Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00461
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/25/2007
PARCEL: 1 S 135CA -90324
SITE ADDRESS: 11044 SW GREENBURG RD 324 ZONING: R -12
SUBDIVISION: ASH CREEK PARK CONDO LOT: JURISDICTION: TIG
PROJECT: MULLER
Project Description: Gas line to fireplace insert.
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:
OTH 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: 1
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
ROBERT R. MULLER Description Date Amount
11044 SW GREENBURG RD
#324 [MECH] Permit Fee 7/25/2007 $72.50
[TAX] 8% State Surcha 7/25/2007 $5.80
Total $78.30
Phone: 503 - 572 -2252
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
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 503.246.6699 or 1.800.332.2344.
Issued By: Go_, , ° 41_4 Permittee Signature: juk �j j' /� � ` / _ / 4
Call 503.639.4175 by 7:00 a.m. for inspections 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.
Mechanical Permit A lira ion FOR OFFICE'USE ONLY T City of Tigard r,i.,,v, 1 . 1: o e ie d
q 13125 SW Hall Blvd., Tigard, OR. 97Y 7 a , Permit No.:M�ao0.7 _c:;,e/G
23
1111
Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date /By:
T I G A RD Inspection Line: 503.639 JUL 25 2001 Date Ready /By: Jus[ ® See Page 2 for
Internet: www tigard- or.gov Notified/Method: Supplemental Information
CITY O1- ti a4 1 ARf)
TYPE /0, rk—rl 7T0 T rs- i 1 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
x.. L x" "= Si st 1-'1 Si = vg V1 Si 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 INFOR � M AND LOCATION Heating/cooling
Job site address: fl(J•LrL{s23 ; / -6a2[,/ Air conditioning or heat pump
(requires sue plan showing placement) 14.00
City /State /ZIP: 7Z ' � e2 ���� 9 7,;z,23 Furnace 100,000 BTU (ducts /vents) 14.00
J Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: :=" 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 -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00 l
71 IJA.I %Q fig i .tvz . /vea2-r 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
[PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
•
Name: '..0/5,,,,,, v1,1--&72 Environmental exhaust and ventilation
Address: M: 6 , 4 _0 ve Rd Range hood /other kitchen
,�-`- equipment 10.00
City /State /ZIP: '. 0€ Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 563) v 7 — 5 c 9 .... Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ 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
Business name: at--)A/&—.r Clothes dryer (gas) Other.
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: • i s i diae_i permit ap ylica expires if a permit is not obtained within 180 days after it has been accepted as complete.
Print name: ri/ l Date: 7 „aS * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permiis\MEC- PermitApp.doc 01/19/07 440 -4617T ( I /02 /COM/WEB)
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.
l:\ Building \Permits \MEC- PcrmitApp.doc 01/19/07 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007-00461
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/25/2007
Phone: (503) 639 -4171 as Ina u'iI
Inspection Requests (24 Hrs.): (503) 639 -4175 t
INSPECTION WORKSHEET FOR DATE: 7/27/2007 • TIME: 7:03AM PAGE: 68
r
SITE ADDRESS: 11044 SW GREENBURG RD 324 CLASS OF WORK:
SUBDIVISION: ASH CREEK PARK CONDO LOT #: TYPE OF USE: - -.,; .`
PROJECT NAME: MULLER
DESCRIPTION: Gas line to fireplace insert.
OWNER: MULLER, ROBERT PHONE #: 503-572-2262
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/27/2007 . Pour Time:
Code # Inspection Description Confirm # Contact # Message �2�y
699 Mechanical final 052872 -01 503-572-2252 Y U�� pa
f23 2- Corrections /Comments/ Instructions:
C / 5 hula_
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X PASS n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL I CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .1 ; Date: 27 7/ Phone #: (503) 718 -
CITY OF TIGARD /y�/
BUILDING DIVISION ,. , PERMIT e -D" 4 `� /
13125 SW Hall Blvd., Tigard, OR 97223 U DATE ISSUED:
Phone: (503) 639 -4171 I�pT n(� 1 Vol__
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Inspection Requests (24 Hrs.): (503) 639-4175 �g r ,_�� _....
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INSPECTION WORKSHEET FOR DATE: 2C 0 TIME: f ` 2 PAGE:
SITE ADDRESS: //® '/ / . :& LASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: / J' 4= /�
DESCRIPTION LI_ AVE,' h1-5 -P k J am' /'y
OWNER: ) &2tr 1 PHONE #: ��' � 2_LZ�Z
CONTRACTOR: PHONE #:
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Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Desf rip Confirm # Contact # Message
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