Permit � CI ■ Y OF TIGARD �S
�,t„ *�� MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00507
TIGARD`, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/13/2008
PARCEL: 2S103DA - 00400
SITE ADDRESS: 13150 SW WATKINS AVE ZONING: R -4.5
SUBDIVISION: DERRY DELL LOT: 004 JURISDICTION: TIG
PROJECT: O'LEARY
Project Description: Oil to gas furnace conversion.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
DAWN O'LEARY Description Date Amount
13150 SW WATKINS AVE
TIGARD, OR 97223 [MECH] Permit Fee 10/13/20C $72.50
[TAX] 12% State Surch 10/13/20C $8.70
Phone: Total $81.20
Contractor:
GREENTECH HEATING & COOLING
6403 SE 22ND. AVE
PORTALAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 235 -5895
FAX 503 -235 -5897
Reg #: LIC 176370
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. At work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/74
,,J Issued By _ 4.4 _� Perm ittee Signature: L��
Call 503..E 5 by 7:00 a.m. for inspections th. s usiness day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application '' V M'�'` ` l t OFF I i r '
,.� yjs i : Z . .. { FO I CE�USE ONLY i � ,
`Y '� ��i fir:, .. T.. �.i: Z J' °_sy , w� v . (fv_ .,, qr !e' . r!'::
Cit of Tigard ; l 1 Date/By: d LI '' Permit No. A js , a
5
. 1 i ° 13125 SW Hall Blvd., Tigard, OR 97223 y Plan Review '
'; a Phone: 503.639.4171 Fax: 503.59. 'C'. • i t ` _ ' Other Permit: ■e, '@ 4P , % %$' Date /By:
Inspection Line: 503.639.4175 a
...-is. I G A R D . and -or. ov a Date ady /By: ® See Page 2 for
Internet: www.ti
g g � � �® otifi Method: Supplemental Information
TYPE OF WORK`Q� s $ COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
12 New construction Addition /alteratioifff ® ent 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*
0'1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family 0 Master builder
❑ Other:
Description p Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
? c c / Air conditioning or heat pump
Job site address:
/360 ✓v J J W � jt
��4 r/� (requires site plan showing placement) 14.00
City /State /ZIP: '1740 O Gi/ — Furnace 100,000 BTU (ducts /vents) 1 14.00 / o^
( f � / � Furnace heat 100,000+ BTU (ductsh -ents) 17.90
Suite/bldg. /apt. no.: Project name: '
Gas as heat pump 14.00
Cross street/directions to job site: JA D Duct work 10.00
/� ' /" 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. 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
0 /7 / , I v S g/t/4( (U A ; OA/ 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
Chimney /liner /flue /vent 10.00
PROPERTY OWNER ❑ TENANT Other 10.00
Name: t - ' 11. Environmental exhaust and ventilation
Range hood /other kitchen
Address: 14/11e-_- equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT - ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: 7 // *---,-7-74 (L- �i f."„ t/►/ Fuel ( Fuel 10.00
— J% piping
Contact name: (� � I $5.40 for first four; $1.00 for each additional
r ni
Address: /' (L 3 - , / Furnace, etc. � .5"0— (� Gas heat pump
City /State /ZIP: /
.l q, O2 97 Wall/suspended/unit heater
Phone: (5 . 3s- - 5 -sG� -� Fax: ''03) - ?35 _s_ .7 Water heater
v 7 Fireplace
E -mail: ~Oa- -47A 7lil.� , &t-r Range
CONTRA T Barbecue
Business name: Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal I `7 4l-
Minimum permit fee ($72.50) 7�.S
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 1 7� 3 7v / State surcharge (12% of permit fee) 7r)
TOTAL PERMIT FEE A t .
K This application expires if a permit is not obtain within 180
Authorized signature: `/i . s permit obtained within
after it has been accepted as complete.
Print name: ) / I4 , Date: r(, • / 3 • 03 ' Fee methodology set by Tri- County Building Industry Service Board
RBuilding \Permits\MEC- PermitApp.doc 01/19/07 440 -4617T (11 /02 /COM /WEB)
i
Mechanical Permit Application - City. of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule: 1 '
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.
1:\ Building \Permits\MEC- PermitApp.doc 01/19/07 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 1v1F 20O 08587
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13!"008
Phone: (503) 639 -4171 A,�n u�I llll
Inspection Requests (24 Hrs.): (503) 639 -4175 `__..
INSPECTION WORKSHEET FOR DATE: fly /2'10008 TIME: 7 PAGE: •I5
SITE ADDRESS: 1:150 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: DERRY DELL LOT #: 004 TYPE OF USE:
PROJECT NAME: 01FARY
DESCRIPTION: Oil to gas furnace conversion.
OWNER: O'LEARY. DAWN PHONE #:
CONTRACTOR: GREENTECH HEATING & COOLING PHONE #: 503- 235 -5895
Inspection Request Scheduled For: Date: 10/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 078980-01 503 - 276.8799 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CAL FOR INSPECTION — ADDITIONAL FEES ASSESSED
Inspector: D ate: t v I 6 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: M 02008 Oi3507
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/13/')008
Phone: (503) 639 -4171 - ' i , ^F4 I
Inspection Requests (24 Hrs.): (503) 639 -4175 ^:_
INSPECTION WORKSHEET FOR DATE 1O/23/2O08 TIME: 7:00AM PAGE: q
SITE ADDRESS: CLASS OF WORK:
DER
SUBDIVISION: 1315 FR DRY DELL 1/1jVATEUNti AVE LOT # 004 TYPE OF USE:
PROJECT NAME: O' EARY
DESCRIPTION: tail tra gas furnace conversion.
OWNER: PHONE #:
C�`LFARY, DAWN
CONTRACTOR GREENTECH HEATING & COOLING PHONE #: 503 - 235-5895
Inspection Request Scheduled For: Date 10/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 077106-01 503 - 2587993 Y
;. Corrections /Comments /Instructions:
S — _,- — 'S'.— — - 4 ..4 z
:ik
-
L!.:.-- .0 • . - • 11PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: JO- 2 —o 6 Phone #: (503) 718- '24,21