Permit '.` . y' ~ �. CITY OF TIGARD
MECHANICAL PERMIT
. - COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00596
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/5/2008
PARCEL: 2S102DB -08600
SITE ADDRESS: 09088 SW HILL ST ZONING: R -4.5
SUBDIVISION: CHELSEA HILL NO. 2 LOT: 063 JURISDICTION: TIG
PROJECT: MILLER
Project Description: Installation of gas fireplace and gas piping for the fireplace and future range.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 2
> 10000 cfm:
Owner: FEES
MIKE & ALLIE MILLER Description Date Amount
• 9088 SW HILL ST
:' TIGARD, OR 97223 [MECH] Permit Fee 12/5/200E $72.50
[TAX] 12% State Surch 12/5/200E $8.70
Total $81.20
Phone: 503- 746 -7256
Contractor:
GAS PRO, INC.
7603 SE LOUNSBERRY LN
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 775 -7020
FAX 503- 775 -7014
Reg #: LIC 167493
•
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 ma :: -in copies of these
rules or .. que ion to OUNC by calling 503.246.6699 or 1.800.332.2344.
f t ' Iss -d By: A/Ilt ,I / Permittee Signature: i 1/
•
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 o the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received P erm i t No.: e Gl � /_
`J g Date/By: 1 0- 9 D ,619 Z1 t65
° 13125 SW Hall Blvd., Tigard, OR ' 7 . T Plan Review
Phone: 503.639.4171 Fax: 5'j'. ;' :4 I' ± i Date /By: Other Permit:
TI G A RD Inspection Line: 503.639.4175' Date Ready /By: ton 65 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: / / ( Supplemental Information
r�, :: r 0 5 2008 C ,
TYP ciorti IARD COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
❑ New construction Addittet 3 WNW Mechanical permit fees* are based on the value of the work
SS1 performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1 -and 2-family g ❑ Commercial /industrial ❑ Accessory building
Multi - family ❑ Master builder 111 Other: For special information use checklist.
Description Qty. Ea. Total
JOB SITE INFORMATION' AND LOCATION Heating/cooling
Job site address: / / ' / r Air conditioning or heat pump
S �/ f � t / f / (requires site plan showing placement) 14.00
City /State /ZIP: /# 4- 69 4 L y" 9 -7 .2-2_3 Furnace 100,000 BTU (ducts /vents) 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 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
-0 _ Gas fireplace ,t• 10.00
64- s AO ' Flue vent for water heater or gas
fireplace 10.00
/
l.v 4 5 /' f /eFi L 4C L Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
— PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
A Other: 10.00
/f/ Name: i E �I , J f� 4 Environmental exhaust and ventilation
/ Range hood /other kitchen
Address: $ )T 44 equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( %cq) 7 Li 6 - -d S 6 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 /
ONTRACTOR Barbecue
Clothes dryer (gas)
Business name: G , / ' C_ Other:
Address: 7w 3 5 [ t vrr s1 e ,a k j 1-, /i/ MECHANICAL PERMIT FEES*
City /State /ZIP: a j.4 4 frd 0 4 y i r / Subtotal �J� 5-n
Minimum permit fee
Phone: ( SO? ) ") $ - 7) Fax: ( ) (f {� permit ) . J
/ � Plan review (25% of permit feeee) —
CCB lie.: / 6 -2 L ! State surcharge (12% of permit fee) g 70
AIM. _
TOTAL PERMIT FEE ()
Authorized signal e;` �r� This permit application expires if a permit is not obtaine 180
�� � A days after it has been accepted as complete.
Print name: L��"�I/LGi� /' ATM ` Date: / 2 * Fee methodology set by Tri- County Building Industry Service Board
I.\ Building \Permits\MEC- PermitApp.doc 01/19/07 440 -461 (11/02 /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.
1: \Building \Permits \MEC- PermitApp.doc 01/19/07 2
,.
CITY ������U��������
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BUILDING DIVISION PERMIT ~�"�^~~^~~"~ � #: KHEC2008'0O586
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12V5/2008 a A , Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 RAIL' 'I-- W '
INSPECTION WORKSHEET FOR DATE: 12/8$2008 TIME: 7:02Ahvl PAGE: 5
SITE ADDRESS: 09088 SW HILL ST CLASS OF WORK:
SUBDIVISION: CHELSEA HILL NO. 2 LOT #: 083 TYPE OF USE:
PROJECT NAME: MILLER
DESCRIPTION: Installation of gas fireplace and gas piping for the fireplace and future range.
OWNER: M|LLFR. kNNE& ALLIE PHONE #: 6O3-746'7256
CONTRACTOR: GAS PRO, INC. PHONE #: 503-775-7020
Inspection Request Scheduled For: Date: 121900O8 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 078904'03 603-818-9494 N .
Corrections/Comments/Instructions: '
'x
.
.
. .
.
-
.
PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
Al
. FAIL 14 CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED
Inspector: ' ' Date: t 4 2/75 Phnne#: (503) 718- llb . . /
, , -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEG2OOB-00696
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i 202008
Phone: (503) 639-4171 Am 1 Is
_ViglittAl it'
Inspection Requests (24 Hrs.): (503) 639-4175 AM ■ 11..,
INSPECTION WORKSHEET FOR DATE: 12/9/2008 PAGE: 6
7:02AM
TIME:
SITE ADDRESS: 09088 SW HILL ST CLASS OF WORK:
SUBDIVISION: CHELSEA HILL NO 2 LOT #: 063 TYPE OF USE:
PROJECT NAME: MILLER
DESCRIPTION: Installation of gas fireplace and gas piping for the fireplace and future range.
OWNER: MILLER, MIKE & ALLIE PHONE #: 603-746-7256
CONTRACTOR: GAS PRO, INC. PHONE #: 603.7m-7020
Inspection Request Scheduled For: Date: 12/9/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 078904.02 503-818-9494 N
Corrections/Comments/Instructions:
AS - PARTIAL APPROVAL 0 CANCEL El NO ACCESS
FAIL ALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
(...
Inspector: Date: 77../7 0 0 Phone #: (503) 718- 26 i l
_ .. .
CITY OF TIGARD
BUILDING DIVISION
4 Illhi PERMIT #: MEC2008-00596
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/5/2008
Phone: (503) 639-4171 ArsholimAjil
Inspection Requests (24 Hrs.): (503) 639-4175 sb_11 111.
INSPECTION WORKSHEET FOR DATE: 12i9/20013 TIME: 7 PAGE: 7
SITE ADDRESS: 09088 SW HILL ST CLASS OF WORK:
SUBDIVISION: CHELSEA HILL NO. 2 LOT #: 063 TYPE OF USE:
PROJECT NAME: MILLER
DESCRIPTION: Installation of as fireplace and gas piping for the fireplace and future range.
OWNER: MILLER, MIKE & AWE PHONE #: 603-746-7256
CONTRACTOR: GAS PRO, INC. PHONE #: 503-7757020
Inspection Request Scheduled For: Date: 12/9/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
(310 Gas line 078904-01 503-818-9494 O 68
Corrections/Comments/Instructions:
'o 4- Ft i
•
.,,
OW # ra PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n FAIL - /1 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
' -
Inspector: Ai A-A.__ Date: ri / 46 Phone #: (503) 718-
Nil