing placement) 14.00
l
City/State /ZIP: 4', 4 /,./ o^ 9 7 Z 2'1 /7 Furnace 100,000 BTU ( ducts/vents) ( 14.00 /4
/ / / Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no:: Project name:
Gas heat pump 14.00
Cross street/directions to job site:
/11.2.#443077 5 r 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 (c
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK , Water heater 10.00
A ) ,At't� ( Yc Gas fireplae 10.00
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
❑ PROPERTY OWNER Chimney /liner /flue /vent 10.00
❑ `TENANT Other: 10.00
Name: // �j„ 1• e9 "/�� �a te, Environmental exhaust and ventilation
4-1 ,._ f- A Range hood /other kitchen
Address:
7 gy �' !� C' id ; equipment 10.00
City/State /ZIP: 2 Clothes dryer exhaust 10.00
C �� { / � C Single -duct exhaust (bathrooms,
Phone: KU 7, i (yet �
7 z� Fax: � ^ /�/ 7 J� toilet compartments, utility rooms) 6.80
❑ 'APPLICANT 0 CONTACT. -PER ON. , Attic /crawlspace fans 10.00
Business name: ���4 J2 1 ^ - t S /7 i 5 Other: Other: j j 10.00
_ 4.5,610 ping
Contact name: / (,, 4�� $5.40 for first four; $1.00 for each additional
i /- Fumace, etc.
Address: 2 i • ( S
� C- F ieGli c (2Q 5 - 7 _/ / Gas
City/State/ZIP: ` G C> Wall heat /sus /suspen ends ded unit heater
Phone: . (5n) 233 01` Fax: : (5z9 ,23 s ' (- Oj Water heater
t / Fireplace
E -mail: Range
CONTRACtTOR . • - Barbecue
Business name: •
Clothes dryer (gas)
' Other:
Address: MECHANICAL - PERMIT FEES*
City/State /ZIP: Subtotal
Phone: ( ) Fax:
( ) Minimum permit fee ($72.50) 74 54 _
Plan review (25% of permit fee)
CCB lic.: /4 DJV 4z _/ _i/ State surcharge (8% of permit fee) S gd
4 A ,4, c / TOTAL PERMIT FEE 77 180
days after it has been accepted as complete.
7
Authorized Signature: This permit applicati expires if a permit is not obtains w
Print name: / 1 7� / j - Date: //c/o S to 7 * Fee methodology set by Tri- my Building Industry Service Board
•
7 7g o
C o(k\ ---e33 C 0 v cis )
OL47 CITY F T MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00029
ti�'�a + DATE ISSUED: 1/12/2007
xT.I�GAR,1 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AC -01000
SITE ADDRESS: 11545 SW BEEF BEND RD 17 ZONING: R -40
SUBDIVISION: WELLINGTON ESTATES APARTMENTS LOT: JURISDICTION: TIG
Project Description: Gas furnace replace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
PRINCETON PROPERTIES Description Date Amount
783 SE LAKE RD.
PORTLAND, OR 97268 [MECH] Permit Fee 1/12/200i $72.50
[TAX] 8% State Surcha 1/12/200i $5.80
Total $78.30
Phone: 503- 794 -9004
Contractor:
ROBBEN + SONS HEATING
2214 SE 8TH AVE
PORTLAND, OR 97214 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 233 -5841
FAX 503- 238 -8849
Reg #: LIC 1884
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: T _ti L1,..2 'r te Permittee Signature: JL c
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.