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Permit c. CITY OF TIGARD MECHANICAL PERMIT PERMIT #: MEC2004 -00810 ��1 DEVELOPMENT Tigard, ) 639 -4171 DATE ISSUED: 12/9/2004 PARCEL: 2S1 02C C -00304 SITE ADDRESS: 13435 SW CRESMER DR SUBDIVISION: CRESMER HILLS ZONING: R -4.5 BLOCK: LOT: 003 JURISDICTION: TIG 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: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Replace gas piping. Owner: FEES STONER, BEN E + EVELYN D Description Date Amount 13435 SW CRESMER DR [MECH] Permit Fee 12/9/200 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchart 12/9/2002 $5.80 Phone: 503 968 - 1842 Total $78.30 Contractor: OWNER REQUIRED INSPECTIONS Phone: Gas Line lnsp Final Inspection Reg #: 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 99. Issued y: ��:� I Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application FOR OFFICE USE ONLY Received cltyLaf,!3igard A D � Plan Review / i'lll�L_ PermitNo.: ' ..�glp 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Phone: 503.639.4171 Fax: 503.598.1960 �„�a�p �riF�M1°Ws "� Date/By: Other Permit: 'di" Inspection Line: 503.639.4175 !I' Date Ready/By: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction ❑ Addition/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: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating /cooling /`q CC� / , � / Air conditioning or heat pump Job site address: 7 l / )-(/ C 1 /z PX_ (requires site plan showing placement) 14.00 City/State /ZIP: ;p /f/ / OA' � I Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: 5fO/c/h 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.: d 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 p r Gas fireplace 10.00 A / /l7 7c ,4A s /rV /// ( /t �/ Q //7 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 ROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: / j f/ )7//I. Environmental exhaust and ventilation (_ r / Range hood /other kitchen Address: JJ / 7 Jt' ' /a Y/ € 4' ,/�- & equipment 10.00 City/State /ZIP: 7;p ©j 9 7,2 3 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (f273 ) fir /t42 Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT El CONTACT PERSON Attic /crawlspace fans 10.00 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 CONTRACTOR Barbecue D ) E/2"---- Clothes dryer (gas) Business name: /� / / p e O e / - 5 Other: ( l� - �t/ Address: . - - 7ProlECHANICAL PERMIT FEES* City/State /ZIP: i Subtotal c Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) 7 .57 U . Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) `J 4 CO • TOTAL PERMIT FEE 7g. 50 – Authorized signature: / � f _ — This permit application expires if a permit is not obtained within 180 �`� days after it has been accepted as complete. Print name: g 57 Date: 72_- Q e( * Fee methodology set by Tri -County Building Industry Service Board t6 `5 /• 6° Mechanical Permit Application - City of Tigard , Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: 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. • • • • i:\ Bui lding\Permits \MEC- PermitApp.doc 12/03 2 CITY - OF.TIGARD BUILDING DIVISION PERMIT #: MEC2004 -00810 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/9/2004 Phone: (503) 639 -4171 di � �� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/27/2006 TIME: 7 :09AM PAGE: 10 SITE ADDRESS: 13435 SW CRESMER DR • CLASS OF'WORK: SUBDIVISION: CRESMER HILLS LOT #: 003 TYPE OF USE: PROJECT NAME: STONER DESCRIPTION: Replace gas piping. OWNER: STONER, BEN E + EVELYN D, PHONE #: 603- 968 -1842 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/27/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 010232 -01 503-968-1842 N Corrections/Comments/Instructions: GL /A6 4107 ' ?) SS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED y___ Inspector: r Date: Z?" Phone #: (503) 718-