Permit CI TY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00248
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/2/2007
PARCEL: 25111 DD -13900
SITE ADDRESS: 15704 SW 87TH AVE ZONING: R -7
SUBDIVISION: MILLMONT PARK LOT: 016 JURISDICTION: TIG
PROJECT: DAVIES
Project Description: Replace existing gas furnace and add heat pump.
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: 1 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
GRANT DAVIES Description Date Amount
15704 SW 87TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 5/2/2007 $72.50
[TAX] 8% State Surcha 5/2/2007 $5.80
Total $78.30
Phone: 503- 684 -0842
Contractor:
GL HEINTZ HEATING & COOLING, INC.
20871 SW 216TH PL.
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 625 -6798
Reg #: LIC 102831
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 o - -stions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue' By: 4 L j � Permittee Signature: A ' , MA(
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 p
Approved plans are required on the job site at the time of each inspection.
.MecJlanica Permit Appit p i ED Received 5 FOR OFFICE USE ONLY
Cl of Tigard :) ,"p Daced it )-/f e � � g
Date/By: e % D � Permit No.:
13125 SW Hall Blvd., Tigard, M97222
Phone: 503.639.4171 Fax: 5 8.19604 � U U � Plan Review
Date/By: Other Permit.
T 1 G A K D Inspection Line: 503.639.4175 TIGARD Read B Ju
Internet: www.tigard or.gov CIT OF T IG ARD Ready /By.: 0 See Page 2 for
B �� fSi^ Notified/Method: /t6 Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction4ddition /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: $
V.1- and 2- family dwelling ❑ Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder
❑ Other:
Description p I Qty. I Ea. I Total
JOB SITE INFORMATION AND L Heating/cooling
Job site address: bid
1 `` v Air conditioning or heat pump
(requires site plan showing placement) 1 14.00
City/State /ZIP: \ Fumace 100,000 BTU (ducts/vents) t 14.00
Fumace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: 1 Project name: 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
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
q „� ` � � Gas fireplace 10.00
'�'J� , r�e Flue vent for water heater or gas
1 t t 1 /► r o 4 J - t i kilo fireplace 10.00
`r` V l f l Log lighter (gas) 10.00
tt�� Wood/pellet stove 10.00
Wood fireplace /insert Ft-PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 10.00
n Other: 10.00
Name: ,qt '{- tte-3 �(� Environmental exhaust and ventilation
Address: l ` `a s a " 1 (y � ` � ' \ Range hood/other kitchen
equipment 10.00
City /State /ZIP: l ( �A -- ��� Clothes dryer exhaust
10.00
2 LI— 4- 9 � toilet compartments, exhaust (bathrooms, rooms) s,
Phone: L Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON - Attic /crawlspace fans 10.00
Business name:
Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Fumace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: _, i I• C.J0 -4 Clothes dryer (gas)
Other: II Address: ( . I' •
t �• MECHANICAL PERMIT FEES*
City /State /ZIP: Cibi 9-7 i 4 l Subtotal
Tom-' ,t,
F--�j \� / �/ Minimum permit fee ($72.50) ��`JV
Phone: c. J t(, o F ( ) Plan review (25% of permit fee)
CCB lic.: ( o 2- 1 1 State surcharge (8% of permit fee) 5.80
TOTAL PERMIT FEE - 7 t.
Authorized signature: Thi permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ( • . ( ` e ), Date: * Fee methodology set by Tri -County Building Industry Service Board
\ Building \Permits\MEC•PermitApp.doc 04 /06/06 440 -4617T (t t /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.
1:\Building\Permits\MEC- PermitApp.doc 12/30/05 2
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CITY OF TLGARD ...` ,-
BUILDING DIVISION PERMIT #: MEC2007.00248
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2/2007
Phone: (503) 639 -4171 LAa'i vi 1 �i
Inspection Requests (24 Hrs.): (503) 639 -4175 M
INSPECTION WORKSHEET FOR DATE: 5/4/2007 TIME: 7:00AM PAGE: 45
SITE ADDRESS: 1;704 SW 87TH AVE CLASS OF WORK:
SUBDIVISION: MILLMONT PARK LOT #: 016 TYPE OF USE:
PROJECT NAME: DAVI
DESCRIPTION: Replace existing gas furnace and add he pump.
OWNER: DAVIES, GRANT PHONE #: 503- 684 -0842
CONTRACTOR: HE:"INTZ HEATING & COOLING, INC., GL PHONE #: 503-625-6798
Inspection Request Scheduled For: Date: 5/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 047643 -01 503-313-5123 Y
Corrections /Comments/ Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:.- 1--° ? Phone #: (503) 718- 2. t