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I CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00002
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/2/2007
PARCEL: 2S103BB -02000
SITE ADDRESS: 12285 SW 124TH AVE ZONING: R -4.5
SUBDIVISION: BROOKWAY LOT: 020 JURISDICTION: TIG
Project Description: Gas piping to range.
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:
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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
PETE GILL Description Date Amount
12285 SW 124TH
TIGARD, OR 97223 [MECH] Permit Fee 1/2/2007 $72.50
[TAX] 8% State Surcha 1/2/2007 $5.80
Total $78.30
Phone: 503 -590 -3135
Contractor:
HOLMES INSTALLATION SERVICE
33535 NW VADIS ROAD
CORNELIUS, OR 97113 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 267 -7974
Reg #: LIC 102473
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: Permittee Signature: )
Call 503.639.4175 by 7:00 a.m. for inspections that b mess 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 _ Aa P -
4 pl .icat><,a - FOR OFFICE USE ONLY ♦ Ny CI '! L' r
{ ..
•. �.:v f � �� Received C
City of Tigard D�e/By j - G 7 Z Permit No: • 7 iii 7
14 .
13125 SW Hall Blvd., Tigard, OR 97223 - 2 2007 Plan Review
. ® Phone: 503.639.4171 Fax: 503.598.1960 A N Date/By. Other Permit:
T I GA R D Inspection Line: 503.639.4175 F , ,. t Ready/By: g
Internet: www.ti and -or. ov
CITY 1 IL �' �rt� Date Supplemental See Page l for
g g t� Notified/Method: Supplemental Information
BUILDING TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
1:1 New construction ddition/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 CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT, /SYSTEMS FEES* -
- 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
' * ' '°. .,2 J OB S ITE 'INFORMATION' AND LOCATION Heating /cooling
Job site address: ' Z a t 7 SW /z t(4- L i;11-. Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: 17- T - `9 c. I. I> 0 y`_ q 7'7 r3 Furnace 100,000 BTU (ducts/vents) 14.00
t Furnace 100,000+ BTU (duds/vents) 17.90
Suite/bldg. /apt. no.: I 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
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
• Tax map /parcel no.: Other fuel appliances
. . -, DESCRIPTION OF WORK . - . , . Water heater 10.00
ep,-n�
Gas fireplace 10.00
T/J5.Yealkl i q S Q ( l /L C / 4. 5 Q A--,..., Flue vent for water heater or gas
// / l! fireplace 10.00
Log lighter (gas) 10.00
. Wood /pellet stove 10.00
. Wood fireplace /insert 10.00
.ROPERTY ; OWNER . ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: t \ Environmental exhaust and ventilation
Address: t 7 2 8 5 1i ,j /2_ 1( .L_ Range hood/other kitchen
equipment 10.00
City /State /ZIP: 1 4 % ,,P,..... .7 l Single -duct exhaust (bathrooms, 10.00
Phon ) t 4 0 3 / J� Fax: ( ) 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: I
Range
. CONTRACTOR . , Barbecue
Business name: 4 vnPs' MA/
VA-0/5 . (1 5'� Clothes dryer (gas)
re 7 7-1 ' " " � Other:
Address: MECHANICAL PERMIT 'FEES*
City /State /ZIP: ''4/1 ,4c ' t v S d (/�- „ LT 70 ) Subtotal
• Phone: Minimum permit fee ($72.50)
3 ) 21„ .7 7 F ax:( )
Plan review (25% of permit fee)
CCB lic.: t 0 2 , 7 3 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized si ature: � This permit a pplication expires if a permit is not obtained within 180
;j j days after it has been accepted as complete.
Print name: �(A 7 1 - ay �n , Date: t/1_10 7 * Fee methodology set by Tri- County Building Industry Service Board
. I:\ Building\ Penni ts\MEC- Permit4pp.doc 04/06/06 440 -461 / 7T(I I /07/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
• Total Valuation:: • ,. Permit Fee:.. n
$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 ' . C . .
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. •
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L:\Building\Permits\MEC- PermitApp.doc 12/30/05 2 .1
CITY Of TIGARD , , -
BUILDING DIVISION
114W PERMIT #: MEC2007-00002
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1,12/7001
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 113/2007 TIME: 7 PAGE: 6
SITE ADDRESS: 12285 SW 124TH AVE CLASS OF WORK:
SUBDIVISION: BROOKWAY LOT #: 020 TYPE OF USE:
PROJECT NAME: GILL
DESCRIPTION: Gas piping to range.
OWNER: GILL, PETE PHONE #: 503.590-3135
CONTRACTOR: HOLMES INSTALLATION SERVICE PHONE #: 503-267-7974
Inspection Request Scheduled For: Date: 11312007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
$99 Mechanical final " 041753-01 503-590-3135
As
CO rrections/Comments/Instructions:
aekt. L /7.!.-0;z-, / Pec.q r■_)
PASS I PARTIAL APPROVAL pi CANCEL fl NO ACCESS
pt. FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: / - 6 2 Phone #: (503) 718- 2--q-cke
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00002
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/212007
Phone: (503) 639 -4171 p "bgiii"
Inspection Requests (24 Hrs.): (503) 639 -4175 ALL
INSPECTION WORKSHEET FOR DATE: 1/12/2007 TIME: 7 :04AM PAGE: 25
SITE ADDRESS: 12285 SW 124TH AVE CLASS OF WORK:
SUBDIVISION: 13' OOKWAY LOT #: 020 TYPE OF USE:
PROJECT NAME: GILL.
DESCRIPTION: Gas piping to range,
OWNER: GILL, PETE PHONE #: 503 -500 -3135
CONTRACTOR: HOLMES INSTALLATION SERVICE PHONE #: • 503 -267 -7974
Inspection Request Scheduled For: Date: •l/ l2J2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
599 Mechanical final 042082 -01 503 -590 -3135
Corrections /Comments /Instructions:
ASS 111 PARTIAL APPROVAL CANCEL 0 NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: / —L a - Phone #: (503) 718 - Z.-5—