Permit 4 CITY OF TIGARD MECHANICAL PERMIT
1/ DEVELOPMENT SERVICES PERMIT #: MEC2005 -00335
A 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/14/2005
PARCEL: 2S111 CC -05800
SITE ADDRESS: 10000 SW CENTURY OAK DR ZONING: R -12
SUBDIVISION: SUMMERFIELD LOT: 081 JURISDICTION: TIG
Project Description: AC, furnace, water heater and gas outlet.
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: 1 DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
WILSON, ELEICE P Description Date Amount
10000 SW CENTURY OAK DR [MECH] Permit Fee 6/14/200f. $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 6/14/200E. $5.80
Phone: 503 885 - 8983 Total $78.30
Contractor:
BULL MOUNTAIN MECHANICAL
13580 SW RHETT CT. REQUIRED ITEMS AND REPORTS
TIGARD, OR 97224
Phone: 503 - 702 - 2945
Reg #: LIC 157814
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.
.4 ,462
Issued By: 411 ��. Permittee Signature:
Cal{ 503 - 639 -4175 by 7:00 a.m. for inspections that • siness 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 OFFICFU Y ;' w .1:.
City of Tigard 0 8 L l V V I U Received /:
Da Permit No.: Mee �
13125 SW Hall Blvd., Tigard OR 97223 / ��j 3 ) .n Plan n Review
Phone: 503.639.4171 FaxiJ5.0S,598.19:602005 Pg4rN1 D ateBy: Other Pen
Inspection Line: 503.639.4175 I Date ReadyBy:1 EJ See Page 2 for
Internet: www.ci.tigard.o s "�" �W Notified/Method: 10 S Information
l
Y OF TIGAID
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ED New construction 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
xe. ^"i" .�"°"���`3 `�z - „rw..,=,..a�`°�. e sr . „� n .,,�� � ...- � .° '''`,s"'E�.�;
1 t s ' �:;. rCA'EGORY OF CONSTRUCTIO ,,
1, ',', 1.0- Mi i '&s Ai.' - -;,:., ,. °sc,: <.,:n .' „_. --- >. _ .. �-_..tr 1,..IV "- 1 ..,„-, ' ? , s'a : 4''x E IDENT ALaEQ' >/ SYSTEMS FE E ,
g1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building of - . . ; * � -E` ""'Z"Ig',,, " 4,' ,,' ,,,'
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
l '�ktiX�. 'ri ' ; °�; � °4 ° '.;g�.�:.r,,r�°.a�Ym'" ", � >.a»� -� ,� '-: : <uew -;�: � �° a;°�S:re , +"
It wJOBtT II FORIVIATION°AND,IOCATION. '.c.4 '` ti- -4� HeatinWcooling
Job site address: f 0l/'�� + � 4 ( .:7,1T azi Uc- Air conditioning or heat pump
/
(requires site plan showing placement) 14.00
City/State /ZIP: . 4J2z) �✓L 7 ..2 9' Furnace 100,000 BTU (ducts /vents) / 14.00
��
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: a / / /6,4) 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
•r' - :DESCRIPTION OFD 1" 641 •1
t ;, Water heater / 10.00
�kw. r �.., ,r • s., �t .. .� 7?./a_ � Gas fireplace 10.00
G /7 / /ice 64-s . 6 IM n-iv/l,GG_- /3 Flue Vent for water heater or gas
/ /1 5 t / //
fireplace 10.00
g3,�,1� • /'�'` �c� f ' Log lighter (gas) 10.00
_. /9-4 Wood /pellet stove 10.00
Wood fireplace /insert 10.00
vs . - - ° S r i . ,- . . . . �. :.. ,� a °.. , ;g ,., . - .... ,. ti, r 3, : aa: =: , Chimney /liner /flue /vent 10.00
`4G � „fi R4 I tz. ' t � �'. . w. ' ,. T IAN ` gi
rt.� <.� � < . .�. .w, - ,.�.�,, 'z.. a taeE�,. �,� � � �ild Other: 10.00
Name: 0 /st,y Environmental exhaust and ventilation
Range Address: ip oao 2 j Zf f /2 j/ 6.7/t < R .1 ✓ - equipment od /other kitchen 10.00
City/State /ZIP: 7 / / � » e2 , 7'2-2 (( Clothes dryer exhaust 10.00
7 Single -duct exhaust (bathrooms,
Phone: (S - 63 ke, ' g leg - 6 Fax: ( ) toilet compartments, utility rooms) 6.80
w . 1 ' + ` ' i COL AGT * "" Attic crawls
I i, v ' n 1 *� x `` PERSO ' / ace fans 10.00
P
Other: 10.00
Business name: .
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc
Gas heat pump
. City/State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater /
Fireplace
E -mail:
Range
x '' }:> F CI, CONRAC . g i nu., Barbecue
���•-. ' „";;3.:`''�,i:�.;�<r�s s ..' ` ,�.. � .� � ' � �. T
. x. u+r x �.,•�.��z a x's .. .. � � ,; � � 'S` . : . .:3,. .�...����
f -� ) / / Clothes d (
Business name: u /1 `ju,�f v fn�G v; e. L
Other:
Address: K/ �G�L � ` x RXE.. ,W.,. ''
I S S Gt /1 L pp iIGIEG$ ER IVIIT F EES* :' � '. . - • :.E4; �.< 5 :°t@�':.1..�.'' .Yi'e.. "a.:;:::t artJ R't`.Y: ..best.. •
City/State /ZIP: / f m-LC, �Z 9 7,7 / -.70,L1) Subtotal
Phone: (t ! ) - 7,0 `Z -2 q' S Fax: (6 1}
3 � ' �js Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: / 6- 7e/i.. t 1 I I)- (d J o 7 State surcharge (8% of permit fee) 5 'b
I t TOTAL PERMIT FEE 7 g. - c .)
Authorized signature: This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
Print name: J 0- K /4/44 fix.) (1 n Date: /�- 0 c * Fee methodology set by Tri- County Building Industry Service Board
i:\Building \Permits \MEC- PermitApp.doc 12/03 440 -46l7T (I 1/02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
rTgtal,Valuato> Perm>It
$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.
•
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00335
131 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/24/2006 TIME: 7 :09AM PAGE: 20
S [A
SITE ADDRESS: 10000 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 001 TYPE OF USE:
PROJECT NAME: WILSON
DESCRIPTION: AC, furnace, water heater and gas outlet.
OWNER: WILSON, ELEICE P, PHONE #: 603- 88583983
CONTRACTOR: BULL MOUNTAIN MECHANICAL PHONE #: 503.702 -2945
Inspection Request Scheduled For: Date: 6/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010114 -01 603.702 -2945 Y
Corrections/Comments/Instructions:
C.<'S i ) /•/6- —.'/o TCT
PASS M PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL % CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Zip Inspector: Date: Phone #: (503) 718 -