Permit CITY TIG ®RD MECHANICAL PERMIT
AA � DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00519
; DATE ISSUED: 10/25/2006
•' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102CB - 05500
SITE ADDRESS: 09984 SW GARRETT ST ZONING: R -
SUBDIVISION: GREENBROOKE LOT: 005 JURISDICTION: TIG
Project Description: Mechanical reconnect for (2) duplex units.
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:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
VAL & LIZ MARGUTH Description Date Amount
14447 NW LISTEL LN
PORTLAND, OR 97229 [MECH] Permit Fee 10/25/20C $125.00
[TAX] 8% State Surcha 10/25/20C $10.00
Total $135.00
Phone: 503- 629 -8169
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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.
Issue y: _ � Permittee Signature: 1 a Z6
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.
Y° 3 2{f : v
Mechanical Permit Application a : 4 tr
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-� Ci of Tigard Permit No.: ft) / � � �6E 9�• 60575
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
s -� ; 6 Phone: 503.639.4 Fax: 503.598.1960 Other Permit
yam Inspection Line: 503.639.4175
Date/ By.
�T� I ' � C A R n . Date Ready/By: 1ud El See Page 2 for
7,-.m'...: 'yemi Internet: www.tigard - or.gov Notified/Method 114 Supplemental Information
TYPE OF WORK - COMMERCIAL FEE* SCHEDULE -- USE CHECKLIST
❑ 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
. - CATEGORY OF CONSTRUCTION Value: $
. • RESIDENTIAL EQUIPMENT / FEES*
❑ 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. I Total
. • JOB SITE ORMATION . AND LOCATION Heating/ cooling •
Job site address: 99g q 9 / / r * 60Q.)
a t - ( ,„6.;--- Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
fr R....0,7,1.4.7-74.
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 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
• /� /..--:7e Gas fireplace 10.00
LH P1 Iv i Q-A L CC it ./ cC Q /? Flue vent for water heater or gas
Pe.---2. fireplace 10.00
De4. X ( r 75 Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑`PROPERTY OWNER 1 ❑ TENANT - Chimney /liner /flue/vent 10.00
• Other: 10.00
Name: L/ Z MA g C 7- L( Environmental exhaust and ventilation
Address: / �V�,/ Range hood/other kitchen
T 1 V �� � � cy equipment 10.00
Z�
City /State /ZIP: ( , -'e. sL� e--)A7 72 Z �/ Clothes dryer exhaust 10.00
/ / Single-duct exhaust (bathrooms,
Phone: (303) 6 z — �' / L 9 Fax: ( ) toilet compartments, utility rooms) 6.80
0- APPLICANT ❑ CONTACT PERSON . - Attic/crawlspace fans 10.00
Other: 10.00 _
Business name:
Fuel piping
Contact name: $5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) -
Fax:: ( ) Water heater
Fireplace
E -mail: Range
C NTRACTOR Barbecue
Business name: Clothes dryer (gas
Other : tti c-I4. �in5n�cCf .'f. 4.1.5v /A5 .‘:•`"
Address: MECHANICAL PERMIT FEES *,
City /State /ZIP:
(\s, Subtotal - r
Minimum permit fee ($72.50) /A J ' 4 ,c
Phone:( ) Fax:( ) "- —
Plan review (25% of permit fee) _
CCB lic.: State surcharge (8% of permit fee) it, ,,,Cr
_ TOTAL PERMIT FEE /,� ^�'!'
�!I ��� y -�� /� This permit application expires if a permit is not obtained within 180
Authorized signature: G� �/ 1i days after it has been accepted as complete.
Print name: E /( Z,,, ,g6-7-,c( (L/r AWC77-(-7 Date: l e'/ � • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Pe /mits \MEC- PermitApp.doc 04 /06/06 440 -4617T(1I / / / / 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 $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\Buildin PermitApp.doc 12/30/05 2
CITY OF TIGARD -# t
BUILDING DIVISION
A PERMIT #: KiEC200&00519
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 10/25/2006
Phone: (503) 639-4171 I t 1 011104I ill`
Inspection Requests (24 Hrs.): (503) 639-4175 1.1. riEr eito 6 — 00 57 9
INSPECTION WORKSHEET FOR DATE: 12/19/2006 TIME: 7: 00AIVI PAGE: 31
SITE ADDRESS: 09984 SW GARRETI ST CLASS OF WORK:
SUBDIVISION: GREENBROOKE LOT #: 005 TYPE OF USE:
PROJECT NAME: MARGUTH
DESCRIPTION: Mechanical reconnect for (2) duplex units. _
OWNER: MARGUTH, VAL & LIZ PHONE #: 503_629_8169
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 12/19/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 041273-01 503-201-9720 Y •
Corrections/Comments/Instructions:
12) -r s-5 b yelce470AJ i$' 1-- c.. 9 q 496 K Z. V), 4-ppi./4-,L,C., ze
.--------'
ex ts77-4-,s 27 A.417 -- tz-vs,P,..1c.r)
fl PASS PARTIAL APPROVAL fl CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: . Date: if.-- / —.0 Phone #: (503) 718-
-c ;
CITY OF' JGARD ~.
BUILDING DIVISION PERMIT #: 0f
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10125/2006;
��'
Phone: (503) 639 -4171
A ��H iill
Inspection Requests (24 Hrs.): (503) 639 -4175 Afg-e01006 - oes7 9
INSPECTION WORKSHEET FOR DATE: 12/13/2006 TIME: 7 :04Am PAGE: 32
SITE ADDRESS: 099B4 SW CARREI 1 ST CLASS OF WORK:
SUBDIVISION: GREENBROOKE LOT #: 005 TYPE OF USE:
PROJECT NAME: hVMARCUTH
DESCRIPTION: Mechanical reconnect for (2) duplex units.
OWNER: MVMARGUTH, VAL & LIZ PHONE #: 503-629-8169
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 121.13/2066 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 041032-01 503- 201 -9720 Y
Corrections/Comments/Instructions:
4. 5 wvggi c- 7 it. if c /L- (l"w1-7 9 667_ CGS- c._r -
f
PS I I PARTIAL APPROVAL I I CANCEL n NO ACCESS
e LTFAIL I I ALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: /r7 Date: - -'/-3 —,-/- Phone #: (503) 718- Z¢-¢
CITY QE-*GARD
BUILDING DIVISION
, PERMIT #: MEC2006-00519
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/25/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ' 1 / ,2oo 6 — 0057 9
INSPECTION WORKSHEET FOR DATE: VP/2006 TIME: 6 58Atvi PAGE: 23
SITE ADDRESS: 09984 SW GARRETT ST CLASS OF WORK:
SUBDIVISION: GREENBROOKE LOT #: gas TYPE OF USE:
PROJECT NAME: MARGUTH
DESCRIPTION: Mechanical reconnect for (2) duplex units.
OWNER: MARGUTH, VAL & LIZ PHONE #: 503-629-8169
CONTRACTOR: ()INNER PHONE #:
Inspection Request Scheduled For: Date: 12/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 040553-01 503-201-9720
Corrections/Comments/Instructions:
4..44 6,, Co, L.
V65-1C' ere> i sry
fl PA pi PARTIAL APPROVAL pi CANCEL El NO ACCESS
FAIL El ALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: - Date: / Phone #: (503) 718-
_ . • _ , .
.
CITY OGARD ,
BUILDING DIVISION PERMIT #: MEC2006-00519
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/25/2006
Phone: (503) 639-4171 /11e00 — O 0-57 9
Inspection Reque 6 sts (24 Hrs.): (503) 639-4175 Atileliii
.4.5.W 1.1..
INSPECTION WORKSHEET FOR DATE: 11/30/2006 TIME: 7:00AM PAGE: 69
SITE ADDRESS: 09984 SW GARRETT ST CLASS OF WORK:
SUBDIVISION: GREENBROOKE LOT #: 005 TYPE OF USE:
PROJECT NAME: MARGUTH
DESCRIPTION: Mechanical reconnect for (2) duplex units.
OWNER: MARGUTH. VAL & LIZ PHONE #: 503_629.0169
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 11130/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 040455-01 503-201-9720 N
Corrections/Comments/Instructions:
I PASS El PARTIAL APPROVAL fl CANCEL NO ACCESS
FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: , 9`
Date: /1– 30 a e7 Phone #: (503) 718