Permit , CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00435
YIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/19/2009
. Parcel: 25 110AC01000
Jurisdiction: Tigard
Site address: 11545 SW BEEF BEND RD 19
Subdivision: WELLINGTON ESTATES APARTMENTS Lot: 0
Project:
Project Description: Replace gas furnace.
Owner: FEES
FERN VALLEY PROPERTIES LLC Description Date Amount
BY CAMBRIDGE REAL ESTATE SERVICES, PO
Permit Fee 08/19/2009 $72.50
BOX 2968 12% State Surcharge - Mechanical 08/19/2009 $8.70
PHONE: 503 - 620 -5088
Contractor:
ROBBEN & SONS HEATING INC
2214 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 233 -5841
FAX: 503 - 238 -8849
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load: ,
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 1 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Fumaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP: '
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $81.20
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: .t 5c_ Permittee Signature: 071 4 C 7
Call 503.639.4175 by 7:00 a.m. for an inspection 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.
V , Mechanical Permit Applic . CEJVED FOR o ib USE ONLY
Received
City of Tigard oateroy: / G ' ! P ermitNo.: _ oo' —CIO .1 w 13125 SW Hall Blvd., d, oR 311 G 1 8 2099 Plan Revie
Phone 503.639,4171 Tigar Fax 503 598 9723 1960 Date/By: Other Permit: 117ai i i (� n t t [) Internet n www,u S and -or9 ov7S CITY OF TIGARD Ntfed/Met od: Supp ment rata I n f ormation
g g BUILDING DIVISION
TYPE OF WORK ' COMMERCIAL FEES SCHEDULE USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction �; Addit t.1/alteratiorUfeplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ■ Other: mechanical materials a ui ment, labor overh and rofrt.
Value: $
1 CATEGORY OP CONSTRUCTION :
, -:'RESIDENTIAL EQUIPMENT SYSTEMS FEES* •
go I- : .. • ..•- dwelling ❑ Commercial /industrial ❑ Accessory building For special Information use checklist.
t ali ulti- family ❑ Master builder ❑ Other: Description _I Qty. I Ea. - 1 Total
. JOB SITE INFORMATION AND LOCATION Heattu�/cooling
• , , �r �, m Air conditioning or heat pump
Job site address: 0 +a �1 wir es site .lay or he pump 14.00
�. qtr 1
fit 1 Furnace 100,000 BTU (dam/vents) ; 14.00 1
City/State/ZIP: . r , /�(�j/� /� , ` 1 Furnace 100,0001- BTU (ducts/vents) 17.90
Suite/bldg. /apt,no.: 1 I ( \�" fa Project name; Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic 14.00
Unit heaters (fuel -type, not electric).
in -wall, in-duet, suspended, etc. 14.00
Flue/vent for anv of above 6,80
Subdivision: } Lot no. Other: 10.00
Tax map /parcel no.: _Other fuel appliances _ _
-
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Vh NI l h - Flue vent for water heater or gas
Ti VUr fireplace 10.00
tog lighter (gas) 10.00
Wood/pellet stove _ 10,00
Wood fire41ace /insert 10.00
Chimney /liner /flue /vent _10.00
❑ PROPERTY OWNER ❑ TENET Other: 10.00
Name: i lik l ` �/' Environmental exhaust and ventilation
• Range hood/other kitchen
Address: = _.. `1 / 1 equipment , 10:00
City /State /ZIP:`! OA ,, ��, r Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone:1 Fax: ( ) toilet corn partments, utility rooms) 6.80
. . •' .6"771.- : ' ' LICANT ❑ CONTACT P RSON Attic/crawlspace fanS 10.00
Other: _ 10.00
Business narn At il\ . & ', 111 11110J. ' Fuel piping
Contact name: r„. 1 Nfl--- $5.40 for first four; $1.00 for each additional
Furnace, etc
Address: ,E- er. A v L Gas heat .um■
M Ir. • l Wall/suspended/unit heater
Phone: •^y Z- ( Fax:: �+ ) „`_ : `+`� Water )!cate —
�, . _ Fireplace
E-mail: `'„, �,Q ()F ,,,._ `-4 . ' / - , r • Range
4 �`/� CONTRACTOR Barbecue
�` ' Clothes dryer (gas)
� �1- *:.� r P I 'tri .i. • Other:
Address: " I �� MECHANICAL PERMIT FEES' •
1 -2J Subtotal
City/State/2.1P, WI C , C �{' I ■ Minimum permit fee ($72.50) -*/1 Phone:' 0 0 — �� `Y ( Fa > �4 -6) i� 5 `� Plan review (25% of permit fee)
CCB lie.: k (4 r _ State surcharge (12% of permit fee) /
TOTAL PERMIT FEE a i/
This permit application expires if a permit is not obtained Within 180
Authorized signature: days after It has bee* accepted as complete.
Print name ` RD,..._ do, Date: 1 • r. "0/ • Fee methodology set by Tri County Building Industry Service Board
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