Permit •
'CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00254
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/20/2008
PARCEL: 1 S134BD -11100
SITE ADDRESS: 10957 SW 118TH CT ZONING: R -4.5
SUBDIVISION: PENN LAWN ESTATES NO.2 LOT: 039 JURISDICTION: TIG
PROJECT: BROKKE
Project Description: Installing furnace.
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:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
•
GAS OUTLETS:
Owner: FEES
CHRIS BROKKE Description Date Amount
10957 SW 118TH CT
TIGARD, OR 97223 [MECH] Permit Fee 51201200E $72.50
[TAX] 12% State Surch 5/20/200E $8.70
Total $81.20
Phone: 503- 435 -7252
Contractor:
ROSE CITY REFREIGERATION
PO BOX 19207
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 636 -5371
FAX 503- 655 -4669
Reg #: LIC 161325
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.
n
Issued By: ` Permittee Signature: �G / / 17
Call 503.6 .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.
May 19 08 01:07p Rose City Heating & Air 503- 655 -4669 p.1
1ll �1 n E1VE echnica� Permit Appl � FOR OFFICE USE ONLY- ' ,
City of Tigard Received
- 2008 Daten3y: (S o b 'ermit No.:
q 13125 SW Hall Blvd., Tigard, OR 972PAY 1 9 2008 Plan Review rri �.��� �
Phone: 503.639.4171 Fuse 503.598.1960 Date :By: Other Permit:
TIGARD Inspection Line: 503.639.4175 ii4 r �� y 'Date [Zc .d Al lurix.
�Y 1 U OF e �17ftl1f t�J Y} 0 See Petal Information
Internet: tvww.li�tfd or. Votified1vtcthod: Supplemental Information
BUILD NG DIVISION pp
TYPE OF WORK COMMERCIAL FEE* SCHEDULE -- USE CHECKLIST
['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.
CATEGORY OF CONST'RUCFION Value: S
gi Commercial/industrial building
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
I_ and 2- family dwetling
❑ ❑ Acce ssory buildin
for special information use checklist.
❑ Multi ❑ Master builder ❑ Other:
Description Qty, Ea. Total
JOB SITE INFORMATION AND LOCATION Ileatinglcooling
Job site address: Air conditioning or heat pump
� 0 95 7 SW / I -e, (_), t (requires site pl,ti showing placement) 14.00
City/Stale' /1P: -T� - �, ��y d 2 (I 7 � , Furnace 11)0,000 BTU (duc:s.bents) / 14.01) / y� a f ! Furnace 100,0001- BTU (dectshv:nts) 1 7.00
Suiterbldg ./apt. no.: Project name: i 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
link heaters (fuel -type, not electric).
in -wall, in -duct, suspended, eta 14.00
Subdivision: Flue /vent for any of above 6.80
Lot no.:
Other: 10.00
Tax map /parcel no.: /5 / 39 63 D 1,7 D 0 Other fuel appliances '
DESCRIPTION OF WORK
heater 10.00
IT/7 s &G // 9 C Vo Gas fireplace 10 -00
7 Ur'/!�L � Flue veto for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10,00
Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00 / 0. [is
❑ PROPERTY OWNER 0 TENANT
Other: 10.00
Name: G/4 ris , et - ck,st c Environmental exhaust and ventilation
Address: Range hood/other kitchen
▪ S S W N g GO % equipment 10.00
CihdState. +LI Gs,_,/ Gi( 9 7Z 3 Clothes dryer exhaust , 10.00
Single -duct exhaust (bathroom
Phone: ( S - • O _§ g...33---.... 7 ZS-2 Fax: ( ) toilet compartments. utility rooms) 0.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace tans 10.00
Business name:
Other: I O.UC
Fuel piping
Contact name: S5.40 for first four; $1.00 for each addition!'
Address: Furnace etc. _ I g,-.5"°
Gas heat pump
Cih' ?Stag' /.IP: \b'all suspcndcd/ unit heater
Phone: ( ) Fax: : ( ) Water heater
E-mail: - Fireplace
Range /
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
osC G:e emu,e 0 fi
r y Other. �
Address. ,P / 207 MECHANICAL PERMIT FEES*
City/State/ZIP / o 9 . 7283 Subtotal
Minimum permit ice ($72.50) 72.5
Phone: So3) 6s _ s 3 7/ F (- a 5y 6,5 x'66 67 Plan review (25% of permit fee)
CCH lie.: /6/J25 f � — State surcharge (12% of permit fee) g / 7U
TOTAL PERMIT FEE 8' /., 2 0
� ' - -- -' -" This permit application expires if a permit is nut obtained within t10
Authorized signature: /// days after It has been accepted as complete.
PT int name: ft/ A,v 68 0 ,J , Da(e: S"/ / A- q • her methodology set by Tri- County Building Industry Sarrioc Board
1sLbukhn gl'euut6 Permitlpp.dec 01: // ■ 9,0' ' 440 -461TT ; 11t02iCOt4JWF13)
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008.C)0264
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/20/2008
Phone: (503) 639- 4171�w4 @�N�°
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:01AM PAGE: 50
SITE ADDRESS: 10957 SW 118TH CT CLASS OF WORK:
SUBDIVISION: PENN LAWN ESTATES NO.2 LOT #: 039 TYPE OF USE:
PROJECT NAME: BROKKE
DESCRIPTION: Installing furnace.
OWNER: BROKKE, CHRIS PHONE #: 503.135- 7252
CONTRACTOR: ROSE CITY REFREIGERATION PHONE #: 503- 636 -5371
Inspection Request Scheduled For: Date: 6/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 Mechanical final 070919 -01 503-636-5371 Y
Corrections /Comments /Instructions:
6Z-..<67 C4 - /A 157 7 L 3 '6ir.9>- i 4'
ACo
ASS U PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL I. CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
"/
Inspector: Date: —6--6A Phone #: (503).718- ?4•