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Permit • CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00541 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/3/2006 PARCEL: 2S 104DB -05200 SITE ADDRESS: 13275 SW GREENFIELD DR ZONING: R -4.5 SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Installation of gas insert and gas piping. 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: NAT 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: 1 GAS OUTLETS: 1 > 10000 cfm: Owner: FEES TIMOTHY LEBRUN Description Date Amount 13275 SW 132ND AVE TIGARD, OR 97223 [MECH] Permit Fee 11/3/200E $72.50 [TAX] 8% State Surcha 11/3/200E $5.80 Total $78.30 Phone: 503 -579 -5383 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. Issu d By: 3, / ��G�� Permittee Signature: a /rZLlii'` 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. Me Permit Application roll OFFICE. ONLY City of Tigard p ' Br Jr*/ 41.9i Permit No.: 13-16 , 5c// . 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review G • Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit: Inspection Line: 503.639 TI6ARID Date Ready/By: Er El See Page 2 for Internet: www.tigard - or.gov Notified/Method: , Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST' ❑ New construction ddition/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: $ 4 000 - 00 CATEGORY OF CONSTRUCTION / RESIDENTIAL EQUIPMENT/ SYSTEMS.FEES *' -1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total • : JO SI TE INFORMATION AND LOCATION Heating/cooling s� Air conditioning or heat pump Job site address: 3 ` s 3 W G reC,, -. 2\ \ �ts _ (requires site plan showing placement) 14.00 City /State /ZIP: —" c 5t' a 0 R 1 `? a 3 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: , ,r\ Gas heat pump 14.00 Cross street /directions to job site: ,. A \ n V -- \ Et G & S d■�_ 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 ' . DESCRIPTION OF WORK ' ' Water heater 10.00 \ ` ` e Gas fireplace I 10.00 (,.D . OD G 4 5 'V re. ` `a. c_ Q l t.7- " I\'� 0 Flue vent for water heater or gas fireplace 10.00 eX \S -1'� \(- -Cc\S(..e Log lighter (gas) , 10.00 • Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue/vent ( 10.00 iU . 00 • ROPERTY OWNER I ❑TENANT Other: 10.00 Name: —1- , . Et - \- tI C 0 r Environmental exhaust and ventilation Address: 1 -- y)_9 S S G tccf\ \ � � • Range hood/other kitchen \ equipment 10.00 City /State /ZIP: c � a X 0 R l as 3 Clothes dryer exhaust 10.00 ( ) 5 ! S 3 (503) 6 14 1 - 3 ct 3E t Single-duct comp rtm exhaust s (uathro roo Phone: S 3 ° � -- Fax: toilet compartments, utility rooms) 6.80 APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping • Contact name: CA..C•f\ $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 4 \ Fireplace r 5. 0 E -mail: \ e_ �j 0 IN � \'\'\ 7 (& YN 0 O . co t1'1 Range CONTRACTOR Barbecue Business name: D L T) f___ Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) 72,50 Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) 6. S TOTAL PERMIT FEE � This permit application expires if a permit is not obtain within 180 Authorized Signature: days after it has been accepted as complete. . Print name: `1-- . m \-12.. V f\ Date: k ( / 3/aO ( * Fee methodology set by Tri -County Building Industry Service Board 1:\Building\Permits\MEC- PermitApp.doc 04 /06/06 440.4617T (1'1 /07/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. • • I:\Building\Permits\MEC- PermitApp.doc 12/30/05 2 CITY OF 'TIGARD BUILDING DIVISION PERMIT #: MEC2006 -00541 13125 SW Hall Blvd., Tigard, OR 97223 0 DATE ISSUED: /113/2005 Phone: (503) 639 -4171 N�"I Inspection Requests (24 Hrs.): (503) 639 -4175 J '.. INSPECTION WORKSHEET FOR DATE: 12/14/2006 TIME: 7 :02AM PAGE: 42 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: , SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: In tallaton of gas inmrt .and;gas piping. 11/8/06, adding (1) woodslove insert. L._ OWNER: LEBRUN, TIMOTHY PHONE #: 503.579_5383 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/14/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 041086-01 503 -579 -5383 N Corrections /Comments /Instructions: • 7 — P ASS n PARTIAL APPROVAL n CA NCEL I I NO ACCESS 1 I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED ,_ ( ) . t.: , :j Inspector: Date: Ji_�- 1� —�� Phone #: 503 718- ; "' CITY OF _1 BUILDING DIVISION PERMIT #: MEC200S -00641 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/3/2005 Phone: (503) 639 4171 'ilia Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/1/2006 TIME: 6 PAGE: t# SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: Installation of gas insert and gas piping. 11/8106, adding (1) woodsiove insert. OWNER: LEBRUN, TIMOTHY PHONE #: 503. 579-5383 CONTRACTOR: owNER PHONE #: Inspection Request Scheduled For: Date: 1211/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 040561 -01 503 - 579-5383 N Corrections /Comments /Instructions: /4 0/6,--d& ,e11/" Y ; i&e 10 '/ /7) e ASS — I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL / CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED Inspector: , Date: /----/-- CCU Phone #: (503) 718= -Z.4-- CITY 0,FITIGARD ,... BUILDING DIVISION PERMIT #: ME G. ''' .., , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: lini2th Phone: (503) 639-4171 * SPA I # Inspection Requests (24 Hrs.): (503) 639-4175 '-'E. INSPECTION WORKSHEET FOR DATE: 11/30/2006 TIME: 7:00Aivi PAGE: 83 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: Installation of as insert and gas piping. 11/8/06, adding (1) woodstove insert. OWNER: LEBRUN, TIMOTHY PHONE #: 503-679-5383 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/30/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 040296-01 503-579-5383 N Corrections/Comments/Instructions: ' ., V44-,& C )", /lac ,...- PASS' n PARTIAL APPROVAL I I CANCEL n NO ACCESS _,,,,' 1 FAIL 4: ., I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: _ Date: //---.7). Phone #: (503) 718-