Permit . J r
rtITY OF TIGARD MECHANICAL PERMIT
�� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00462
"� '' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/29/2005
PARCEL: 2S104DD -04400
SITE ADDRESS: 13531 SW AERIE DR ZONING: R -4.5
SUBDIVISION: EAGLE POINTE LOT: 035 JURISDICTION: TIG
Project Description: Extension of gas line to BBQ.
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:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
BERG, APRIL D + BRUCE M Description Date Amount
13531 SW AERIE DR
TIGARD, OR 97224 [MECH] Permit Fee 7/29/200E $72.50
[TAX] 8% State Surcha 7/29/200E $5.80
Total $78.30
Phone: 503- 802 -6620
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED ITEMS AND REPORTS
Phone: 503- 331 -0234
Reg #: LIC 40981
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: ! .. Ae7
Call 503 - 639 -4175 by 7:00 a.m. for inspections that busine- 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 Application . . , _ . FOR OFFICE USE ONLY
City of Tigard_ -- ' Received ....7 _49 ......
Date/By: / ac--- Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' i A■ Date/By: Other Permit:
Inspection Line: 503.639.4175 l eli i , Date Ready/By. WI 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
AMMON fela illirtli* :1 . ! :0 : , - * 14 . 4 04AW 6 4:04C - 4, 0 * 1 040:4 1 #i
0 New construction Z 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
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: S
rantrir SIWA 9 l' ,,,,,,
00:
0 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder • 0 Other: Description Qty. Ea. Total
,I IP*iii - WiffIriMbliwiatiogrA iaigiafloW:latefAR ::: A
4 - 4 : ,,,,.., , .:.:*,,,...„, , . ..,„,... .„ .„ . .. ..„ -, .:„ 4 , -4 ,4, Heating/cooling
Air conditioning or heat pump
Job site address: /3 5 3 / 5-6,./ /4e.-''e D,.... (requires site plan showing placement) 14.00
City/State/ZIP: 7 a ,„4, 0/ e ?72_2,-.3 Furnace 100,000 BTU (ducts/vents) 14.00
Fumace 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
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 I
Tax map/parcel no.: Other fuel appliances
*11;iliiiiti*Ii*,..,,I0 w ater heater .10.00
Gas fireplace ' 10.00
,EX le,i , 6, a ak,-, / 74r / .A-- 6 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
, ,,,,,,, Chimney/liner/flue/vent 10.00
iitc OWNER AFf;M-' iffMliirF?"gArgii ; N '„ s. .,-,
6„.4,.„, .,: :': ''' A54,,,,,,,,,,,,,, ,,;44F
Name: A / /3,... ...,.._, Environmental exhaust and ventilation
Range hood/other kitchen
Address: /,'"? c13/ S‘../ de,-;e ,/9,- equipment 10.00
City/State/ZIP: 7- - ,- , ,, L _ ,„ 1 2- -2■--7 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ($,3 ) 8 6 Fax: ( ) toilet compartments, utility moms) 6.80
tilki:p;
APPLICANT 41 f'00, Attic/crawlspace fans 10.00
Other
10.00
Business name: 64/4_0 ( Fuel piping
Contact name: 114z, e.i4.././ $5.40 for first four; $1.00 for each additional
Fumace, etc.
Address: / 2 0 21 A/,e 4 1 - v 8 y -
Gas heat pump
City/State/ZIP: ,.._//, i / 7/ .972 2- Wall/suspended/unit heater
Phone: ($03 ) 33y - 2y7v Fax: : (S ) 33/ — C70 7 Water heater
Fireplace
E- mail:.' io 0 ,. 4:, ,,, )„,,,,,,
ma,,IRf.,; CO Barbecue / .S
Clothes Myer (gas)
Business name: /
./ Clothes e.c.,,,,T6'.17 - Other:
Address: /2.-0 2,4' /k/F A % A'"1/ C- 0,i
City/State/ZIP: f Oie 7 Z z) OW
Minimum permit fee ($72.50) - 7 . k _..C-
Phone: ( ) 33/— 279' Fax: Cc ) 33 /- 6 9 ....
Plan review (25% of permit fee)
CCB lic.: ?C) .9'6?/ State surcharge (8% of permit fee)
.. TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: / ' Date: 7/24/05 * Fee methodology set by Tri-County Building Industry Service Board
7 Y` 6
iAlluildmePermits\MEC-PermitApp.doc 12/03 440-4617T (11/02/COM/WEB)
CITY OF TIGARD
BUILDINGDIASION PERMIT #: NiEG2005 00 62
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/29/2005
Phone: (503) 639 -4171
i O,u��, f
Inspection Requests (24 Hrs.): (503) 639 -4175 _�� ;_...
INSPECTION WORKSHEET FOR DATE: 8/1/2005 TIME: 7:05AM PAGE: 18
SITE ADDRESS: 13531 SW AERIE DR CLASS OF WORK:
SUBDIVISION: EAGLE POINTE LOT #: 035 TYPE OF USE:
PROJECT NAME: BERG
DESCRIPTION: Extension of gas line to BBO.
OWNER: BERG, APRIL D + BRUCE M, PHONE #: 503 - 802 -6620
CONTRACTOR: MCKINSTRY CO PHONE #: 503- 331 -0234
Inspection Request Scheduled For: Date: 8/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
510 Gas line 012550 -02 503-793 -8933 Y
97
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: /— � C � Phone #: (503) 718-