Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00245
DATE ISSUED: 5/31/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 110BA - 08200
SITE ADDRESS: 11540 SW COLE LN ZONING: R - 4.5
SUBDIVISION: EVERGREEN SPRINGS LOT: 007 JURISDICTION: TIG
Project Description: Gas piping fireplace insert & BBQ.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
GENE DIMAGNO Description Date Amount
11540 SW COLE LN
TIGARD, OR 97223 [TAX] 8% State Surcha 5/31/200E $5.80
[MECH] Permit Fee 5/31/200E $72.50
Total $78.30
Phone: 503- 620 -8447
Contractor:
GAS PRO, INC.
7603 SE LOUNSBERRY LN
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 775 -7014
PRI 503- 775 -7020
Reg #: LIC 167493
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. ,r
Issued By: Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections t, =t . usiness • =
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.
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Meckanical Permit Annlica i n . , .` , ; Y ?.c_,, II cI 1. ! n !' n � ; z g ,
1 ty
'.) 1 'i Received _
::,(1 , , , C ity of Tigard Date/By:
, ,,
w " 13125 SW Hall Blvd., Tigard, OR 97223 2006
�1 Plan Review
4, '. P
,; Pho ne: 503.639.4171 Fax: 503.598.196�01�1 p � e /g y Other Permit:
fi C it l�' Inspection Line: 503.639.4175 y E i� Date Ready/By: lu s: El See Page 2 for
N 4 � Internet: www.tigard or.gov \ / 0_1' � otified/Method: Supplemental Information
` TYPE Q O RK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New constructionlddition /alteration/teplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ •
A1 - and 2- family dwelling 0 Commercial/industrial ❑Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION . Heating /cooling
Job site address: / 5 L,/ J ! �,/ c r / „ / Air
s i l op ing or showing placement) / °►/ L �- L ///
(requires si plan showin acement ) 14.00
City/State/ZIP: ." j �� / /)► q 2 22 (, Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: 11 6! (/ Project name: 7 Furnace 100,000+ BTU (ducts/vents) 17.90
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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater - 10.00
195 ` y Gas fireplace 10.00
Q,1. Flue vent for water heater or gas J
6 / � �/�- _ - fireplace 10.00
n s �I r r f Log lighter g hter
(gas) 10.00
Wood /pellet stove 10.00 -
Wood fireplace /insert 10.00
' ❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: 6 En F n - )4 9 iv Environmental exhaust and ventilation
�i Range hood/other kitchen
Address: K' /
5 /rye E equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( p'2) 6, q L/ 2 Fax: ( ) toilet compartments, utility rooms) 6.80
)APPLICANT ! ❑ CONTACT PERSON Attic/crawlspace fans 10.00
+ Other: 10.00
Business name: ✓1 y �A J piping
/"T /, Fuel t to g
Contact name: a �(1 :///)� J $5.40 for first four; $1.00 for each additional
7 / / Furnace, etc.
Address: ? G 0 > I f ! / ' 1C //7 f 4! ?P'e'J �^� Gas heat pump
City /State /ZIP: bt /- 0 ,( (1 7 (y Wall /suspended/unit heater ,
( Phone: 7 Fax: : i ) �i / f _ 7 Water heater
��- �V �J t ( � y Fireplace 1
E -mail: (2 /1S fa c / �� � d� ✓ 7' - � Al F Range
CONTRACTOR . TT Barbecue f
Business name: fiefr I Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES* .
City /State /ZIP: Subtotal
' Minimum permit fee ($72.50)
Phone: ( ) I Fax: ( )
Plan review (25% of permit fee)
CCB lic.: ' State surcharge (8% of permit fee)
TOTAL PERMIT FEE
trAiliW" days after it has been accepted as complete.
This permit application expires if a permit is not obtained within 180
Authorized signature: ,
Print name: ��' p % rpirw�, � ,� Date: • - ) +/ " Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Pemuts\MEC- PernitApp.doc 04 /06/06 440- 4617T(11/02/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 $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:1 Building \Permits\MEC- PermitApp,doc 12/30/05 2
CITY OF TIGARD
BUILDING DIVISION 1 PERMIT #: MEG2i,l06.00246
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51,3 a /;a iG
Phone: (503) 639 -4171 4 4111 ll
Inspection Requests (24 Hrs.): (503) 639 -4175 / 0 6 _ OQ a i S
INSPECTION WORKSHEET FOR DATE: R112006 TIME: 7:03 \1ti PAGE: 8
SITE ADDRESS: 11W) FM" COLE E E I N CLASS OF WORK:
SUBDIVISION: EV17.RGR1<Ei)i SPRINGS LOT #: 007 TYPE OF USE:
PROJECT NAME: (()NAGA)
DESCRIPTION: (as pi ^ilk; 'f It r -pk ce in of & I3130.
OWNER: D!MAt$WO, t,Ea' L PHONE #: 603-620-8
CONTRACTOR: (3AS PRO, INC. PHONE #: 5D 77b 7010
Inspection Request Scheduled For: Date: 6/1 /2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G;-is Iir 0A01.13/-.01 ! ; ;;03.347-9115
•
Corrections /Comments /Instructions:
•
6 7
E] PASS ( I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
/ Dat Phone #; (503) 718 _
b 0 , 5 on t I I 4-1-
CITY OF TIGARD - + coc
BUILDING DIVISION PERMIT #: MF .2t. 6a..r fr ,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5,631/20C
Phone: (503) 639 -4171 , Nisi&iil
Inspection Requests (24 Hrs.): (503) 639-4175 1_C a Do � -- .0�'a11s
INSPECTION WORKSHEET FOR DATE: (41 2 TIME: 7 :03:e f PAGE: 7
SITE ADDRESS: '$ if440 SW COLE LN CLASS OF WORK:
SUBDIVISION: :.Va ',RGR TEN �; ` INOS LOT #: 07 TYPE OF USE:
PROJECT NAME: DiMA3110
DESCRIPTION: ,,*w ipi 12 filep470 iz3tie BOO.
OWNER: DI MAt;yMO. a` > ».NL I/ PHONE #: >o .. ; ; ;- ei
CONTRACTOR: A A,s p 1), INC. PHONE #: f0'_ ?7&- Y - 070
Inspection Request Scheduled For: Date: 6/1/200t; Pour Time:
Code # Inspection Description Confirm # Contact # Message
EF ° a:Q Meth' ' kaki r4 r1 rrt O.O 37 - 02 Ec :. 347.911E0 N
Corrections /Comments/ Instructions:
•
•
PASS ID PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: / �i/��� D ate: (� P Phone #: (503) 718 - 27 0