Permit CITY OF TIGARD
1,
. MECHANICAL PERMIT
J.= COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00257
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/4/2007
PARCEL: 1 S135AD -00900
SITE ADDRESS: 10655 SW HALL BLVD ZONING: R -12
SUBDIVISION: ASHBROOK FARM LOT: 013 JURISDICTION: TIG
PROJECT: TYLER
Project Description: Gas line and furnace.
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:
NAT 3 - 15 HP: COMML. INCIN: •
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
TONY TYLER Description Date Amount
10655 SW HALL BLVD
PORTLAND, OR 97223 [MECH] Permit Fee 5/4/2007 $72.50
[TAX] 8% State Surcha 5/4/2007 $5.80
Total $78.30
Phone: 503- 417 -7343
Contractor:
WILLAMETTE HEATING & AIR CONDITION
4370 NE HALSEY ST
PORTLAND, OR 97213 -1566 REQUIRED ITEMS AND REPORTS
Contact #: PM 503 - 284 -3740
FAX 503- 284 -2821
Reg #: LIC 154438
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: �77 Permittee Signature: 0 0°1f
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.
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�m� City of Tigard . Date
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` , ' ' 4. 13125 SW Hall Blvd., Tigard, OR 972 Plan Rev w
Phone: 503.639.4171 Fax: 503.598. �Y 4 2007
Date/By: Other Permit:
1-1,6 A RD Inspection Line: 503.639.4175 // va Tp� /� Date Ready/By: /uris .. ® See Page 2 for
t ...4 Internet: www.tigard- or.gov Vt IT YO O t I GARD Notified/Method: 7 Supplemental Information
BUILDING-DIVISION
'• - , :,4, „i .;-:,6, - `sr`.'t OF WORK d : - . •• .° _ COMMERCIAL FEE* SCHEDULE' USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Z- 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
Multi M builder For special information use checklist.
ID y ❑ ❑O ther: Description Qty. Ea. Total
: " -'JOB SITE INFORMATION AND LOCATION . '; Heating/cooling
/( g C j, r / Air conditioning or heat pump
Job site address: < / (�(/�/
(requires site plan showing placement) 14.00
City /State /ZIP: Furnace 100,000 BTU (ducts /vents) 1 14.00
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 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
>i Gas fireplace 10.00
Flue vent for water heater or gas
'' fireplace 10.00
K2 ��- 17 �' � Log lighter (gas) 10.00
vvvv Wood/pellet stove 10.00
Wood fireplace /insert 10.00
w , .
❑ TENANT � " Chimney/liner /flue /vent 10.00
i ❑ PROPERTY OWNER
Other: 10.00
Name: ( j� ' 4: 4: Environmental exhaust and ventilation
Address: 'CCC/ Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Phone: ( exhaust (bathrooms,
��� ��� Fa ( ) 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; 51.00 for each additional
Address: Furnace, etc. 1.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
- Fireplace
E -mail: Range
•
CONTRACTOR Barbecue
jjj G Clothes dryer (gas)
Business name: ,/ Other:
Address: � / '' ' 7 f Gam-- - • ' MECHANICAL PERMIT FEES* •
City /State /ZIP: --q Crae Subtotal
�� ! � �� ( ) Minimum permit fee ($72.50)
(
Phone: Fax: Plan review (25% of permit fee)
CCB lic.: ,/ .5. 7 L--e/ Dl / 9 State surcharge (8% of permit fee)
[[ d ! TOTAL PERMIT FEE � 3
Authorized signature: This permit application expires if a permit is not o b t a i n 'thin 180
days after it has been accepted as complete.
Print name: ( r , te: * Fee methodology set by Tri -County Building Industry Service Board
I' \Building\Permits'MEC- Perm+tApp doe 04 /06/06 440 -4617T (I I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
_ Commercial Fee Schedule:
Total Valuation :, , Permit
$ 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.
1:\ Building \Permits\MEC - PermitApp.doc 12/30/05 2
CITY OF TI . , -
BUILDING [DIVISION PERMIT #: MEC2007 0025/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 514/2007
Phone: (503) 639 -4171 u4�� "'iI
Inspection Requests (24 Hrs.): (503) 639 -4175 ....,,W '_L
INSPECTION WORKSHEET FOR DATE: 5!7/2007 TIME: 7:00AM PAGE: 70
SITE ADDRESS: 10655 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: ASHBROOK FARM LOT #: 013 TYPE OF USE:
PROJECT NAME: TYLER
DESCRIPTION: Gas line and furnace.
OWNER: TYLER, TONY PHONE #: 503-417-7343
CONTRACTOR: WILLAMETTE HEATING & AIR CONDITION PHONE #: 503 - 2843740
Inspection Request Scheduled For: Date: 6/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 047676 -01 503-803-7074 N
b10 r 'J
Corrections /Comments/ Instructions:
(Ord.-45' l' Al, A4, i-- 4-- * -s 944 s 6 , �-C-r-. - dT��
1 i: I -.9E "4 ,- f.D. d -2=7 1a .� ,ic is , I ir. -A.-�-
I PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: c- 7 — e , "? Phone #: (503) 718 - 2,