Permit 7,
"., CITY O F TI CAA ® MECHANICAL PERMIT •
5 .'zE COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00096
°TIG AR,, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/25/2008
PARCEL: 25111 CC - 23300
SITE ADDRESS: 10450 SW GREENLEAF TERR ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.5 LOT: 291 JURISDICTION: TIG
PROJECT: OLBEKSON
Project Description: Installation of gas fireplace and gas piping..
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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
MERLIN & SHIRLEY OLBEKSON Description Date Amount
10450 SW GREENLEAF TERR
TIGARD, OR 97224 [MECH] Permit Fee 2/25/200E $72.50
[TAX] 12% State Surch 2/25/200E $8.70
Total $81.20
Phone: . 503- 624 -0311
Contractor:
ALADIN HEATING & A/C
1924 SW 32ND STREET
GRESHAM, OR 97080 -8500 REQUIRED ITEMS AND REPORTS
Contact #: PRI 618-8311
Reg #: LIC 44097
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 :
C C P Signature: � C/ f/�
Call 503.639.4175 by 7:00 a.m. for inspections that busines 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- to .. .eiN..4,- ..... s ti:
Mechanical Permit Application r.. �•. :: ' F.°R cE,USE ONLY :° :, ., ,O
x 4.1 1�
u Cit of Tigard Received
Date/By: , J Permit No.: Hge - .��g its '
11 1111
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review c �
® , " Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By:
i t 1 G A 1 D Inspection Line: 503.639.4175 Date Ready /By: ® See Page 2 for
_. . _._ Internet: www.tigard or.gov Notified/Method: l / Supplemental Information
TYPE OF WORK COMMERCIAL. FEE* SCHEDULE._ USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El 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: $
. r RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
5-0 Air conditioning or heat pump
Job site address:
o 4, S Li) G re JE 7T 4 k -WLv (requires site plan showing placement) 14.00
City /State /ZIP: ---- (c. Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Q id e k ' 0 n Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
S -t t./l-n m e. fl 1 e_ i J 1 / (;re e.-u-- I e,L -0 - r-^—%J Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace / 10.00
T 5-1-z1 / • . -- • + Flue vent for water heater or gas
pl � ( a_S / 1 r) 6 Log 10.00
6
I l � Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ' 0. TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: 6,1 ".E�ru t h I r le 1 o/ 6 z n Environmental exhaust and ventilation
_ Range hood/other kitchen
Address: i C -5 o scti 6- ye I � ¥ -rr equipment 10.00
City /State /ZIP: ( „:„c i C;_,,,_ d t%? 0 2 Z 4- — 4 Co Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (5 ) 6 02 y-- 0 3 (/ Fax: ( ) toilet compartments, utility rooms) 6.80
❑ 'APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: (5u 3) (, l g - q z 11 Fax: : ( ) Water heater
/
rn 0 e. 1 G S03 - S it: - 5 3 z$ Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: a .1 Q.. d d� i t J i (� y— frQ- /�) Clothes dryer (gas)
9 /� Other:
Address: t! 7 T t4 ' A MECHANICAL PERMIT FEES* -
City /State /ZIP: 0 ,/f / 1- , /-, � g0 Subtotal
'^ G / C- � ? Minimum permit fee ($72.50) 7p1• S 0
Phone: (6b3) (.p 1 O 3/ / Fax: ( ) Plan review (25% of permit fee) —{ '-'
CCB lic.: Vyo 9 7 State surcharge (12% of permit fee) g. 7o
/ TOTAL PERMIT FEE g / . aO
Authorized signature: �"� D ..Ind This permit application expires if a permit is not obtained within 180
/J �iv�r days after it has been accepted as complete.
Print name: Sh t rrl>o,„4 1,, 0 / b e c , Date: 1 - „1,,, d C * Fee methodology set by Tri- County Building Industry Service Board
I:\ Buildin g(Permits\MEC- PermitApp.doc 01/19/07 440-4617T (II /02 /COM/WEB)
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 01/19/07 2
. .
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MEb2009-00096
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2126/2008
Phone: (503) 639-4171 44,04111111\
Inspection Requests (24 Hrs.): (503) 639-4175 ,-4191■ "7& P- 0009k7
INSPECTION WORKSHEET FOR DATE: 3/7/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 10460 SW GREENLEAF TERR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD110.5 LOT #: 291 TYPE OF USE:
PROJECT NAME: OLBEKSON
DESCRIPTION: Installation of gas logs and gas piping..
OWNER: OLBEKSON, MERLIN & SHIRLEY PHONE #: 603-624-0311
CONTRACTOR: ALADIN HEATING & NC PHONE #: 610-0311
Inspection Request Scheduled For: Date: 3/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 066276-01 503-624-0311
Corrections/Comments/Instructions:
"5 A t CD--970.1'
PASS n PARTIAL APPROVAL n CANCEL I NO ACCESS
ID FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 2 e Phone #: (503) 718-