Permit .; CITY OF TIGARD"
MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00472
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/31/2007
PARCEL: 25111 AD -18000
SITE ADDRESS: 14840 SW JONAGOLD TERR ZONING: R -4.5
SUBDIVISION: LADY APPLE LOT: 004 JURISDICTION: TIG
PROJECT: LADY APPLE
Project Description: Install a/c unit.
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: 1 DOMES. INCIN:
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:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
BEACON HOMES NORTHWEST Description Date Amount
12703 SW 67TH AVE.
TIGARD, OR 97223 [MECH] Permit Fee 7/31/2007 $72.50
[TAX] 8% State Surcha 7/31/20M $5.80
Total $78.30
Phone: 503- 407 -0580
Contractor:
THERMAL FLO
7236 SW DURHAM RD. STE 100
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 670 -8343
FAX 503- 620 -1953
Reg #: LIC 151847
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 B . � // Permittee Signature: � `i d
Call 503.639.4175 by 7:00 a.m. for inspection that busi r • ss day.
• • , • mit card shall be kept in a conspicuous place on the job site un -I completion of the project.
Approved plans are required on the job site at the time of each inspection.
`ileclicianical Permit Application .F OFFICE USE ONLY
-." A t;," 4, R e ceiv e d
C of Tigard; $ � Pennit v i � E 0 64 2
, OPe
13125 SW Hall Blvd., Tigard
• N Phone: 503.639 4171 Fax: 503.598.,,11960Q y Plan Review
U L vi A 2007 Date /B �
/ /(�/
Date /By: Other Permit LL200 .d /
T I G A RU Inspection Line: 503.639.4175 Date Ready /By: E1 See Page 2 for
Internet: www.tigard - or.gov ca E . ;4",:,- . ® Notified/Method: Supplemental Information
6_3@_I rdi:l ; NVIStON
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE.CIJECKLIST
❑ 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
K1 and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Master builder For special information use checklist.
Multi -famil
❑ Multi-family ❑ ❑ Other:
Description Qty. Ea. Total
- - JOB SITE INFORMATION AND LOCATION Heating/cooling
o ti G Air conditioning or heat pump
Job site address: �(
� - f g�f 0 � r' �� �� (requires site plan showing placement) I 14.00 I-/•��
City /State /ZIP: -Ltd ®P--- q . 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: (A 'U A__P P 1-e- Gas heat pump 14.00
Cross street/directions to job site: l^ /1, P. Le_ 1 t\---‘Q-Q-- 4 Duct work 10.00
Q ` Hydronic hot water system 14.00
D /E v"� Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: L.-"-0---7 p-? P f .e_ 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
P N - : D ft t iL. (.0 P Ck t ° - e - f - 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: 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: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
' iPPLICANT • XONTACT. PERSON Attic /crawlspace fans 10.00
l l Other: 10.00
Business name: � ,e,a.„o N , .0_,.., 1 0 r w €55--- Fuel piping
Contact name: y 6 ('C ,w J (C-1,.--'. $5.40 for first four; $1.00 for each additional
Address: ' 2 - p3 s 6 .- - Z Furnace, etc.
Gas heat pump
Cit City/State/ZIP: e
y k A n'(Z--- Z2. Wall /suspended/unit heater
Phone: ( 903) Li, b 05 TO Fax: : ( 569 5- b s S 6 cl Water heater
Fireplace
E -mail: Range
• CONTRACTOR. Barbecue
S Clothes dryer (gas)
Business name: ex- A (_ T tic) Clothes
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal 14.00
Phone: ('o j) 6 + O s3 c. Fax: ( ) Minimum (25% fcc ($72.50) fee -9-2 .56
Plan review (25% of permit fee)
CCB tic.: i S / 84- State surcharge (8% of permit fee) J C, ad
TOTAL PERMIT FEE ? O
Authorized signatur
This permit application expires if a permit is not obtaine ithin 180
days after it has been accepted as complete.
Print name: . "i 1
1 1 I I I D L v _ Date: -3/ -� b * Fee methodology set by Tri- County Building Industry Service Board
1:\Building \Permits \MEC- PermitApp.doc 01/19/07 J 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.
L\ Building \Permits \MEC- PermitApp.doc 01/19/07 2
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: MEC2007 -00472
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2007
Phone: (503) 639 -4171 1 q,14jiu I I
Inspection Requests (24 Hrs.): (503) 639 -4175 W '' ..
INSPECTION WORKSHEET FOR DATE: 8 /9/2007 TIME: 7:00AM PAGE: 28
SITE ADDRESS: 14940 SW JONAGOLD TERR CLASS OF WORK:
SUBDIVISION: LADY APPLE LOT #: 004 TYPE OF USE:
PROJECT NAME: LADY APPLE
DESCRIPTION: install a/c unit.
OWNER: BEACON HOMES NORTHWEST, PHONE #: 503-407 -0580
CONTRACTOR: THERMAL FLO PHONE #: 503 - 6708343
Inspection Request Scheduled For: Date: 8/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
699 Mechanical final 053700 -03 503 - 407 -0580
Corrections /Comments /Instructions:
7 )
•
f .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION F I ADDITIONAL FEES ASSESSED
Inspector: '1 Date: F i l l/ 0 7 Phone #: (503) 718 -