Permit .1 ,,y. , is _
C
III a CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00207
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/23/2008
PARCEL: 2 S 104 B B -042 00
SITE ADDRESS: 14051. SW LIDEN DR ZONING: R -12
SUBDIVISION: CASTLE HILL LOT: 025. JURISDICTION: TIG
• PROJECT: BREESE
Project Description: Installation of gas line for 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= cfm: GAS OUTLETS: 1
> 10000 cfm: .
Owner: FEES
NORMAN BREESE Description Date Amount
14051 SW LIDEN DR
TIGARD, OR 97223 [MECH] Permit Fee 4/23/200E $72.50
[TAX] 12% State Surch 4/23/200E $8.70
Phone: 503 - 524 -8159
Total $81.20
Contractor: • -
OWNER
REQUIRED ITEMS AND REPORTS
Contact #: -
Reg #:
•
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.
cs......_ /
Issued // //— e , Permittee Signature: � �L
Call 503.639.4175 by 7:00 a.m. for inspections th- business day
This permit - card:shall.be. kept - in- a.conspicuous-Place on-the-job ite until co , etion •f the project. -- -
- Approved plans are required on the job site at th ime of each ' spect' • n.
Mechanical Permit Application FOR OFFICE USE ONLY
Received p �/�,�y 0
City of Tigard Date/By: r3 oq P ermit No.: ii f%IYOr,/q.�� 9,0 2
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review /` �u��
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
"I I G A It D Inspection Line: 503.639 Date Ready/By: 1 ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: t \�-/ �+� Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees" are based on the value of the work
❑ New construction ❑ 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
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. , Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address:
„/%19 57 s //) . / e, ,/c j0/ -g7/p_.,_ (requires site plan showing placement) 14.00
City /State /ZIP: der -,49ti 0 £ .0Y2 2.3 Furnace 100,000 BTU ( ducts/vems) 14.00
� Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: .. / 3 71e c 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
Gas fireplace 10.00
- J 9 .' , i : 4 1 ) : / Ai 7 - .4 f'7/2/I.1 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: /14/2-/Y140 ; 7 Qrz,ff' /),2 &//rvi�fL '.. Environmental exhaust and ventilation
Range hood/other kitchen
Address: // // /
�i0 ...C/ S /) ,(, �/-„�✓ n/L, equipment 10.00
City / State/ZIP: -2-7630502. //-2-7630502. / /9/0 /9/92.2 Z Single -duct exhaust (bathrooms, 10.00
/
Phone: (5 S2 « _e/s9 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:
Fumace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
_ Fireplace
E -mail: Range /
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: U a/.t/,..i2-- Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Minimum permit fee ($72.50) 1.
Phone: ( ) Fax: ( ) _ Plan review (25% of permit fee) -7
CCB lic.: State surcharge (12% of permit fee) , g .7 o
/
Authorized signs � TOTAL PERMIT FEE. R I , 20
Thi perm app lication expires if a permit is not obtained within 180
_� days after it has been accepted as complete.
Print name: �Y 2 , � /� Date: .2 _.7 d� • Fee methodology set by Tri -County Building Industry Service Board
I:'Buitding'Permits , 1 C- PermitApp.doc , 1119/07 440 -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-'0F. TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00207
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/23/2009
Phone: 503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 11-
INSPECTION WORKSHEET FOR • DATE: 4/28/2008 TIME: 7:02AM PAGE: 8
SITE ADDRESS: 14051 SW LIDEN DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL LOT #: 025 TYPE OF USE:
PROJECT NAME: 13REESE
DESCRIPTION: Installation of gas line for range.
OWNER: BREESE, NORMAN PHONE #: 503524-8159
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/28/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
99 Mechanical final 068966-01 503- 524 -8159 N
orrections /Comments / Instructions:
tZ CA:LL. - / - Cam,' 4 'L) AncS'%coo-
4 1 PASS _ ❑_.PARTIAL APPROVAL — _❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: Date: 4-- ze -O $• Phone #: (503) 718- 2-
CITY. OF TIGARE
BUILDING DIVISION PERMIT #: MEC2000 -00207
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/23/200(1
Phone: (503) 639 -4171 Avatp 1,
Inspection Requests (24 Hrs.): (503) 639 -4175 `_L
INSPECTION WORKSHEET FOR DATE: 5/1/2006 TIME: 7:00AM PAGE: 93
SITE ADDRESS: 14051 SW LIDEN DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL LOT #: 025 TYPE OF USE:
PROJECT NAME: BREESE
DESCRIPTION: Installation of gas line for range.
OWNER: BREESE. NORMAN PHONE #: 503. 524 -B159
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 069132 -01 503 - 639.4175 N
Corrections /Comments/ Instructions:
P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS _
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
A .....---"'
Inspector: Date: 4- J---9J Phon #: (503) 718 - 24� -4-a