Permit !pi CIT 4 ' i OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00463
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/25/2007
PARCEL: 2 S 109 BA -0 5700
SITE ADDRESS: 13750 SW MISTLETOE DR ZONING: R -7
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 LOT: 043 JURISDICTION: TIG
PROJECT: GREGORY
Project Description: Installation of pool heater and gas piping.
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: 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: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
CANDICE GREGORY Description Date Amount
13750 SW MISTLETOE DR
TIGARD, OR 97224 [MECH] Permit Fee 7/25/200? $72.50
[TAX] 8% State Surcha 7/25/200? $5.80
Total $78.30
Phone: 503 - 522 -8005
Contractor:
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NATURAL GAS CUSTOM PIPING INC
19271 SE SUNNYSIDE RD
DAMASCUS, OR 97807 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 335 -9950
FAX 503- 335 -9950
Reg #: LIC 125031
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.
Issue By: kt // � / ` f Permittee Signature: k
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 Application / FOR OFFICE USE ONLY
11, C ity of Tigard< Dat ? ore / Op, Permit No.: Nii6I .0/ ?, /0 (�
° 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T I G A IL D Inspection Line: 503.639 Date Ready/By: Mil 60 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 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: $
❑ 1- and 2- family dwelling ❑Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 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: ` ) Air conditioning or heat pump
�� - \ O �/ \ (� v `5 5� ` I � (requires site plan showing placement) 14.00
City /State /ZIP: 1 V C k 0 9---)a..1) Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name: (5-<) Furnace 100,000+ BTU ( ducts/vents) 17.90
c\s\ 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
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
�n+__ r 1 Gas fireplace 10.00
• C-7'` \ ■ r \ 5 'f 0 IY �L let I 5� Flue vent for water heater or gas
1 �� y / fireplace 10.00
�tl 1 1 (, 1 Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney!! iner/flue/vent 10.00
Other: L hFta r�/L 10.00
Name: C. a f\ to CO G f e s `i Environmental exhaust and ventilation
Address: Range hood/other kitchen
��� S� j w M � b r equipment 10.00
City/State /ZIP: '�" 1 1 F 0 1\ "� . Clothes dryer exhaust 10.00
J V Single -duct exhaust (bathrooms,
Phone: ( ) 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
1k, Other:
Business name: r _ ?-irb Clothes ryer (gas)
a l. or 0 \ 1-4_ - k G_\)'S� P� /f/trEE--
Address: let 1 S C 5 ) r\^ t k _l MECHANICAL PERMIT FEES*
City/State /ZIP: C . l � `) c) , ` Subtotal
� �5� � 4 C ■ r � � Minimum permit fee ($72.50) 7a•�
Phone: St3 ( )
Fax: Plan review (25% of permit fee)
CCB lic.: `Z s 0-5 1 . State surcharge (8% of permit fee) 55 8E) TOTAL PERMIT FEE 73. 3d
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ii3 r • , ` Date: • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 4404617T(11/07/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - S Information a'
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.
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I:\Building\Permits\MEC- PermitApp.doc 01/19/07 2
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CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MEC2007 -00463
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007
Phone: (503) 639-4171 ° � l
Inspection Requests (24 Hrs.): (503) 639 -4175 _' IL
INSPECTION WORKSHEET FOR DATE: 7/26/2007 TIME: 7 :03AM PAGE: 50
SITE ADDRESS: 13750 SW MISTLETOE DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 LOT #: 043 TYPE OF USE:
PROJECT NAME: GREGORY
DESCRIPTION: Installation of pool heater and gas piping.
OWNER: GREGORY, CANDICE PHONE #:
CONTRACTOR: ISIREICEPARYORMIX0130M PIPING INC PHONE #: 503-536°0008
Inspection Request Scheduled For: Date: 7/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 052772 -01 949 -357 -5626 Y
Corrections/Comments/Instructions:
A O 7 1 ` � • r W ? _ — a e!g " 1 - - 7 4,- Z.. 1/11 7
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ./ Date: 7-26-4 7 Phone #: (503) 718 -