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Permit CITY TIGARD MECHANICAL PERMIT C O DEVELOPMENT SERVICES PERMIT #: MEC2006 -00061 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/27/2006 PARCEL: 2S 103AA -01910 SITE ADDRESS: 12330 SW 106TH DR ZONING: R -4.5 SUBDIVISION: COTTONWOOD PLACE LOT: 019 JURISDICTION: TIG Project Description: Gas line vent for water heater & gas fireplace insert. 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: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: 2 FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 2 > 10000 cfm: Owner: FEES RICHARD PEARSON Description Date Amount 12330 SW 106TH DR TIGARD, OR 97223 [MECH] Permit Fee 1/27/200€ $72.50 [TAX] 8% State Surcha 1/27/200€ $5.80 • Total $78.30 Phone: 503- 620 -6384 Contractor: SUBURBAN @ HOME 6014 NE 112TH AVE. PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 257 -5438 FAX 503- 257 -5430 Reg #: LIC 143335 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: 1 ) rt Permittee Signature: %2-c --4 t- 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 A A • licatio FoirOFFICE USE ONLY City of Tigard rf. (_ h 17'F acervy �, D6 f. Permit No. /dal , / Date/By . Cil al I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1 �g e /1Nrr . • �" Date/By. Other Permit: Inspection Line: 503.639.4175 JA 2 7 2006 - , : ' if Vii' Y _ __ _ Daze iedJMetho Supplemental See Page for Internet: www.ci.tigard.or.us Notified/Method: Supplemental l Information CITY OF TIGARD ' BUtLiVi 1P QN COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees' are based on the value of the work El New construction EAddition/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 Value: $ /� RESIDENTIAL EQUIPMENT / SYSTEMS FEES* © I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi - family ❑ Master builder 1:1 Other: For special information use checklist. Description I Qty. I Ea. I Total . JOB SITE INFORMATION AND LOCATION Heating /cooling Job site address: Air conditioning or heat pump a . 6 s i'� � U� � �r (requires site plan showing placement) 14.00 City /State /ZIP: '1 g 4, Ad C, 47 j Z2 3 Furnace 100,000 BTU (ducts/vents) 14.00 , 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 >� i4./ , 4 `7 /-U tr r j ,, v 1 0 L f s` c di .7.? Unit heaters (fuel -type, not electric), ' II e A /6 _` 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 Gas fireplace j 10.00 , Cc, ..i h e < "Il gG' f L ,; ir.Ph e - f r 9- 4 -. Flue vent for water heater or gas fireplace '2 10.00 f t/ A e x_ '. k e"‹ Log lighter (gas) 10.00 (.. 4' /J' c ., -- G S` - , / P. c /� L sf e i sr .c ,e---, Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Ill PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: < <.> 4 crN 4 ,6 #S. Ys6 fi Environmental exhaust and ventilation � Range hood/other kitchen Address: ._,....1 4 _S `„.J 1 v G - -4 equipment 10.00 City /State /ZIP: j y∎ c , pi tJ ? 9 7.2 2 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (_S L_C) k 6 .. f )' l` 4/ Fax: ( ) toilet compartments, utility rooms) 6.80 , ❑ A PPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Business name: Other: 10.00 �� / . F. 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 CONTRACTOR . . • Barbecue �� � Clothes dryer (gas) Business name: S ( \)S .1y„i ,r° " s�'- 1 '- ". ''" " Other: Address: t� e) n 1 \ \)'''j t MECHANICAL PERMIT FEES* . City /State /ZIP: '""? \ 01 - (l 7 2 6 rat Phone: (J��` - o' Fax: ( °� ) Minimum permit fe $72.50) .) J .� Plan review (25% of permit tar CCB lic.: State surcharge (8% of permit fee) jy TOTAL PERMIT FEE Authorized signature: ' This permit application expires if a permit is not obtained wr in ISO ter= �,2�� _ 7 � days after it has been accepted as complete. ry Fee methodology set by Tri -Count Building Indus Print name: /� /C 4 ' a L ' =f p �` Cd A- . . Date: //�2,d� • gY Y y g try Service Board 1:\ Building \Penaits\MEC- PennitApp.doc 12103 440-4617T (1I /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: TotalValuation: Perniit 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:Building \Permits11v1EC- PermitApp.doc 12/03 2 •■•", OF BUILDING DIVISION " PERMIT #: MEC:2006-00061 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/27/2006 Phone: (503) 639-4171 0401101,6, Inspection Requests (24 Hrs.): (503) 639-4175 A- eh! INSPECTION WORKSHEET FOR DATE: 1/30/2006 TIME: 7:01AM PAGE: 54 SITE ADDRESS: 12330 SW 106TH DR CLASS OF WORK: SUBDIVISION: COTTONWOOD PLACE LOT #: 019 TYPE OF USE: • PROJECT NAME: PEARSON DESCRIPTION: Gas line vent for water heater & gas fireplace insert. OWNER: PEARSON, RICHARD PHONE #: 603.620,6304 . CONTRACTOR: SUBURBAN @HOME PHONE #: 503-257-6438 • Inspection Request Scheduled For: Date: 1/30/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 026941-01 603-620•6784 Corrections/Comments/Instructions: 42) /Vor' --K I I PASS n PARTIAL APPROVAL • fl CANCEL El NO ACCESS RI AIL ri CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: . Date: / — Ye 2--- e%'' Phone #: (503) 718- CITY OF TIGARD .,.- . • , BUILDING DIVISION " " - At,„\ PERMIT #: NIFC2006.00061 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/27/2006 Phone: (503) 639-4171 e11491,111 Inspection Requests (24 Hrs.): (503) 639-4175 AA 6 !- 1 --. INSPECTION WORKSHEET FOR DATE: 2/10/2006 TIME: 7:04AM PAGE: 21 SITE ADDRESS: 12330 SW 106TH DR CLASS OF WORK: SUBDIVISION: COTTONWOOD PLACE LOT #: gig TYPE OF USE: PROJECT NAME: PEARSON DESCRIPTION: Gas line '- vent for water heaterlt gas fireplace insert. OWNER: PEARSON, RICHARD PHONE #: 603-620-63m CONTRACTOR: SLIBURf3AN @HOME V PHONE #: 503-257-5438 Inspection Request Scheduled For: Date: 2/10/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 026681-01 . 503-620-6784 N Corrections/Comments/Instructions: K PASS Fl PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS FAIL 7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED ..4.1 Inspector: Date: S t 0 ° 6 Phone #: (503) 718 _ ._ _......._ ' CITY OF TIGARD BUILDING DIVISION - PERMIT #: MEC2006-00061 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/370)(3 Phone: (503) 639-4171 a$00 Inspection Requests (24 Hrs.): (503) 639-4175 A- AL INSPECTION WORKSHEET FOR DATE: 2/3/2006 TIME: 7:02AM PAGE: 8 SITE ADDRESS: 12330 SW 106TH DR CLASS OF WORK: SUBDIVISION: COTTONWOOD PLACE LOT #: 019 TYPE OF USE: PROJECT NAME: PEARSON DESCRIPTION: Gas line, vent for water heater & gas fireplace .. sett. OWNER: PEARSON RICHARD , PHONE #: 603.620-6384 CONTRACTOR: SUBUFR BAN (a) HOME PHONE #: 603.267-6438 Inspection Request Scheduled For: Date: 2/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 026261-01 503-620-6784 N Corrections/Comments/Instructions: . . 4- 6- ---- /e) 5 di 7 R-i----p7.,z16c..c..2 -- ,-, 607-74te.4. d a--Y 2 C - / , t r m i,I, 4 9 e 61 /11,..€e,i,7 r .:ez_e 6..//4-al lw__-e k A PASS 0 PARTIAL APPROVAL 0 CANCEL El NO ACCESS 0 FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: Ohr 9 Date: --07e76 Phone #: (503) 718-