Permit 1�� CITY OF TIGARD
1 G � MECHANICAL PERMIT
"±° .,
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00227
TI 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/29/2007
PARCEL: 1 S134DB -11400
SITE ADDRESS: 11008 SW BRENDEN LN ZONING: R -4.5
SUBDIVISION: DAKOTA GLEN LOT: 016 JURISDICTION: TIG
PROJECT: STEPHENS
Project Description: Gas line for pool heater.
CLASS OF WORK: OTR 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
MICHAEL STEPHENS Description Date Amount
11008 SW BRENDEN LN.
TIGARD, OR 97223 [MECH] Permit Fee 5/29/2007 $72.50
[TAX] 8% State Surcha 5/29/2007 $5.80
Total $78.30
Phone: 503- 358 -6874
Contractor:
AQUA INGROUND POOLS
16429 OAK VALLEY DR.
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 253 -8494
FAX 360 - 253 -8515
Reg #: LIC 169192
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: �L $1 ...1./i Permittee Signature / J / ����
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.
Mecha,ical Permit Appilc tioi FOR OFFICE USE ONLY
- City of Tigard - •r. '" N ^
II DateBy:' i 0 / b Pm Permit N. ,1 4' 1 �p
13125 SW Hall Blvd., Tigard, OR 97223 � � � �
I� . Phone: 503.639.4171 Fax: 503.598.P :' R 2 5 200 1 D Plan a Other Permit:
T I G A R D Inspection Line: 503.639 Date Read -/B tens
ardor. ov q.t�• . Ready /By: / 0 See Pagel Information
for
Internet: www.ti
g g y � N ot ifi e d/ Method. u lemental
Y V 1 P .d i I / if t PP
TAgWO C OMMERCIAL FEE* SCHEDULE – US •1 CKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition iii Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
❑ l -an 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder Fs Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: i 100v S . v1��LV L ;� Air conditioning or heat pump
r (requires site plan showing placement) 14.00
City/State /ZIP: Tywck cO ki e G rn 3 Fumace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: F1 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
\' - 1 ^ ( Flue /vent for any of above 10.00
. L \c at
Subdivision: Lot no.: I V
Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
_
Gas fireplace 10.00
f - ) CA\ `� SItC)• veA k) `tik \412 -- QUD ` 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
IX PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
Name: , \ (� r ; „ ` �� f �l 5 Environmental exhaust and ventilation
1 � %.- V w" � Range hood/other kitchen
' 1
Address: \ k 008 3 l ` v , (key Lvk equipment 10.00
City /State /ZIP: a vet vy 17 2 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (55t? 34 ( Fax: ( ) toilet compartments. utility rooms) 6.80
.APPLICANT ,CONTACT PERSON Attic /crawlspace fans 10.00
`� 1 ! Other: 10.00
Business name: ! C 1ACn ZN _ Grv.,.tn v\ cnAs Fuel piping
Contact name: l k -t Wevs S5.40 for first four; $1.00 for each additional
Address: ibL •2 _9 O U7 /l ) ,t 2
Furnace, etc.
1 J Gas heat pump
City /State /ZIP: ()rtJ C .� � i , ®� 709:5 y 7a- WalUsuspended/unit heater
Phone: ( )3) 703. 72 s -7,....-- " Fax:: (36O) 2_53- 85 /S- Water heater
I //� Fireplace
E-mail: I._ o/ta u:4 Y�t <' G oic t 1 t COVIi Range
CONTRACTOR Barbecue
Clothes dry (gas)
Business name: IVyIQ as
1-1/717 Other: KM, ArCt.�• 1
Address: t b Z 9 a i v /I t'g az . MECHANICAL PERMIT FEES*
City /State /ZIP: O ,• C/l4 etj f– /7 97oVS Subtotal
Phone: (360)-253 �L� CC Minimum permit fee ($72.50) 72"q) G y Fax: ( )
Plan review (25 % of permit fee) Cg J
CC B lic.: ' 69 i -I 3 -Lt -. O V State surcharge (8% of permit fee)
/ TOTAL PERMIT FEE 31. 3)
Authorized signature: ��� e,..c. f WriliMP This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: /9/it h ) Gai `S Date: V _ • Fee methodology set by Tri- County Building Industry Service Board
I :Building\Permits\MEC•PermitApp doc 04 /06/06 440 -4617T (11 /02 /COM/WEB)
Mechanical Permit Application - City of 'Tigard
• /1'
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.
1:\ Building \Permits\MEC- PermitApp.doc 12/30/05 2
CITY OF TIGARD
BUILDING DIVISION - : PERMIT #: MEC2007 -00227
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/29/2007
Phone: (503) 639 -4171 zoti I
Inspection Requests (24 Hrs.): (503) 639 -4175 L . 7 44- - 1 L
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 2
SITE ADDRESS: 11008 SW BRENDEN LN CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 016 TYPE OF USE:
PROJECT NAME: STEPHENS
DESCRIPTION: Gas line for pool heater.
OWNER: STEPHENS, MICHAEL PHONE #: 503 - 358.6874
CONTRACTOR: AQUA INGROUND POOLS PHONE #: 503-253-8494
Inspection Request Scheduled For: Date: 6!13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mes
610 Gas Tine 050158 -01 360 - 241 -1173 Y
Corrections /Cori ments /Instructions:
7:4,e-?_Thur t
. ,._ •
1 ASS - ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL %1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED - 6/7
Inspector: Date: I` d Phone #: (503) 718 -
ti
CITY- OF-=TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00227
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/29/2007
Phone: (503) 639 -4171 ;VII I I Inspection Requests (24 Hrs.): (503) 639 -4175 .�� _..
INSPECTION WORKSHEET FOR DATE: 6/1/2007 TIME: 7:02AM PAGE: 32
SITE ADDRESS: 11008 SW BRENDEN LN CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 016 TYPE OF USE:
PROJECT NAME: STEPHENS
DESCRIPTION: Gas line for pool heater.
OWNER: STEPHENS, MICHAEL PHONE #: 503-358-6874
CONTRACTOR: AQUA INGROUND POOLS PHONE #: 503-253-8494
Inspection Request Scheduled For: Date: 6/1 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 049410 -01 360 - 241 -1173 Y
Corrections /Comments /Instructions:
n PAS Fi PARTIAL APPROVAL n CANCEL 1 I NO ACCESS
FAIL n CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: 4 Date: -‘ —/ 0 Phone #: (503) 718- "?..,4