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Permit C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2003 -00599 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/14/03 PARCEL: 2S 102CC -02600 SITE ADDRESS: 13885 SW 102ND AVE SUBDIVISION: FRELEON HEIGHTS NO.2 ZONING: R -3.5 BLOCK: LOT: 012 JURISDICTION: TIG 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: LPG 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: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Replace oil furnace with natural gas furnace. Owner: FEES GILL, EDWARD W. Description Date Amount 13885 SW 102ND AVE TIGARD, OR 97223 [MECH] Permit Fee 10/14/03 $72.50 [TAX] 8% StateTax 10/14/03 $5.80 Phone: 503 849 - 5244 Total $78.30 Contractor: OWNER REQUIRED INSPECTIONS Phone: Heating Unt Insp Final Inspection 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 -00 Issued By: . , / / r ,ch Permittee Signatur • Call (503) 639 -4175 by 7:00 P.M. for inspections eeded the next business day FOR OFFICE I ONLY Mechanical Permit Application Received Q Mechanical R E C E I Date/By: i O / l � / 0 . 7 . J P e r m i t No. � vt� 073 — e tJ 59 Clt of TI and D Planning Ap roval Building y g Date /By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 OCT 14 103 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post- Review Land Use / / " b I l Date /By: Case No.: Internet: www.ci.tigard.or.us CITY OF T,__ I i Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503 -6fttlaiNG I i" 0 1 ° Name/Method: - t1C \ Supplemental Information. TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work ❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit. ig i & 2 Family dwelling ❑ Commercial /Industrial Value: $ See Page 2 for Fee Schedule ❑ Accessory Building El Multi Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE Description I Qty 1 Fee(ea.) Total ❑ Master Builder ❑ Other: Heating/Cooling JOB SITE INFORMATION and LOCATION t Fu - add -on air conditioning ** 14.00 Job site address: /,3 �'gs C > 6 ` � Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 Project Name: Hydronic hot water system 14.00 Residential boiler Cross street/Directions to job site: (for radiator or hydronic system) 14.00 Unit heaters (fuel, not electric) (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) 10.00 Subdivision: Lot #: Repair units 12.15 Other Fuel Ap ■ liances Tax map /parcel #: Water heater 10.00 DESCRIPTION OF WORK Gas fireplace 10.00 PU LL ©u - 1- Olt Olt 7-7/k10/1C.-E-- Flue vent (water heater /gas fireplace) 10.00 Log lighter (gas) 10.00 7 A/677 � 4 � ..611/—J---' Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 OPERTY OWNER I ❑ TENANT Other: 10.00 Name: a / � / / 7 Environmental Exhaust & Ventilation / A ( p � � l /� ( / Range hood/other kitchen equipment ' 10.00 Address: / ?qv J G0 , OG2 Clothes dryer exhaust 10.00 City /State /Zip: - "c0/41.- oy 9 7.2075 Single � /r J � (( b gle duct exhaust p Phone: � F (bathrooms, toilet compartments, ❑ APPLICANT 0 CONTACT PERSON utility rooms) 6.80 Name: Attic /crawl space fans 10.00 Address: Other: 10.00 Fuel Piping City /State /Zip: * *($5.40 for first 4, $1.00 each additional) Phone: I Fax: Furnace, etc. ** Gas heat pump ** E -mail: Wall /suspended/unit heater ** CONTRACTOR Water heater ** Business Name: 0/.0111E19 Fireplace ** Address: Range ** BBQ City/State/Zip: y h• C Clothes dryer (gas) ** Phone: j Fax: i Other: ** CCB Lic. # ", • Total: Authorized �� / / Mechanical Permit Fees* gn !� /� � ����� Subtotal: $ Si atur / a .t e: 03 Minimum Permit Fee $72.50 $ 7 . Plan Review Fee (25% of Permit Fee) $ � (Please print name) State Surcharge (8% of Permit Fee) $ TOTAL PERMIT FEE $ 7 X, 30 Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 • 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. $100,001.00 and up $1 ,396.50 for the first $100,000.000 and $1.10 for each additional $100.00 or fraction thereof. All New Commercial Buildings require 2 sets of plans. is \Building \Permit Forms \MecPermitAppPg2 09- 01- 03.doc • CITY OFTIGARD 24 -Hour BUILDING. Inspection Line: (503) 639 -4175 INSPECTION DIVISION • Business Line: (503) 639 -4171 MST BUP Received Date Requested / D — 3 - 7 AM PM BUP Location / 3$8'S /Oc nd Ave. Suite ar, 3 — O a599 Contact Person edwvrr-a0 Ph ( ) R'49 — E0-4 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner IV 3 J - 0 0 3 Footing Foundation ELC Ftg Drain Access: Vim t ` ^L i"' v) -gyp ELR Crawl Drain ` Slab Inspection Notes: nr SIT Post & Beam rfec,�' CA-el /A O �^'� 6.e Shear Anchors II Ext Sheath/Shear n v'V'S 44 S► L'o �S 7 r ems' ci4- -5"4.e • Int Sheath/Shear Framing 4 .i G✓+'rl.a._ GP-_ / L Insulation Drywall Nailing Firewall C r?\) Fire Sprinkler Fire Alarm � S ' � t A.c. -'/P--- Susp'd Ceiling Roof 1 S� Gai,V J7 G3 ) 4.7 Slo 75 Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P4. FAIL 1WHANICALI Post & Beam Rouqh -In SmSm = pers Ina PART FAIL ;,ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date /4 0 7 - 4 3 Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL