Permit " OP p.
CITY OF TIG'
IGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00553
.f� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/7/2005
PARCEL: 2S111 DB -05500
SITE ADDRESS: 15390 SW ALDERBROOK CT ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT: 405 JURISDICTION: TIG
Project Description: Reconnect furnace and water heater.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
•
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
JACK SMITH Description Date Amount
15390 SW ALDERBROOK CT [MECH] Permit Fee 9/7/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 9/7/2005 $5.80
Phone: 503- 620 -9519 Total $78.30
Contractor:
PIONEER GAS FURNACE
3615 NE BROADWAY REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97232
Phone: 503 - 249 - 5000
Reg #: LIC 36102
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- - : a .
Issue B y: _ _ 4 / Permittee Signature. i 1 �! ;;
I .
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.
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'- .. Mechanical Permit Applie-: ' j.
. • :.:,_,, EIVED
,r,„„,,,..,.,,. ii ,,,:.,,,, N_
Received a
City of Tigard ' ff A ' M
Permit Noll
13125 SW Hall Blvd., Tigard, OR 97223 SEP 06 . "i 05 Date/By: V
Plan Review
- Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
, Date/By:
, =
..:Inspection Line: 503.639.4175 (WY Oft ":„. 'I j,, Date Ready/By: MI 61 See Page 2 for
Internet: wvAv.ci.tigard.or.us Notified/Method: Supplemental Information
PLANNINIVENGNEERING
.
, TYPE OF 'WORK -- — ' n ligERREFIL - a 3
COMMERCIAL . F,EES014.90._E"i', 1 -7 : . .., ,C
„_,,,,,6,,
Mechanical permit fees* are based on the value of the work
:ID New construction 13 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
▪ 0 Demolition . 0 Other: mechanical materials, equipment, labor, overhead, and profit.
gmtAit41 g,;0A9170kir OF CONSTRUCTION Value: $
• RESTRENtiA 4
[AA- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
-;. • El .Mti ily
lti-fam 0 Master builder 0 Other:
.', •-• Description I Qty. I Ea. I Total
. ::•", S ITE AND LOCATION Heating/cooling
..:,''. - Air conditioning or heat pump
Job site address: 1 530 0 5 Li p Akest,e,69, �M_ c_i- (requires site plan showing placernent) 14.00
. Furnace 100,000 BTU (dacts/vents) 14.00
, - City/State/ZIP: -V- cpc I De __ c.
n o
Fumace 100,000+ BTU (ducts/vents) t, 17.90 C
Suite/bIdg./apt. no.: Project name:
Gas heat pump 14.00
- . Cross street/directions to job site: Duct work 14.00
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• 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
cs
DESCRIPTION OF WORK Water heater I 1000 ID cii
.. . f24eZnAQe-+ water. or gas
Cli, • _ #. N .5 . . ..._ ,......, , 1,1:Al Gas fireplace nptlafocr heater fireplace 10.00
. . - - __ . • , -, - - _ - fireplace . 10.00
. . _
, •, . Log lighter (gas) - -- 10.00
' •. .- . WOod/pellet -- - • - 10.00 - •
Wood fireplace/insert -- . 10.00
* I' • .. MISINVR:„.#0. iftOj:ikr'itle j .. I 0 TENANT ' Chimney/liner/flue/vent 10.00
Other: _ 10.00
•,.'''. 'Name: Ck-C-A<- i C fr tiarNic. . Environmental exhaust and ventilation ,
equipm 10.00
hood/other kitchen
' Addres 1:2
s: k er•Q-- P, f:.\r 10.00 .
- ... . City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
•,.. Phone: (5 (-2_0 q5 k ct Fax: ( ) toilet compartments, utility rooms) 6.80
ORIFMARriViii4CANT 0 CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
. Contact name: 5,?,„, e_.z,-.-s,-,--c„..._A4),-- $5.40 for first four; $t.00 for each additional
Address: Furnace, etc.
. Gas heat pump
'..' City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater , 4_` ,..
Fireplace 61''S-1
Range
, ..- ,Wit*:70,,VilkiiZ ' --:,.:,,, ' , • ,,,, CONTRACTOR . . - , Barbecue
Clothes dryer (gas)
.Business name: p , ,L
- Other:
Address: ,, 5 4 - , , _ 41) - MECHANI ,PERMYI ' "1"
TEES,1.:0
.,:. -.. City/State/ZIP: at k- 7 C/hey ,ote 9 z ii • __ - Subtotal Z7 /0
• / Mnmum permit fee ($72.50) ____7 7__ so
Phone: ( 503 219 5600 Fax: (503 249 g24,) - Plan review (25% of pemnt fee)
• .-,:,_::: ,,. CCB lic.: 36 / 2_ State surcharge (8% of permit fee) 5. SO
TOTAL PERMIT FEE 1 4 K .30
: .. Authorized Signature: 0,,_ ,,,,d„..,,„._, This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
''' • I Pri rint name (V\ ‘,k-Ok,k,t)t.C.LA.A 1 1)3 Tf 1 * Fee methodology set by Tri Building Industry Service Board
•
• Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Tlain . 7 • .
, Pernut Fee.
Sim° 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
$.50,030.00. •
$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 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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iABuilding\PermitAMEC-PermitApp.doc 12/03 2
CITY OF TIGARD 1. g7
BUILDING DIVISION PERMIT #: MEC2006.00553
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005
Phone: (503) 639 -4171 4 0410
Inspection Requests (24 Hrs.): (503) 639 -4175 1
INSPECTION WORKSHEET FOR DATE: 10/3/2005 TIME: 7:07AM PAGE: 84
SITE ADDRESS: 15390 SW ALDERBROOK CT CLASS OF WORK:
SUBDIVISION: SUMMERFIELD N0,7 LOT #: 405 TYPE OF USE:
PROJECT NAME: SMITH
DESCRIPTION: Reconnect. furnace and water heater.
OWNER: SMITH, JACK PHONE #: 503 -620- 9519
CONTRACTOR: PIONEER GAS FURNACE PHONE #: 503- 249 -5000
Inspection Request Scheduled For: Date: 10/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 016963 -01 603 -249 -5000 N
Corrections /Comments /Instructions:
4 A../L---vx-,,C ) 0 : LL-1--t"(-2<—■"- --- V\ A Ck----_ L.--( Lac/?)110.--(-
n e_ c 5..,/ l C--G .
/ti ss 0 d- Lf _____.
„az_
I
)
?-4 .
, .A_>1 A) s-/--/ (-,-, L,,z,' .
1 PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ' `" (' v Date: J 6 l i/ S ---- ' Phone #: (503) 718-
CITY. OF TIGARD _
BUILDING DIVISION PERMIT #: MEC2005-00553
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
9/7/005
Phone: (503) 639 -4171 l'i
Inspection Requests (24 Hrs.): (503) 639 -4175 .,.' /�x�nyNuypipl l
INSPECTION WORKSHEET FOR DATE: TIME 7:05AM PAGE: 63
SITE ADDRESS: 15390 ALDERBROOK CT CLASS OF WORK:
SUBDIVISION: SUPtNtERFIELD NO.7 LOT #: TYPE OF USE:
PROJECT NAME:
SMITH
DESCRIPTION: Reconnect furnace and wafer- heaters
OWNER: PHONE #:
SMITH, JACK 503 -620 -9519
CONTRACTOR: PIONEER GAS FURNACE PHONE #: 503-249-5000
Inspection Request Scheduled For: Date: 9127/200; Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 016716.01 503 -249 -5000 Y
Corrections /Comments/ Instructions:
A mo o - G = S . m _ , ' ii 20 X-. 1 air `
_ L (5: 67:70%/740'/. /O i,Jf$/ ..4 s 6 Z
c,4 ,fl- 7 (.L / ate, =4'�O'
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ,1 Date: -- Z 7 ij Phone #: (503) 718 -