Permit CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC201000385
T I G A R D; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/12/2010
Parcel: 2S101 DD00400
Jurisdiction: Tigard
Site address: 6825 SW SANDBURG ST
Subdivision: Lot: 0
Project: Vigilant
Project Description: Venting for gas boiler replacement.
Owner: FEES
TOC MANAGEMENT SERVICES INC Description Date Amount
6825 SW SANDBERG ST Permit Fee 08/12/2010 $827.77
TIGARD, OR 97223 Plan Review 08/12/2010 $206.94
PHONE: 12% State Surcharge - Mechanical 08/12/2010 $99.33
Contractor:
GVA NORTHWEST LLC
4434 SE DIVISION
PORTLAND, OR 97206
PHONE: 503 - 233 -8811
FAX: 503 - 233 -8876
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Occupancy Load:
Stories: 2
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $1,134.04
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6., - • or 1.800.33 .' • 4.
Issued By: /�` /" ��� Permittee Signature:
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Call ': . • 39.4175 by 7:00 a.m. for an inspection 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.
Mec 'hanical Permit Application � � a°fira -7!c JS O�vk� s
l C o Ti gar d Re ceived
Permit No.: +
I n 13125 SW Hall Blvd., Tigard, OR 97223
RECEIVED Date /By. '- ,c, (� 603SS
` ? L .k Phone: 503.639.4171 Fax: 503.598.1960 Date By: 4 4 /��) \' . 0 to Other Permit:
7 GAR Inspection Line: 503.639.4175 Date Read 11 .>,.;.._
I { � ® See Page 2 for
- t.Wr a Internet: www.tigard or.gov `J ®3 G` ! Notified/Method: g / to /! Supplemental Information
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,TYPE OF BrilitINd DIVISION COMMERCIAL' E *- SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
New construction
❑ ®Ad dition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, lab r, verhead, and profit. • . .C OF CONSTRUCTION
. N
Value: S O l 960
1:1 I - and 2 family dwelling ® Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SISTEMS FEES*
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE I AND LOCA • • - - Heating/cooling •
Job site address: 6825 SW SANDBURG ST. Air conditioning
(requires site plan showing placement) 46.75
City/State /ZIP: TIGARD, OR 97223 Furnace 100,000 BTU (ducts /vents) _ 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: VIGILANT Heat pump 61.06
Cross street /directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.:
Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
' - DESCRIPTION OF WORK Water heater 23.3
REPLACE EXISTING GAS FIRED HOT WATER BOILER WITH NEW Gas fireplace 33.39
CONDESING GAS FIRED BOILER Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /clue /vent 23.32
•® PROPERTY .OWNER ❑ TENANT • . Other: 23.32 •
Name: VIGILANT (Customer contact is Ronda Walker) Environmental exhaust and ventilation
Range hood /other kitchen
Address: 6825 SW SANDBURG ST equipment 33.39
Clothes dryer exhaust 33.39
City /State /ZIP: TIGARD , OR 97223 Single duct exhaust (bathrooms,
Phone: (503)620 -1710 Fax: (503)620 - 3935 toilet compartments, utility rooms) 23.32
® `APPLICANT • El CONTACT PERSON , Attic ;crawlspace fans 23.32
Other: 23.32
Business name: GVA NORTHWEST LLC Fuel piping
Contact name: GARY JAECKEL $14.15 for first four; 54.03 for each additional
Furnace, etc.
Address: 4434 SE DIVISION ST Gas heat pump
City /State /ZIP: PORTLAND, OR 97206 Wall/suspended/unit heater
Water heater
Phone: (503) 233 -8811 Fax: : (503) 233
Fireplace
E - mail: GARY @GVANW.COM Range
• - .. CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: GVA NORTHWEST LLC
Other
Address: 4434 SE DIVISION ST , . MECHANICAL PERMIT FEES*
City /State /ZIP: PORTLAND, OR 97206 Subtotal
Minimum permit fee (S90.00)
Phone: (503) 233 - 8811 Fax: (503) 233 -8876 Plan review (25 %ofpennit fee)
CCB lic.: 136496 p ( State surcharge (12% ofpennit fee)
TOTAL PERMIT FEE
T his permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
R * Fee methodology set by Tri- County Building Industry Service Board
Print name: GARY JAECK Date: 6 - -
1: gilding Permits'YIE('- PermitApp.doc 10010 440-46171 (11.02 COI \A, E13) 1 1
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_CITY OF TIGARD M Ec Jo
114, is 13125 SW Hall Blvd.
Tigard, OR 97223
TIGARD 503.639.4171
Inspection Requests: 503.639.4175
Permit No MEC2010 -00385
Site Address 6825 SW SANDBURG ST
Description Venting for gas boiler replacement.
Contractor
Phone No
Inspection Request Scheduled For:
Date December 02, 2010
Pour Time N/A
Inspection Code 699 Mechanical final
Fax final inspection approval to (503)657 -3674
Request Comment
ATTn. Paul Schiager
Requestors Phone
(Result Comments
Results PASS - No C of 0
Inspector Chip Barnett
Date December 02, 2010
Phone No (503)718 -2644
,„‘Atrel Boiler & Pressure Vessel Registration
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z Department of Consumer and Business Services
Building Codes Division • 1535 Edgewater NW, Salem, OR
Mailing address: P.O. Box 14470, Salem, OR 97309-0404
503-373-7499, Fax: 503-378-2322
www.bcd.oregon.gov
This temporary operation: authorization is liailid for 126 days from the inspection date.
ORS 480.585(4) states no person shala operate 2 boiler or pressrim. vessel without a vallid permit
2 Vil0h2tiell/ inay result in fines up to $1,000 (ORS 486.670),
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Department of Consumer and Business Services
Building Codes Division • 1535 Edgewater NW, Salem, OR
Mailing address: P.O. Box 14470, Salem, OR 97309-0404
503-373-7499, Fax: 503-378-2322
www.bed,oregon.gov
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Th is temporary operation authorization ii: 'allliccil for 31.2,ill days from the inspection date,
CRS 41...585(4) states nu, person shalg: operate .Ci! ID(Difier (14' pressure: vesei without a vaiicll permit,
a vioiation raaay result in fines up to $1„000 (ORS 48C„670),
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