Permit CITY OF TIGARD MECHANICAL PERMIT
Permit #: MEC2009-00408
g .. COMMUNITY DEVELOPMENT
:TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/02/2009
Parcel: 1 S135BC01100
Jurisdiction: Tigard
Site address: 11101 SW GREENBURG RD
Subdivision: Lot: 0
Project: Greenburg Building
Project Description: New gas lines.
Owner: FEES
ROBINSON FAMILY TRUST Description Date Amount
PO BOX 91305
PORTLAND, OR 97291 Permit Fee 09/02/2009 $72.50
Plan Review 09/02/2009 $18.13
PHONE: 12% State Surcharge - Mechanical 09/02/2009 $8.70
Contractor:
WESTERN PLUMBING
9460 SW TIGARD, AVE STE 101
TIGARD, OR 97223
PHONE: 503 - 639 -5296
FAX: 503 - 684 -9015
Type of Use: COM
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: S -1 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 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 $99.33
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or • uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No • cation Center. �T rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to OUNCby =: ' g 503.246.6699 or 1.800.332.2344.
Issue By: • /412-44.( Permittee Sign.ture:
Call 503.639.4175 by 7:00 a.m. for an inspection that bu ess day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
oI f
I I ( I �tD - aaoo 9 -tea 1�
' Mechanical Permit Applicati 9 FOR OFFICE USE ONLY
City of Tigard Received
g �� =+ �* � Date /B _ 101/49 Permit No.:� � 4 - ,t 0
III - Phone: 503.639.4171 Fax: 503.598. 13125 SW Hall Blvd., Tigard, OR 97223 :, Y . _. 1 ! •
Plan Revie
E �+ r e Other P ermi t :
TIGARD Inspection Line: 503.639.4175 U O , �O Date/By: Date Ready/By: �� a � Fl See Page 2 for
Internet: www.tigard- or.gov 1 o,9 Notified /Method: Supplemental Information
av ii„muEr
�`�,.,.�t�'���czie�:'" `> "'' ,.',x�.^ �'�''•. •o �$��,-,. -x-� .�:t..,x<::a:.•a� °':�.�.i "x.KaT^� sib-„ .,•�„ . F�- ' 7s�^?ay
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CO MM EIY IAI'� ` „S. CHE'.CTfL_�I •
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1:1 s i i Mechanical permit fees* are based on the value of the work
New construction 11 Addition/alteration/replace ent
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ether: mechanical materials, equipment, labor, overhead, and profit.
I:fic': ;g` 4 0 , g , :' 'lIa 'P° �, s;o: a .`�;i, ":, ? .. � s ”, g Value: $
.r :' _ ^.� " ? GO:Y fJ O SRT O <y I60d , C)0
1- 2 -f � -; =�.. - ':A:.'
❑ 2-family dwelling *ommercial/induStri 0 building Y EOr 'EQr ., < SYST S;# * w
S ;-
❑ For special information use checklist.
❑ Multi - family ❑ Master builder Other:
�" ." Description I Qty. Ea. Total
"'"" 'r;' ,',1/"s °i3' a,',...
k a ' '_' , N> :, JOB. TPE INFORMAJTIOIV N,D: "�CATYON M ., ; .. ^ 'M >. 'sxN'' "„ ; Heating/cooling
._ k .M- .,�:; �.... ,,� �,��,^.�.h�, ,�. ,�:�����- .u•�� mg /cooling
Job site address: 1 1 1 l C QQ/A kJiL �n l Air conditioning or heat pump
O V 0 '� r tVL (requires site plan showing placement) 14.00
City /State /ZIP:71'0 A l \ j j"�(� , (�`] '1� Furnace 100,000 BTU (ducts/vents) 14.00
`' F 1 Fumace 100,000+ BTU (ducts/vents) 17.90
Suite /bldg. /apt. no.: Project name: ( VI h C r ( Lb t l Gas heat pump 14.00
Cross street/directions to job ste: 1 � � 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: 1 10.00
Tax map /parcel no.: Other fuel appliances
';,�`s•�,�':i •'��3 `t. '.: %L , ��, "" "l�i•;,`�e'i,7� > <`: ., s�::�".:w .s°sz' ��a:.. ".t. %1/3 >�;.,� � «�'i: ;xr`:
:. ,.,:'; •. ,'', :; ,k, " '" ` =`^? w •;N ' ' Water heater
,:��:���:° . ," , ", . �.�:;�;;� "�w- ,.,�D 'SCItYPT)t�U FO; �V�QR�K,:.,� €..,.... > °.;.., 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
/ ,n O f fireplace 10.00
6 �4' �. Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
e %; ? ;� . �: s .-•x<:..v, . ,, �� {t a i m; s ,ar .,,, . „,.. x ,8,, ;.., Chimney/liner/flue/vent li
,�d ; ,u "� „� ” "D�U;WN'R �.p.. , �..; �`•-� � T ^.� ��`" >�°;;` :,�. Y/ ner /flue /vent 10.00
, ktrZi ,„ , ,,. vsx l k.:giial , a: i �r;. , itit ..Z714Q
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) m o0
Fax: ( ) toilet compartments,
utility rooms) 6.80
i:.j,. 3 . "� ^',' # e; � ,,:f s :�,' y ' , � - y ,. y ...;. " ,,,.. 3:�`,, `rc: �, :xs`x6(;, `; +ps,.: ,..1.
: „,l xa ,, V ,-. , ,' I' PERSOI, Attic/crawlspace 10.00
"� ' _ ��? ., � % .''�P�PIyTiC� 7' ?,. ; , , ::5k � �. ` s ace fans
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
E -mail: Fireplace
,, w ., �:� ,g Range
”. .m. t 1 '„ ': ":° I2A ,. _ ~;,, �,, ;, '. Barbecue
Business name: Western Plumbing, Inc. Clothes dryer (gas)
Other:
Address: 9460 SW Tigard Avenue, Suite101 7')a >� : =rt �'� _-, '
City /State /ZIP: Tigard, OR 97223 Subtotal .:�:�c��: „ w'�as'�PER1I.1T,��Sy�.,�/
Io� A
Phone: (503) 639 -5296 Fax: (503) 684 -9015 Minimum permit fee ($72.50)
Plan review (25% of permit fee) g I
CCB lic.: 2439 State surcharge (12% of permit fee)
f TOTAL PERMIT FEE 1 3
Authorized signature: • C� A _ ( - I (} A /� SOA This permit application expires if a permit is not obtained within 180
`LLLX t es u e' days after it has been accepted as complete.
Print name: Dana Jensen Date: X -nc * Fee methodology set by Tri- County Building Industry Service Board
I:\Building \Permits \MEC- PermitApp.doc 04/06/06 440 -4617T (I I /02/CCOM/WEB)