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Permit CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00460 13125 SW Hail Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/28/2006 PARCEL: 25111 BB -02100 SITE ADDRESS: 10342 SW MCDONALD ST ZONING: R -12 SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 001 JURISDICTION: TIG Project Description: Heat pump replacement and air handler. 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: ELE 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: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Owner: FEES BULLOCK, MICHAEL T AND Description Date Amount CAROL HOOPES 10342 SW MCDONALD [MECH] Permit Fee 91281200€ $72.50 TIGARD, OR 97224 [TAX] 8% State Surcha 9/28/200€ $5.80 Total $78.30 Phone: 503- 684 -1192 Contractor: SHAMBURG HEATING LLC PO BOX 829 TUALATIN,•OR 97062 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 692 -5563 FAX 503 -691 -6855 Reg #: LIC 126881 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: ✓iG Permittee Signature: AIL ..2111/1 I :� 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. Mechanical Permit A lie 1 4 // ¢ FOR OrFICI - ; I Six ON I,Y City of Tigard Roza . B �-'fOb , Permit No.: rilGC.20GYo oo • lig q 13125 SW Hall Blvd., Tigard, OR 972 Plan Revi bt ' Phone: 503.639.4171 Fax: 503.598. 2 8 2006 Date/By Other Permit: T I G A 113 Inspection Line: 503.639 2006 Date Ready/ay. El See Page 2 for Internet: www.tigard- or.gov �h •,, Notified/Method VII Supplemental Information TYPE OF WORK $ . . C COMMERCIAL FEE* SCHEDULE - USE CHECKLIST • Mechanical permit fees* are based on the value of the work El New construction IA 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* D S 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: r Air conditioning or heat pump 0 34� •� (N/ t — �J e� ` (requires site plan showing placement) 14.00 City/ State/ZIP � R R ©� � ( f 2`� Furnace 100,000 BTU (ducts/vents) 14.00 1 1 , Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: P roject name: • Gas heat pump 14.00 Cross street/directions to job site: 5 S 1D� All, Ott [t. .3' 7 Duct work 14.00 rV`t�C� D1e� EJ ` - 1 , \R1� Residentialboilerr(radiatoror 14.00 ' hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue/vent for any of above , 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 p� � ukcE \- _ --- co a p t( � �R t\OD Gas fireplace 10.00 �` �"�`�' Flue vent for water heater or gas O x Z) 1 1 \ , L 1 {F �C fireplace 10.00 tjJ M \\ L.. r v R- 1�1�G Jr Log lighter (gas) 10.00 G � S Wood/pellet stove 10.00 Wood fireplace/insert 10.00 XPROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: ; eg \ 4 j ( Environmental exhaust and ventilation Address. 0.3 � - ) ` ' b AL S c — Range hood/other kitchen \ Vl \�\ 1 l equipment 10.00 City / State/ZIP: _ kN(4. 0 tom �-. Clothes dryer exhaust 10.00 �Z f-� ,) toilet file compartments, ust (bathrooms, Phone: ) Fax: ( ) l compartrt meentss, 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: ( ) I Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Q� /��` lye �� \` t Clothes dryer (gas) Business name: i � \", J `` `� �p Other: . '` dress: 0 on( 29 �y MECHANICAL PERMIT FEES* City /State/ZIP: v MIA R "'1`7b6Z Subtotal cy' Phone: 7)) 6 �� 4 Fax: ( ) 1 Minimum permit fee ($72.50) 7a, �V Plan review (25% of permit fee) • CCB lic.: \ 6 gig ` State surcharge (8% of permit fee) 5 1G TOTAL PERMIT FEE Ig, 3 This permit application expires if a permit is not obtained within 180 ► 1 days after it has been accepted as complete. 1 , 1� 1 11 t Date: •1 M • • • Fee methodology set by Tri- County Building Industry Service Board \ 1:Building \Pamils\MEC- PennitApp.doc 04/06/06 " ip '`- 440.46I7T (II /G2JCOM/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:\Bu ildingTermits NEC- PermitApp.doc 12/30/05 2 , k f \TS LI,o 342k t\ktki, 2 T. t . f . z g - 5 CITY OF TIGARD BUILDING DIVISION , - PERMIT #: MEC2006-00460 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9128 /2006 Phone: (503) 639 -4171 Ake i ( I Inspection Requests (24 Hrs.): (503) 639 -4175 "'I �.. INSPECTION WORKSHEET FOR DATE: 11/7/2006 TIME: 7 :03AM PAGE: 30 SITE ADDRESS: 10342 SW MCDONALD ST CLASS OF WORK: SUBDIVISION: TIGARDVILL.E HEIGHTS LOT #: 001 TYPE OF USE: PROJECT NAME: BULLOCK DESCRIPTION: Heat pump replacement and air handler. OWNER: BULLOCK, MICHAEL T AND, PHONE #: 503-684-1192 CONTRACTOR: SHAMBURG HEATING LLC PHONE #: 503 692 - 5563 Inspection Request Scheduled For: Date: 11/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 039378 -01 503 -684 -1192 N Corrections /Comments /Instructions: o /q-f't A. M 4 ■ d, P C� � ' t `(7 - Z 14i2L 0 S S El PARTIAL APPROVAL El CANCEL El NO ACCESS fkA ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G.11-1/ Date: // 7 br Phone #: (503) 718- ZG / y