Permit 1
''' ., CITY OF TIGARD
Il
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00146
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/15/2007
PARCEL: 2S104AA -90151
SITE ADDRESS: 12658 SW KAREN ST 15 ZONING: R -12
SUBDIVISION: BELLWOOD TERRAC CONDOMINIUMS LOT: 015 JURISDICTION: TIG
PROJECT: BELLWOOD TERRACE CONDOS
Project Description: 1 ea. dryer vent and exhaust.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: R1 VENTS W/O APPL: VENT SYSTEMS: 0
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 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: 1
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
OREGON, STATE OF DEPT OF VETS Description Date Amount
do ZAKOCS, EDWARD + MOZINSKI,
PO BOX 336 [MECH] Permit Fee 3/15/2007 $72.50
YAMHILL, OR 97148 [TAX] 8% State Surcha 3/15/20W $5.80
Phone: Total $78.30
Contractor:
RELIABLE HEATING
RELIABLE HOME IMPROVEMENT
PO BOX 4821 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97208
Contact #: PRI 222 -1010
Reg #: LIC 00048637
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: ` 6 64 1,.. P ermittee Signature: /L . wen. ,
Call 503.639.4175 by 7:00 a.m. for inspections that busi ess day. fIll.
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.
1
Mechanical Permit Application , OFFICE USE ON ` LY ' , ,: r" ; . :1
mat, °-a � �a. a. I ' ..
CI Of T'1 and Receive.
4 g Date/By / 0 Permit • No : ®� I
13125 SW Hall Blvd., Tigard, O,R. 723 ��
II
r + Plan Review
Phone: 503 639.41a l 1 SI13 8q 1` 0 Date/By: Other Permit:
' TIG °A RD Inspection Line: 5033 j159,^,
I nternet. www.ti ardor, ov c Date Ready /By: See Page 2 for
g g J 20 S Notified/Method: Supplemental Information
k\AN
7 ,.; , ` ,- -::" .,...-=-..,; W iOIV ; '. ' t;=;, :j.t,, COMMERCIAL FEE'', SCHEDULE - USE CHECKLIST,
o + t sthlt tit tl Mechanical permit fees* are based on the value of the work
❑ New construction [W Aiddttton /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 c - _ r . =::".„::-- ` .` Value. $
❑ 1 - and 2- family dwelling ❑ Commercial/industrial ^', RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Accessory building
For special information use 49 0 - Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total
, - JOB SITE INFORMATION AND LOCATION Heating/cooling
{ Air conditioning or heat pump
Job site address: / 6 SC., J , ' q :70 (requires site plan showing placement) 14.00
City/State /ZIP: l P � r v '% 7 2 � Fumace 100,000 BTU (duct vents) 14.00
t l / (rT Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no • oject name: �
1, �fU' /�2 frfid Gas heat pump 14.00
Cross street/directions to j i • site: Duct work 14.00
/, ;25 7 y � / R n t hot water 14.00
n Residential enti al boiler r (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Flue /vent for any of above 10.00
Lot no.:
. Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
`_� 7( ,, /} Gas fireplace 10.00
-�,v
- Z k ‘e-- p)/L ��� , C/ Flue vent for water heater or gas
fireplace 10.00
/ ".cJ'n ( C T dig.e----al 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: � 7 f� `,v,e ' _ - — Environmental exhaust and ventilation
Address: 1, /L / Range hood/other kitchen
. t i J equipment 10.00
City /State /ZIP: t/ rt // 7 /(..,,e__
Clothes dryer exhaust J 10.00
/ Single -duct exhaust (bathrooms,
Phone: (5 d? 6, 6 ' — 36 / Fax: ( ) toilet compartments, utility rooms) / 6.80
❑ APPLICANT ' - ❑ CONTACT PERSON • . ' Attic /crawlspace fans 10 00
, -' Q Other: 10.00
Business name: R!`` / i T y `-/ X e /-{�J�� 0 � J . � ' , j f Fuel t in
P P� g
Contact name: (27 t� ( /fr.) j / $5.40 for first four; $1.00 for each additional
Address: n C) f '�3 637 Furnace, etc.
I7 ` el t A i s Gas heat pump
City /State /ZIP: po 4TLdgyt, ) Q 7' 1 Wall /suspended/unit heater
Phone: 6 ) yew / — & L/ I Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: r, t 19 f? /7nY14-(2 / �! C !� ) l� t , Clothes dryer (gas)
Other:
Address: P, Q j 0,)l 6736 -t (5 MECHANICAL PERMIT FEES*
City/State /ZIP: 71.091- ✓ / c 1 za ---'/ Subtotal
Phone: 3) 47,4..../ ,_ O� F ax: ( ) Minimum permit fee ($72.50)
o ( J Plan review (25% of permit fee)
CCB lic.: ( . ' /? State surcharge (8% of permit fee) �/ 3
2 /,
I q TOTAL PERMIT FEE 775 ,
Authorized sign • •.• // This permit application expires if a permit is not obtained within 180
'// 7 11 — days after it has been accepted as complete.
'nt name: 77, / '
Date: Fe e methodology set by Tri- County Building Industry Service Board
l:\Building\Permit 1EC- PermitApp .. ,•/067 440-4617T (11/02/C0104/WEB)
1,
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuitionil Permit
$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.
1ABuilding\Permits\MEC-PermitApp.doc 12/30/05 2
CITY OF TIGARD r , A ,,
BUILDING DIVISION PERMIT #: MEC2007-00146
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2007
Phone: (503) 639-4171 .111,144-111t
Inspection Requests (24 Hrs.): (503) 639-4175 /i& ,:ov7 -d0/
INSPECTION WORKSHEET FOR DATE: 3119/2007 TIME: 7:00AM PAGE: 34
SITE ADDRESS: 12658 SW KAREN ST 16 CLASS OF WORK:
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUM LOT #: 015 TYPE OF USE:
PROJECT NAME: BELLWOOD TERRACE CONDOS
DESCRIPTION: 1 ea. dryer vent and exhaust. •
OWNER: OREGON, STATE OF DEPT OF VETS, . PHONE #:
CONTRACTOR: RELIABLE HEATING PHONE #: 2211010
Inspection Request Scheduled For: Date: 3/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 045015-01 503-481-0240 N
Corrections/Comments/Instructions:
(14 a 'ARTIAL APPROVAL pi CANCEL I I NO ACCESS
Li FAIL El P A FOR INSPECTION I I ADDITI• AL F ES ASSESSED
Inspector: . A. _.....m.....— Date.. 0 Phone #: (503) 718-
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