Permit 1
•
IN � CITY OF TIG MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00464
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/26/2007
PARCEL: 25111 BA -06900
SITE ADDRESS: 09529 SW INEZ ST ZONING: R -4.5
SUBDIVISION: BUTLER TERRACE LOT: 003 JURISDICTION: TIG
PROJECT: PHOENIX REDEVELOPMENT
Project Description: Replace existing gas 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
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:
Owner: FEES
PHOENIX REDEVELOPMENT Description Date Amount
[MECH] Permit Fee 7/26/20W $72.50
[TAX] 8% State Surcha 7/26/20W $5.80
Total $78.30
Phone: 503- 238 -0113
Contractor:
BRIDGETOWN HEATING LLC
14161 SE BRYN MAWR CT.
MILLWAUKIE, OR 97267 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 789 -5544
FAX 503- 353 -6783
Reg #: LIC 152320
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 BEM z‘ � � Permittee Signature:
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.
Miekianical Permit Application,... a r FOR OFFICE USE ONLY
' City of Tigard y ed E ed P ermit No.:
1 1111
'" ® 13125 SW Hall Blvd., Tigard, OR 97223
y: ? o MEcZZa.9- _0064
Phone. 503.639.4171 Fax: 503.598.1960 Plan Review
Inspection Line: 503.639.4175 JUL 26 2001 Date /By:
Other Permit:
T I G A R D p Date Ready /By Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method• -7-7r Supplemental Information
CITY UF{ I iuARD
TYPE It ' t DT TS1101.?
' 7 " COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
• . DINIC4
['New construction Addition /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.
. CATEGORY OF CONSTRUCTION ' . Value: $
l - and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION . Heating/cooling
Job site address: c .21 S � .4 N f ' Air conditioning or heat pump
/ (requires site plan showing placement) 14.00
City /State /ZIP: l' 6--A RI 0
Furnace 100,000 BTU (ducts/vents) I 14.00 izt,
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
Hydrontc 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
Gf}S - . - 0 G' xi C k n9c !- t--'--
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 Chimney /liner /flue /vent 10.00
❑ TENANT Other: 10 00
Name: p ` .c)el•-‘ �!c• i Q ¶) J-4.1-41, en , . ' -� n 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: ( )2_3 if- s i 1 7 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT - ❑ CONTACT PERSON - Attic /crawlspace fans 10.00
Other: 10.00
Business name: OR D t b .c - w �
la ie,A,. 4 L c. Fuel piping
Contact name: c,, ti G-VG+/A PI ,-h $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
��G ��� �r h9�� C T Gas heat pump
City /State /Z1P: .�t t 'L L. f 0 ('Z 9 7 'Z G 7 Wall /suspended/unit heater
Phone: ( ?j3 ) >f�. e cc 1 -/ Fax: : (co) ) 3 S'3 4'? 8y Water heater
8y Fireplace
E -mail: Range
CONTRACTOR . . ' . Barbecue
Business name: Clothes dryer (gas) 9 Other
Address: MECHANICAL PERMIT FEES* . - .
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) 7-2,, SO
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: / S . 3' Z!/ State surcharge (8% of permit fee)
TOTAL PERMIT FEE 94.E
Authorized signature: E4 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ,v, c L. SFr. �S ..;-1 Date: 2 f -c,7 * Fee methodology set by Tri- County Building Industry Service Board
1. \ Building \Permits\MEC - PermitApp.doc 01/19/07 440 -4617T (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.
I: \Building \Permits \MEC- PermitApp doc 01/19/07 2
CITY OF TIGARD
.
BUILDING DIVISION PERMIT #: MEC2 00'164
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7 12F 007
Phone: (503) 639 -4171 /�imu�Vill�����@ ii
Inspection Requests (24 Hrs.): (503) 639 -4175 ‘_'
INSPECTION WORKSHEET FOR DATE: 9/2512007 TIME: 7:00AM GE: 11
t-v_. S1'TE ADDRESS: 09529 SW'INEZ ST CLASS OF WORK:
SUBDIVISION: BUTLER TERRACE LOT #: 003 TYPE OF USE:
PROJECT NAME: PHOENIX REDEVELOPMENT
DESCRIPTION: Replace existing gas furnace.
OWNER: PHOENIX REDEVELOPMENT, PHONE #: 503- 23BM113
CONTRACTOR: BRIDGETOWN HEATING LLC PHONE #: 503 - 789 -5541
Inspection Request Scheduled For: Date: 9/25/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mess.ge
699 Mechanical final 056278 -01 503-785 -9554 0 7
Corrections /Comments /Instructions: -
NI /A/0 L,4 2.. c llG'7s
PASs) 0 APPROVAL n CANCEL I I NO ACCESS
FAIL , LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ''� Date: Z 0 y Phone #: (503) 718- a G/j