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Permit
RI CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00296 `'- TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/22/2007 PARCEL: 1 S134BD -04600 SITE ADDRESS: 11680 SW ASHWOOD CT ZONING: R -4.5 SUBDIVISION: ENGLEWOOD NO.2 LOT: 134 JURISDICTION: TIG PROJECT: COOK Project Description: Convert (2) wood fireplaces to gas, plumb for new gas range. 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: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2 GAS OUTLETS: 3 > 10000 cfm: Owner: FEES MICHAEL E. COOK Description Date Amount 11680 SW ASHWOOD CT TIGARD, OR 97223 [MECH] Permit Fee 5/22/2007 $72.50 [TAX] 8% State Surcha 5/22/2007 $5.80 Total $78.30 Phone: Contractor: SUPERIOR GAS CORPORATION 11380 N WESTSIDE RD CARLTON, OR 97111 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 852 -4492 Reg #: LIC 102250 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 :y: � it / Permittee Signature: A Call 503.639.4175 by 7:00 a.m. for inspection- that busine 'd 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. '.d i I ' i` rt F l 1 f } F`x �e..SPV i .t,, 4 � T N: t � Mechanical Permit Application t � � a` F;OR OF,FI O C EjUSE NIA t p G ' a l r ; �` ! City of Tigard Recved � E Permit No : � 2 �1 J/yt �YS � DateBy: � � !/r-v /'LrCJ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review i Phone: 503.639 4171 Fax: 503.598.1960 Date/By: Other Permit: TI G A RD" gar g Notified/ Inspection Line. 503.639.4175 Date Ready/By. /B J Internet. www.tid -or. ov Supplemental See Page 2 for c Method: ( / Supplemental Information TYPE OF WORK ' . - , COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction E iltddition /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 " RESIDENTIAL EQUIPMENT /SYSTEMS FEES* ' y g ❑ CommerciaUindustrial ❑ Accessory building For special information use checklist. El Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: Air conditioning or heat pump / (p Q s � �'s W , J - J �T (requires site plan showing placement) 14.00 City /State /ZIP: .-77 GA -rL_ © � el: -7 223 Furnace 100,000 BTU (ducts/vents) 14.00 Fumace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt.no.: Project name: �O R/ a 5 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 „`Z 10.00 .' C) e_o e/.. t ip r..) i n t = t - n e , , , , , o u 2/J r A) 6. IG! �� PLs}C Flue vent for water heater or gas fireplace 10.00 IV g/2 S /4-1■)- Pz t w p / ^) c g - A /t l 6s`) a fY_s Log lighter (gas) 10.00 ,e.._,q -zOr. -� -77) /2_67 c __C---C, --r2_,; r / t JG� , Wood/pellet stove 10.00 Wood fireplace /insert 10.00 wJ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: m (K - e<.... (� Environmental exhaust and ventilatio Address: Range hood/other kitchen // (n .S�J A�SI�i,.j00� c...7___. equipment 10.00 City /State /ZIP: bra 4 ©,e____ g - ..2. Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (5.13 )S-9 0 _ X2. -60" !7 Fax: (503 ) G.N _z-(. r,, toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10 00 Business name: Other: 10.00 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 o2- E -mail: Range / CONTRACTOR Barbecue Clothes dryer (gas) Business name: J r'�2/ e.,,e �TA-S Cr) 2 P . .6. yd Address: // 2 , eF D k) /.6 2b MECHANICAL PERMIT FEES* City/State /ZIP: , . h n) 0 2 91 / / / Subtotal Minimum permit fee ($72.50) � ,5D Phone: �O3 ,�? / O O / /� Fax' ( ) Plan review (25% of permit fee) CCB lie.: . / l7, o c r (t✓F-P . , / F 7 / 1 State surcharge (8% of permit fee) D, , O C) TOTAL PERMIT FEE 7g, , Authorized signature: N This permit application empires if a permit is not obtained within 180 / a /....,... days after it has been accepted as complete. Print name: 6 y � / J Date �_ _ , ' Fee methodology set by Tri- County Building Industry Service Board I \ BuildinglPermits\MEC- PermitApp. doc 04/06/06 440 -4617T (1 I /02 /CO.M/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Va 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. 1:\Building \Permits \MEC- PermitApp.doc 12/30/05 2 1 - ' 1- - - CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007- 00296 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 512212007 Phone: (503) 639-4171 lir Inspection Requests (24 Hrs.): (503) 639-4175 W'- I L.. INSPECTION WORKSHEET FOR DATE: 5/30/2007 TIME: 7: 00AIVI PAGE: 19 SITE ADDRESS: 11680 SW ASH WOOD CT CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.2 LOT #: 134 TYPE OF USE: PROJECT NAME: COOK ■ DESCRIPTION: Convert (2) wood fireplaces to gas, plumb for new gas range. OWNER: COOK, MICHAEL PHONE #: CONTRACTOR: SUPERIOR GAS CORPORATION PHONE #: 503-852-4492 ) Inspection Request Scheduled For: Date: 5/30/2007 .. Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 049252-01 503-310-0176 V /d orrections/Comments/Instructions: • . ASS I 1 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS 0 FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED ___..... Inspector: , Date: 5 Phone #: (503) 718 __Zs)4,