Permit 1 ,
` v CITY OF TIGARD
MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00180
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/9/2008
PARCEL: 1 S 135DC -00700
SITE ADDRESS: 11870 SW LINCOLN AVE ZONING: R -7
SUBDIVISION: TIGARDVILLE PARK LOT: 008 JURISDICTION: TIG
PROJECT: NASS
Project Description: Installing new gas furnace, duct work and A/C.
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: 1 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: " <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Owner: FEES
KRAIG NASS Description Date Amount
11870 SW LINCOLN AVE
TIGARD, OR 97223 [MECH] Permit Fee 4/9/2008 $72.50
[TAX] 12% State Surch 4/9/2008 $8.70
Total $81.20
Phone: 503- 267 -2265
Contractor:
HARDY PLUMBING + HEATING
COUNTRYSIDE
AUROURO RAA, , OR 97002
REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 222 -9654
FAX 503- 678 -4498
Reg #: LIC 60947
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: // _ �� Permittee Signature
Call 503.6 • . • 5 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.
Mechanical Permit Application FOR OFFICE USE ONLY
F City of Tigard . \ v rit',.. ; � • L/L .1_ : • .
p; 131 ' :
IN
a 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
17 . Phone: 503.639.4171 Fax: 503.598.1 S '1 QO Date/By: er erm
Other Pit:
�� --at.0 (J • Q
T 1 G A R D Inspection Line: 503.639.4175 9 I " s ions: ® See Page 2 for —U •r
Internet: www.tigard or.gov
`I 0? /I - ljN Supplemental Information
TYPE OF WORK���11,QW 0 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Ei 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*
g 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. 1 Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: J) ye-) .! W L1 LoL� Aiconditioning heat pump
• (reqguires site plan sho howing placement) I 14.00 /Y. t:J(-
City/State /ZIP: 77 /, f g4 i OR_ Furnace 100,000 BTU (ducts /vents) 1 14.00 /L(. Ja
` / Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: /1 s S Gas heat pump 14.00
Cross street/directions to job site: Duct work l 10.00 (p, vo
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
/ (-- 2 - / RS cuR_ �-J 4- Flue vent for water heater or gas
fireplace 10.00
1 /2 P_.4 1,,z)R,L. ) Al C 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 q _") p 5 S Environmental exhaust and ventilation
Range hood/other kitchen
Address: 7) ?-'--) b S -✓ Li ID L--/ equipment 10.00
City/State /ZIP: -77 l kola , ix Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 03 ) L ') _ ' 2 , 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 _
CONTRACTOR Barbecue
Business name: J) ie P Y 1 L a-- ) —,Z Clothes dryer (gas)
Other:
Address: 9 q 7 p,p /it o / �iZ to U,- S J MECHANICAL PERMIT FEES*
City/State /ZIP: Al) / 2 4 b 6 ,bf 'Z Subtotal
/� Minimum permit fee ($72.50) 74 .V
Phone: 7J7) -k--2K-1... � L S /i Fax: trf ?) - 1,-2 r - L z) 7 i)
, [ Plan review (25% of permit fee)
CCB lic.: b il, 9 LI ? State surcharge (12% of permit fee) $ -70 ^ / TOTAL PERMIT FEE ¶5 ( .
Authorized signature: 1 �-" — This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: rJ ,T 21)\/ Date: ' - t _ Oj _,,,,,/- • Fee methodology set by Tri -County Building Industry Service Board
1:\ Building \Permits\MEC- PennitApp.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.
1:\Building\Permits\MEC- PermitApp.doc 01/19/07 2
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00180
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/9/2008
Phone: (503) 639-4171 w �e
Inspection Requests (24 Hrs.): (503) 639 -4175 !� "� L
INSPECTION WORKSHEET FOR DATE: 4/11 /2008 TIME: 7:01AM PAGE: 17
SITE ADDRESS: 11870 SW LINCOLN AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: NASS
DESCRIPTION: Installing new gas furnace, duct work and NC.
OWNER: NABS, KRAIG PHONE #: 503-267 -2265
CONTRACTOR: HARDY PLUMBING + HEATING PHONE #: 503222 -9654
Inspection Request Scheduled For: Date: 4/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
09 Mechanical final 068251 -01 503-222 -9654 N
Corrections/Comments/Instructions:
i
,/(C, -
76, ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
las6i) .
Date: q 1 1 I t Phone #: (503) 718- '2 /;