Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00087
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/02/2011
Parcel: 2S110AC01000
Jurisdiction: Tigard
Site address: 11545 SW BEEF BEND RD 32
Project: Wellington Estates Subdivision:NELLINGTON ESTATES APARTMENT; Lot: 0
Project Description: Furnace replacement.
Contractor: ROBBEN & SONS HEATING INC Owner: FERN VALLEY PROPERTIES LLC
2214 SE 8TH AVE BY CAMBRIDGE REAL ESTATE SERVICES
PORTLAND, OR 97214 PO BOX 2968
PORTLAND, OR 97208
PHONE: 503 - 233 -5841 PHONE:
FAX: 503 - 238 -8849
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/02/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/02/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/02/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.3 344.
Issued By: / " ee Signature: - /-
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Mar. 2. 2011 9:20AM Robben & Sons Heating Inc. No. 2933 P. 1
Mechanical Permit Application - I,,lz OI II( I 1 I•()NI.,
City of Tigard RDeceivedy.
e
U 13125 SW Hall Blvd., Tigard, OR 97223 P V " •
Phone: 503.639.4171 Fax: 503.598.1960 MAR 1• 0I Dstq w Other Permit
i , , ; \ „ . , Inspection Line: 503.639.4175 .42. Data Ready/By IRIS ® See Page I for
Internet www,tigard- or.gov CITY O1-• ,A' D Nolified/Mclhod: Supplemental raformotiou
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• :�.,,:. .. , " ���� , ..; +� - = , ` USA GHECKLIST:
❑ : New construction Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
.: CA�EGbk1l QF r� .��"1T6N'-•,---314.4., `(1s ft;P L .; k ��% � , value $ k • tego •MMM's . 1V1EM' M3 FEES .'
❑ and 2- family dwelling I3 Commercial/industrial 11 Accessory building For speciesl information use checklist
L�f Multi- family [] Master builder 0 Other: Description a. Total . �,,��a�( 9 P Qty. )r To a!
} ,. ri i . OR1 ( b ` ,..§.: 1 .. ° p° ' V i . 1 'r � , . , Henting/cooltng
Job site address: \ 1 '7 S 1 +�� i � Air conditioning
- - _ _ J (requires site plan showing placement) 46.75 �-
City /State/ZIP. `/ Furnace l00 000 BTU (duots/venis) \ 46.75 Ll (p 77
Furnace 100,000+ BTU (dncte/ventiL 54.91
Suite/bldg. /apt. no.: _ Project name: ' I _4,,, g .;,w,,,. Heat pump 61.06
Cross street/directions to job site: Duet 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
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances
; % ,,,.r :', p ; i , E$ 1(ifs p ,ir.� F "$ l c e r .''',,!11,..'N' ;• a - g, ' Water heater 3.32_
Gas fireplace 33.39
1 1/1:44:11 PA ..��* Flue vent for water heater or gas
fireplace 23,32
- • Log lighter (qas) 23.32
Wood/pellet stove 33.39 _
y� Wood fireplace /insert 23.32
� p F . ,� b� a „,. �y� ,, r r � -a 6 } a y �,,��, Chittney/liner /flue/vent 23.32
,x ,:1 :4:4 ..42 fsfY v�'� .V74, , :t4. se .tM141,'°R� r�r°Si4! }��' Other: ._
23.32
Name:
A., f slrtmb Environmental exhaust and ventilation
— Address; Range hood/other kitchen
r` \ c3� / rl_&g4._ !`i. 0 , .r equipment 33.39
City /State/ZIP: - r& / C• X17 .41, Clothes dl�er�exhaust - 33.39
(%•.5 —i Single -duct exhaust (bathrooms,
Phone: t • : Ica Fax: ( ) toilet compartments, utility rooms) _ 23.32
.,. ' A1►P O'4NT: W „� ' ,. tt ,, ,',00. N :.; Altic/crawlapace fans 2332
. O ther: 23.32
_
-,�� •i�� 14 Iruel pipleA
Contact name.
w . �_, ...,tP', _ 514.15 for first four; $4.03 for each additional
Address: _� twill
Furnace, etc.
Gas heat porn ,
City/State/ZIP: . Ii�titz�e 6140 r IMF Walt/suspended/uniliteater
Phone: • ._rte y � ` .1-...: I Water heater
E -mai ,, Fireplace
. A� r y . .. ••. g imii i,e GA Range
�� . A,k tr , S'�' ;40:11'N1 U w. "LY011A tiyarrtiglita Barbecue
MEM io Clothes dryer (gas)
tai
Other
Address: «= �,� f jy /�7' ��{ W y .$� � y p
: !!:9,.,, lYit: ,____ :I____A'tlF G� l:: '.
city/State/Z.I': _ 4* umit.IS (. 41111 in.
{-� . Subtotal
Phone.' a 3. At.. •d1
ril * w rM. Minimum permit fee ($90.00) le r r�ty _Plan review (25% of permit fee)
CCB lies: \ t — State surcharge (12% of permit fee ,() .tC
TOTAL PERMIT FEE air ,
Authorized signature; * .., 4 nil permit appilt ■lion elplrea it a permit tss not obtains. within 18
days after It bas been accepted as complete.
2% , a •tl♦,t , Date s • • Pee methodology gat by Tri- County Building Industry Service Hoard
I: laulldioaVorolas ■MmGPtanitApp.doo 10/01/09 ... ................._. _____