Permit v .
CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2006 -00032
��' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/18/2006
PARCEL: 2S1 10 BA -00 390
SITE ADDRESS: 14040 SW 117TH AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Install gas piping for furnace, water heater, barbeque.
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: 3
Owner: FEES
JAMSHED, SINA Description Date Amount
14040 SW 117TH AVE [MECH] Permit Fee 1/18/200€ $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 1/18/200€ $5.80
Phone: 503 - 590 - 6792 Total $78.30
Contractor:
NATURAL GAS CUSTOM PIPING INC
4450 NE SUMNER REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97218
Contact #: PRI 503 335 - 9950
FAX 503 335 - 9950
Reg #: LIC 125031
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 _.� j Permittee Signature: ,,,, r ` ,< .
Call 503 - 639 -4175 by 7:00 a.m. for inspections that busin 1 day.
This permit card shall be kept in a conspicuous place on the job site until «i mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
Meehan cal Permit Application FOR OFFICE USE ONLY
City of Tigard Date/By / /2 O a, Permit No.: He io ,- "
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JJ 'my. t ''�jr S I " "� Date/By Other Permit:
Inspection Line: 503.639.4175 J� 1, e�I l Date Ready/By: ® El See Page 2 for
Internet: www.ci.tigard.or.us g - J Notified/Method: ' ��} Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El New construction El Addition /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: $
❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT !SYSTEMS FEES*
El ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: /e.: C7� / ( 'l Air conditioning or heat pump
5 Ltd J Y (requires site plan showing placement) 14.00
City /State /ZIP: Ay j� 0 g 7 ,Z Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite /bldg. /apt. no.: Project name: E i It., 14 , A wt 5 1 t e 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
Gas fireplace 10.00
G ' t Y1 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. S 1 11 C� / ( 3 0,.. WI S ti el Environmental exhaust and ventilation
,, 1 � Range hood/other kitchen
Address:
/6/7'1/ 1 (,3 .3 5 t•J rs f i 11 1,7 equipment 10.00
City /State /ZIP: e et , o K 9 7 zz - / Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone:
( 5 0 3 ) 5 — e 7 70 Fax: ( ) toilet compartments, utility rooms) 6.80
• ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 1 0.00
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 I
Fireplace
E -mail:
Range
CONTRACTOR Barbecue I
Clothes dryer (gas)
•
Business name: A/ G C 7 T NC_
Other:
Address: 4/ G, 6 0 A I F 5 Lk m Yl r.-✓ MECHANICAL PERMIT FEES*
City /State /ZIP: p \- 1 d\ o g g 7 2' i Subtotal Q
Phone: ( o3) 3 3 - - 9 -- (3 Fax: ( ) Minimum permit fee ($72.50) r? S �
5 Plan review (25% of permit fee)
CCB lie.: AZ State surcharge (8% of permit fee) tj ge
TOTAL PERMIT FEE _7s- , 5
Authorized signature: 441---1..1 This permit application expires if a permit is not obtained within 180
't days after it has been accepted as complete.
Print name: S' 14 Y ig f A j 9A15 5 ; Date: i// 7 / O t < * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits\MEC- PermitApp.doc 12/03 440 -4617T (I I /07JCOM/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.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00032
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1812008
Phone: (503) 639 -4171 I�l
a
Inspection Requests (24 Hrs.): (503) 639 -4175 ��
INSPECTION WORKSHEET FOR DATE: 10/1012006 TIME: 7 :06AM PAGE: 7
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JANISHED
DESCRIPTION: Install gas piping for furnace, water heater, barbeque,
OWNER: JAIVISHED, SINA PHONE #: 503. 590.6792 •
CONTRACTOR: NATURAL GAS CUSTOM PIPING INC PHONE #: 5503 - 33,
• Inspection Request Scheduled For: Date: 10/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 037960-03 971 -732 -0712 N
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: AP Date: /VOX" Phone #: (503) 718197
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CITY OF TIGARD �� � &�
BUILDING DIVISION PERMIT #: MEC2006.00032
13125 SW Hall Blvd., Tigard, OR 97223 ,_ DATE ISSUED: 111812006
Phone: (503) 639 -4171 /o u,7 1yI
Inspection Requests (24 Hrs.): (503) 639 -4175 .... „W
INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7 :03AIVl PAGE: 16
SITE ADDRESS: 1 (W0 SW 117TH i7T AVE � !!JT � CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: Install gas piping for furnace, water heater, barbeque.
OWNER: JAMSHED, SINA, PHONE #: 503 - 90 -6792
CONTRACTOR: NATURAL GAS CUSTOM PIPING INC PHONE #: 5O3 -335 -99 ()
Inspection Request Scheduled For: Date: 1/19/20% Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 t.: as line 025288-01 503-380-3778 Y .Ntlit, Ca
-r t 1t)17f .
Corrections/Comments/Instructions:
(r PASS I 1 PARTIAL APPROVAL ❑ CANCEL 1 1 NO ACCESS
❑ FAIL I I CALL FOR INSPECTION 1=1 ADDITION , L FEES ASSESSED
s ,
' / 2:7o Inspector: Date: J - Phone #: (503) 718- 2:7o-k)