Permit l *CITY OF TIGARD MECHANICAL PERMIT
i1l DEVELOPMENT SERVICES PERMIT #: MEC2006 -10025
DATE ISSUED: 3/13/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 111 AB -00500
SITE ADDRESS: 09150 SW MCDONALD ST ZONING: R -4.5
SUBDIVISION: ELROSE TERRACE LOT: 001 JURISDICTION: TIG
Project Description: Gas line to FP insert.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
JAMES HOLM Description Date Amount
9150 SW MCDONALD ST
TIGARD, OR 97224 [MECH] Permit Fee 4/3/2006 $72.50
[TAX] 8% State Surcha 4/3/2006 $5.80
Total $78.30
Phone: 503- 620 -8450
Contractor:
ENERGY SAVERS PLUS, INC.
3747 SE 49TH AVE.
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
•
Contact #: PRI 503- 777 -0389
FAX 503- 775 -6772
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Reg #: LIC 103273
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:
/e.„
Permittee Signature: / j/ /�
AZie.2&.... 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.
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.. _ . .. ........... WJUU.L
Mechanical Permit Applicatio FOR OFFICE USi: ONLY
caw El',1i}' Of Tigard RECEI�I Received
y : 3 - t -o4 Big P— itwo,n Ce 5
13125 SW Hall Blvd, Tigard, OR 97223 .��b� �U °7
Phone: 703.639.4171 'Fax: 503.598.1960 A Yon Review
IaspecrMn Line: 503.639.4173 ,',..4 Dare/By: Other Permit;
Internet www.eLtigard_or.us 3 _ -- Date Readyaty. See Page I for
MAR 1 2:-:,,P- Notified/Method SupplmentalIeformatloo
TYP1 IPASMIGARD • ' : COMM dE*NALIOIC'' BekODULA - ,. USE If;$$Gt{Ltri
❑ New construction ca�di UhlaMlJ gitlent Mechan perrn fees' are b rm th v ue of the work
performed. indicate the value (rounded to the neatest dollar) of all
❑ Demolition ❑Other.
mechanical materials. equipment, labor. overhead, and profit.
. : . -,
CATEGORY rOF CONSTRUCTION ' .,::. - : :
Value: $
t- sad 2 -fhmil dwelling ❑ Commercial /industrial 1i SIDEN? IALEQUiPMENT / SYSTEMS FEES*
fi
Y 1tn8 ❑ Accessory building For special information use Macklin.
p Multi- family ❑ Master builder p otter:
Description
1 Qty. I Ea. Total
' JOBi_SITE. I140ORMAIY'I011, ANA LOCATION - • H jigrlcpoline
Job site address: 1 a O & t C o n 6t. l �Str . Air o res she conditioning ho hat pump
� -- ( ratltheasite planshowrltlplacamvni) 14.00
City/State/ZIP: t o rA n (L c— a �4 I Furnace 100,000 BTU (ewe/vents) 14.00
Furnace 100,000+ BTU (duabvatu) 17.90
Suitc/bldgJapt. Project name: Gas heat pump 14.00
Cross street/directions to job site: Duet work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydro) 14.00
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, eta 10.00
Subdivision: Lot no.: Flue/vent far any of above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
..::. DESCRIPTION OF WORK.:. Water heater 10.00
/� Gas fireplace 10.00
T r•-.1- L-a.. (i I a l e r -e,p 17. � .o t "n S ,a. �k- . Flue vent for water heater or gas I
fireplace 10.00
Lox lighter (Ras) 10.00
W el to ^v^ 10.00
fireplace/insert ttc {
er/Dueiven
w G� ( 10.00 1 D • r h)
. [l- PftOP'F -IITY OWMIpR 1 10.00 Id •A t7
III O r1sNxNT:.. other: 10.00 1 `
Na . es — a c A--k-0 1 ,-. Eavironmental exhaust and ventilation
Address: C 1 1 S O S.(L.) 1^tC - l d &- .
Range hood/odtet kitchen
� r.r egt pment 10.00
City /stale Zt'P:— - t - �.� Clothes dryer exhaust 10.00
Phone: Single-duct exhaust (bathrooms,
� �- 0 y '1 ix 7 .O - R4sn Fa ( ) toilet compartments. utility rooms) 6.80
t!
I lltPP :ICANT' :.. >:.:: it} ONTACT: PERSON ' . Attic/crawlspeoe fans 10.00
Other 10.00
Business nacre. 9 r, A o •_ l t.L-S -. t --- ,., , .
S d� Fuel piping
natnt� a r`c i I e 14 : ^ �L�� $5,40 for first fear; $1.00 for each additiona
Address: Furnace. etc.
Oas heat pump
City /State/Z3:
_ walUaucpmded/utit heater
1)11°": t()- ) 31.) - S7 in q nt (I 1 ` ":: ( ) water beater
Fireplace 1 SAD
E -mail: Range
• • CON3�RACrOR .. Barbecue
Business name: fr,e, 0� 1 T� , Clothes! dryer (gash
�/1t r > d ,- Other.
Address: 3'74 --1 & e 4 I14 r , e MECHANICAL PERMIT FEES *' • :
City/StateeZlP: � r ,t-t ` 2 C ( 0 . `7�O Co - Subtotal 40
minimum permit fee (372.10) 1 -, SD
Phone: (5r).) `1`i - O3 o, I Fax : tn1 ) - 1S - lel `rte e
Plan review (25/. of permit fen)
CCB lic.: 1 0 3 ..5,,. - I - 0 ( Stnte surcharge (8% of permit fee) X{)
- TOTAL PERMIT FEE ? .3 [ )
AUfOriZtld 6ig3atl . 'then permit appdcatlon =pica if a permit Is net obmlecd within 190
w.., 9c w t4_, L .l days after it has beta accepted as sompiete.
P rint name: 4.., , r. ,. (4I..- „ O 6 ..., I Date: -l3 .-. , • Fee rnethodulow act by Tri-County Building hide try Service Bead
CITY OF TIGARD ,. . ■` rn_
BUILDING DIVISION PERMIT #:2_0 06 - -/00x5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: � Q
Phone: (503) 639- 4171w��I 4 Al- �- "'"
Inspection Requests (24 Hrs.): (503) 639 -4175 _. _�+�- •
- .. astir
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: Cf x$ 3 r c DaY1 Cpl, CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 --i d ( Pour Ti - e. /4 ' 111 _,_
Code # Inspec Confirm # Contact # Message J
6 q q vv,..
--1.:,._,J i r'llgil -- ki.ern/iL Corrections/Comments/Instructions: - ----( q— C J .D.- 07
M - l,' ,/in..-,14 )
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—fr:i - x1 4- .7 b c7
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(..;A. jes r;/-14,6,e
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6 to , •Wiest
t '7 : /4,,� er��-e✓
e PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: it 46 Phone #: (503) 718- 2-1-461‘