Permit t t,
C ITY OF TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00227 -
" ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/11/2005
PARCEL: 2S 104AB -07200
SITE ADDRESS: 13165 SW KATHERINE ST ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 4 LOT: 101 JURISDICTION: TIG
Project Description: Change out gas furnace to electric, install heat pump & electric water heater.
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: 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:
Owner: FEES
BERQUIST, KATHLEEN Description Date Amount •
13165 SW KATHERINE ST [MECH] Permit Fee 5/11/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 5/11/200E $5.80
Phone: 503 -579 -2920 Total $78.30
Contractor:
ENERGY PLUS HEATING + COOLING
608 NW 189TH ST REQUIRED ITEMS AND REPORTS
RIDGEFIELD, WA 98642 -
Phone: 360 887 - 2014
Reg #: LIC 95422
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: �f Permittee Signature: ,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that iness day.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr. ect.
Approved plans are required on the job site at the time of each inspection.
,
Mechanical Permit Application ( : :FOR OFFICE IJSE olv x ;' . .
City of Tigard Received `
13125 SW Hall Blvd., Tigard, Mali Q E I V E D Date/By: j / i J
Plan Review Permit No �v� Are"-- y
Phone: 503.639.4171 Fax: 51" . ' /'yi Date/By: Other Permit:
Inspection Line: 503.639.4175 . e it
Internet: www.ci.ri ard.or.us MAY 11 2005 �� Date Ready/By:
lin S See Page 2 for
g Notified/Method: Supplemental Information
� te z.t: . , �.. x. ;. ' .s� � r:.:. .,?,�t:r,� _
: „ s '1 ' , �a O _ :, :, . �` rCOMIViET2C.IAI ; F1 F S60 41SE- CI1ECKEIST `.
El 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 U Other: mechanical materials, equipment, labor, overhead, and profit.
b" , �1 , , ' ATEG0 2 OF7.CONgitio ION t. y , i Value $
.4u5„`+, .� .u, r ,z.., :: ; . .. :,,o.. :a�..e:.....n .,- _ , s .. . . _ F_-_ _ ,,,. - .,.ern, t°u. t -t fr ,,,�, - -
bCl 1 -and 2-family dwelling Commercial /industrial , $ SI DE I y TIAZ P) TP4 FEES*
/� y g ❑ ❑ Acc essory building
Multi famil Master builder For special information use checklist.
El y ❑ ❑ Othe r: Description Qty. Ea. Total
1..._� �,x 3, JOB "`BITE >INIORM �O ON x " - ' Heating/cooling
Job site address: c ,/ Air conditioning or heat pump
/3/65-- J' �' . (� (requires site plan showing placement) / 14.00 riOD
City/State /ZIP: (9r, 97,1? 3 Furnace 100,000 BTU (ducts /vents) / 14.00 / ` a)
� / ' Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name://k%‘14_ 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
Flue /vent for any of above 10.00
Subdivision: 1 Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
. . =� �' _ , ` D, OF m . 0 . 12.K r `� - _� x' -
t s l Water heater 10.00 000 �t�C
M�. 1 . :� -,..." .t, �...� .,.. �. _,-�., r.,sRa:a�.- �e � ,� .c�„,.'�t, b. ..,c - s �z...'`�, �,_ �..,.. E '.&4..'.., ,.'��'�:
• Gas fireplace 10.00
��� 0 / AL. _ LLri ■ ■ // . ' I / _/ . ' / A li _ Flue vent for water heater or gas
al u L ` I Wi / ,! / /1.00 , / I fireplace 10.00 n f7 Log lighter (gas) 10.00
/ , / , .. " 0 - % ■ L /0_/ _r Wood /pellet stove 10.00
Wood fireplace /insert 10.00
t Chimne /liner /flue /vent 10.00
`k4� PRgPERr , ' # ,. x � . -, C �. 10.00
Chimney/liner/flue/vent
Name: u ,V4 (am_ Environmental exhaust and ventilation .
Address: / �! *6 S 5' Z;) / / Range hood /other kitchen
equipment 10.00
City/State /ZIP: '77 (3 t .- Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 63 - ?0 Fax: (j 5 ' ,..._.
toilet compartments, utility rooms) 6.80
k APPI TCA . , � fi x, CON �CT aPERSONj Attic /crawlspace fans 1 0.00
Other: 10.00
Business name: f , ' ' i „ t
/J/ ♦ �� pip g
Ed _ ! / Fuel pi pi /if Contact name: / �}� ' $5.40 for first four; $1.00 for each additional
Address: b Ai W /,.' e Furnace, etc.
Gas heat pump
City/State /ZIP: a� , g �� /./i/9_ % U CJ Wall/suspended/unit heater
Phone: (30) ��./t T Fax:: ( ,).�� Lam. Water heater
Fireplace
E - mail:
Range
,
, ,1 " = lerig °yam a. Ilk: ^: :.g 3 2 sv 5i - ''''^t
. 1 iii :. �, 4k . it 01 ,Ci' �. , .. :4 + :.,ft 4 : _ g ` Barbecue
Business name: Clothes dryer (gas)
Other:
Address: �iYL -L eiz) 0/ 0 / 21 /& - -
/ J 0 / 21 /LE * `t
m ys.:��wx�. ��'ME'CHANTCAI; <�p,I`RMI� �`EES�„.�:,..
&...�� ��v; »,,, :.��.. - ��� � .��r_ �.� �:. _.
City/State /ZIP: Subtotal
Phone: ( ) -Fax: ( )- - - -- _ __ _ Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 475 y .2„ � 12_ State surcharge (8% of permit fee)
- �7// TOTAL PERMIT FEE
Authorized signature: CC j� `i' ' / ` This permit application expires if a permit is not obtained within 180
j days after it has been accepted as complete.
Print name: s /$ a ,, / /'/ Date: 5 * Fee methodology set by Tri- County Building Industry Service Board
i:\Building\Permiis PermitApp.doc 12/03 440 -4617T (11 /02 /COM /WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
��'. �,:'� � . a : - _ :.' �`»''
Total Yalu ; at> ou t ii OPerinr s ee , ' Nseamiwqmki
$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 12/03 2
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CITY OF TIGARD
BUILDING DIVISION .. . .
PERMIT #: MEC2005-00227
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2005
Phone: (503) 639-4171 aviloplati it
Inspection Requests (24 Hrs.): (503) 639-4175 11.. -
INSPECTION WORKSHEET FOR DATE: 5/2002005 TIME: 7:1 lAM PAGE: 87
SITE ADDRESS: 13165 SW KATHERINE ST CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 4 LOT #: 101 TYPE OF USE:
PROJECT NAME: BEROUIST
DESCRIPTION: Change out gas furnace to electric, install heat pump & electric water heater.
OWNER: BEROUIST, KATHLEEN, PHONE #: 503-579-2920
CONTRACTOR: ENERGY PLUS HEATING + COOLING PHONE #: 360.687-2014
Inspection Request Scheduled For: Date: 5/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007343-02 503-579-7802 Y
Corrections/Comments/Instructions:
C.-- (.---
g PASS EI PPARTIAL APPROVAL 0 CANCEL 111 NO ACCESS
n FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: #L.c.„—ik Date:<(7 — 0 Phone #: (503) 718-