Permit l
"� "�" MECHANICAL PERMIT
t � t
CITY OF T I D
t� COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00030
, fi a' DATE ISSUED: 1/12/2007
rT„,I,GAR,D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AC -01000
SITE ADDRESS: 11545 SW BEEF BEND RD 50 ZONING: R -40
SUBDIVISION: WELLINGTON ESTATES APARTMENTS LOT: JURISDICTION: TIG
Project Description: Gas furnace install.
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: IT
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
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
7831 SE LAKE RD
PORTLAND, OR 97268 [MECH] Pernut 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: �,, �.�� �1 � Permittee Signature: X a refe
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 Pernit.A ' ,_ \ FOR OFFICE USE ONLY
City of Tigard - sir l _ �1 \ fl w ReceivedI /i ` a n
vie
Permit No.: t M f ) v
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Phone: 503.639.4171 Fax: 503.598.1960 /�maar t F,ti ; I DateB Other Permit:
Inspection Line: 503.639.4175 ' R tl 1 ' 700 _„1,1_ I� y '
jhl '' Date ReadyBy: funs: See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
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,: - .�_ .':. . , a , `_ = , Lt F.EF*�SJ11EDU,UE gUSE CH ECKI�IST,
r�. � +,�GOMMER,:..,.,
❑ New construction `�i 1 � ddition/alteration/replacement Mechanical petinit 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.
'; 1CATEORikl.P Oi!�Si T1G O) . -' I ' V.40 Value $
'1_- .,.. � � _...- rt ' ,
❑ 1- and 2-family dwelling ❑ Commercial/industrial ', i RES» ENTI;AL,EQUIPMEIyI, / SYSTEMS
❑ Accessory building
[Multi- family ❑ Master builder For special information use checklist.
❑ Other Description I Qty. Ea. Total
J,OB oSITE `TNFORM%�;73I "ANDt1;OCATION r yeli „', f Heatinp,/cooling
Job site address: J L / J�Yj Air conditioning or heat pump
/ I ��� S �� l�; �� y " (requires site plan showing placement) 14.00
! (,'
City/State /ZIP: , 4.„....w O. 7 ZZ` 5 , Fumace 100,000 BTU (ducts/vents) r 14.00 /
V 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 _ (0
Other: 10.00
Tax map /parcel no.: Other fuel appliances
. - DESCRIPTION OFWO)tK. ' k " , ", ? ,',. Water heater 10.00
/ t Gas fireplace 10.00
i • �.od`•-tei Q. 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
❑'. PROPERTW ";OWNER , _ : ,, i ® TENANP'
+ Chimney /liner /flue /vent 10.00
,( , : ... _ . .::. � ..t' Other: 10.00
Name: pr, vtiee kyt y/� Environmental,exhaust and ventilation
Address : / `7' 3 / / �� / /2 Range hood/other kitche
!!! !v ,equipment 10.00
City/State /ZIP: / /,-: d � y 7 2 Clothes dryer exhaust 10.00
// Single -duct exhaust (bathrooms,
Phone: 643) / �f Fax (. . `7 J � ,Q
toilet compartments, utility rooms) 6.80
❑ ?`APPL'IC" wri '� . , a fir i,; ® CON ON L ', F': Attic /crawlspace fans 10.00
Business name: Abp t o--: s Other:
Fuel piping 10.00
Contact name: 4 J f � jeo $5.40 for first four; 51.00 for each additional
Address: /// ��� 2 - 4 / e / 5 r g 14-`-‘ Furnace, etc.
`� /4 � - ( " ? 72/ Gas s pump
City /State /ZIP: �j� 61 Wall /su /suspended%unitheater
Phone:15 ) X33 tr /7 Fax: : (SDI .23 -(/'9. Water heater
/ Fireplace
E -mail: Range
• .,, CON,TRA�I.�TQR. a ' 1r r a;: A; Barbecue
Business name:
Clothes dryer (gas)
Address: I/ , Other
`;r: ,,, 'ME'GHAIVIC_ AI: `PEJ 51JT FEES* ..
City/State /ZIP: Subtotal
Phone: ( ) Fax
( ) Minimum permit fee ($72.50) ,Zr
Plan review (25% of permit fee)
CCB lic.: /g « U State surcharge (8% of permit fee) 5 $U
/ j / TOTAL PERMIT FEE 77
Authorized signature: / T his permit application expires if a permit is not obtalne whin 180
/t days after It has been accepted as complete.
Print name: i6i,? (e. L / ' /P/! Date: / /S to 7 * Fee methodology set by Tri-County Building Industry Service Board