Permit 11111 q CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00482
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/6/2006
PARCEL: 2S 101 AA -09700
SITE ADDRESS: 12587 SW 68TH AVE ZONING: MUE
SUBDIVISION: PP1996 -024 LOT: 001 JURISDICTION: TIG
Project Description: Alter interior ductwork Value$2200 11/28/06 changed address (from 12585 68th Ave)
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MARK NIELSON Description Date Amount
7150 SW HAMPTON
STE. #228 [MECH] Permit Fee 10/6/200E $74.80
TIGARD, OR 97223 [TAX] 8% State Surcha 10/6/200E $5.98
Total $80.78
Phone: 503 - 582 -5777
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 462 -4822
FAX 503- 462 -6555
Reg #: LIC 50897
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: Permittee Signature:
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.
Mt ical Permit p li(c I Fog OFFICE USE ONLY
CI and - ,c----.'..:, 1 - I - l i Received �/p
`� y Date/By: 1 (/ O � j j�� Permit No.: i 06' OU 7 p •.-
13125 SW Hall Blvd., Tigard, OR 97223
Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960Q d �' Other Permit:
0 > Date/By:
Inspection Line: 503.639.4175 U C1 0 (� 2006 , • � � D Date Ready/By: Juro: J 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 7 Supplemental Information
-- INPE,OF WQRtC n. - , COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/ terati placement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ .7, ,20o . op
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling om t U ustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. 1 Ea. I Total
/ -g 7 JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / a s W 0i-e' Al/e.-./ Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /Z1P: 'Tk 5cu`,`� , o c ,, , Furnace 100,000 BTU ( ducts/vents) 14.00
( Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: ��ttSLv✓ Gas heat pump 14.00
Cross street/directions to job sue: 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
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
041-E /NV I � P () fireplace 10.00
p�(Q�[ Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT . Chimney/liner /flue/vent 10.00
Other: 10.00 _
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
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
Other: 10.00
Business name: ,
Fuel piping
Contact name: S5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: / 4U/'rtC , Clothes dryer (gas)
Other:
Address: S l O Q`4--1' Vi P ,/ MECHANICAL PERMIT FEES*
City /State /ZIP: 'Ma) GZA,.kw ' b� Subtotal ,, //
Minimum permit fee ($72.50) - 7y. yo
Phone: 52 t-k ; _ L. f �' F . ) Ci &D , (D SS6 Plan review (25% of permit fee)
CCB Iic.: 503 t7 7 State surcharge (8% of permit fee)
t _ TOTAL PERMIT FEE ,--7 Thispermit application expires if a permit is not obtaine within 180
Authorized Signature: �
� )/t..0 0 iek,Q days after it has been accepted as complete.
Print name: V\',Y V I , R,e, Vvir - Date: Icy 5 J otp 1 • Fee methodology set by Tri-County Building Industry Service Board
is\ Building \Permes\MEC- PermitApp.doe 12/03 440- 461rr /02/COM/WEB)
CITY OFTIGARD 1 - --
BUILDING DIVISION PERMIT #: MEC200€- 004132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6/2006
Phone: (503) 63.9 -4171 )
Inspection Requests (24 Hrs.): (503) 639 -4175 2 A 1
INSPECTION WORKSHEET FOR DATE: 10/31/2006 TIME: 7 :01AM PAGE: 23
%2S77
SITE ADDRESS: 58'rSW 68TH AVE CLASS OF WORK:
SUBDIVISION: PP1996 -024 LOT #: 001 TYPE OF USE:
PROJECT NAME: NEILSON
DESCRIPTION: Alter interior ductwork. Value$2200.00
OWNER: NIELSON, MARK PHONE #: 503 - 582 -5777
CONTRACTOR: HVAC INC PHONE #: 503 - 462 - 4822
Inspection Request Scheduled For: Date: 10/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 039077 -01 503 - 462 -4822 Y
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: Date;/ 3 de...0. Phone #: (503) 718- �9-$3