Permit n
f {, CITY OF TIGARD
, MECHANICAL PERMIT
� COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00092
TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/21/2008
sRD PARCEL: 1 S133CD - 01000
SITE ADDRESS: 11748 SW SWENDON LP ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS LOT: 008 JURISDICTION: TIG
PROJECT: GOODPASTURE
Project Description: Gas line for new range.
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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTYERS:
FURN < 100K BTU: AIR HANDLING UNITS CUD DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
GABBY GOODPASTURE Description Date Amount
11748 SW SWENDON LOOP
TIGARD, OR 97223 [TAX] 12% State Surch 2121/200E $8.70
[MECH] Permit Fee 21211200E $72.50
Total $81.20
Phone: 503 - 590 -7154
Contractor:
DEPENDABLE HEATING & COOLING INC
12704 SE POWELL BLVD
PORTLAND, OR 97236 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -421 -8926
FAX 503 -771 -5823
Reg #: LIC 157120
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.
f � „,,,,, e Issu �f ey: _ � .�,1 i1L2 Permittee Signature -
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.
Mechanical Permit Application � '` '� ,,..,,.,,,...,0- R ILE USE O NLY ` " # � ' _
P2 Cit of Tigard Received r D � Permit No.: / / GC' s -G ds
il h
t p Date/By: n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
� Date/By:
T I t GA R D Inspection Line: 503.639 Date Ready /By: to i la • See Page 2 for
. ,:;_;'.: Internet: www.tigard - or.gov Notified/Method: Supplemental Information
° TYPE OF WORK COMMERCIAL FEE* SCHEDULE..= USE CHECKLLST'
❑ New construction 0 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.
' C ATEGORY OF CONSTRUCTION. Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
N 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB' SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / / 7 / g 5t) 5 . en Air conditioning or heat pump
�DYI L � (requires site plan showing placement) 14.00
City/State/ZIP: -C-1 Furnace 100,000 BTU (ducts /vents) 14.00
" / Ga t �� p p Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: OD u p -- �'C____
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK .. Water heater 10.00
A Gas fireplace 10.00
lidd . 8 ni 5 (/ . / /� 4-2- go,-..0 , Flue vent for water heater or gas
fireplace 10.00
•
Log lighter (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: C .p,,, b b Y use.() r 5 rut y , e Environmental exhaust and ventilation
•� -A p Range hood/other kitchen
Address:
--7/./ 7 .5. L,j ,5 i r° n tX or, G / equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
! Y or Py D Y� Single -duct exhaust (bathrooms,
Phone: (5'v3) 5 ` 7/5# 503 ) rl(p - 6 03 5 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; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range x
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: ) of J / / z 7 0,...) 4 L+ h � t f C Other:
Address: a /a 764/ 5E f„,,,, z_[, R Lwf\ MECHANICAL PERMIT FEES* -
City /State /ZIP: (J�, �� _�l y 0,--- ?7,2.30 Subtotal
f �c Minimum permit fee ($72.50) j9., ,J
Phone: ( 5c-3) '/21 _ y92 l P Fax: (503) 77) - S 1;223 Plan review (25% of permit fee)
• CCB lic.: /5 _ 7/ 2 0 / O // 8' /Q State surcharge (12% of permit fee) 70
((( /// / r TOTAL PERMIT FEE ' / .
Authorized si nature: �� l � This permit application expires if a permit is not obtain within 180
g � g�� days after it has been accepted as complete.
Print name: t j y-Qd a c , Date: - / - o S * Fee methodology set by Tri- County Building Industry Service Board
1: \ Building \ Permits MEC•Permit App .doc 01/19/07 440 -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.
1:\ Building \Permits\MEC - PermitApp.doc 01/19/07 2
•
• CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200B-00092
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/21/2008
Phone: (503) 639-41.71 Pak,
Inspection Requests (24 Hrs.): (503) 639-4175 /ICC AV 0? - 6
INSPECTION WORKSHEET FOR DATE: 2/22/2008 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 11748 SW SWENDON LP CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 008 TYPE OF USE:
PROJECT NAME: GOODPASTURE
DESCRIPTION: Gas line for new range,
OWNER: GOODPASTURE, GABBY PHONE #: 603-6904154
CONTRACTOR: DEPENDABLE HEATING & COOLING INC PHONE #: 603421-8926
Inspection Request Scheduled For: Date: 2/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6W Gas line
065186401 603A21-8926
_ — -
Corrections/Comments/Instructions:
bLe. E • 0 4 5cg--zo-A_./
afr 1 Q9 A
•
s El PARTIAL APPROVAL CANCEL 0 NO ACCESS
n FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: )5 Date: 2 -2 2 - 6 6 Phone #: (503) 718-