Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00379
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/7/2006
PARCEL: 2S 102CD -02000
SITE ADDRESS: 09680 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT: 010 JURISDICTION: TIG
Project Description: Convert oil furnace to gas w /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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
MARTY FRANCIS Description Date Amount
9680 SW OMARA ST
TIGARD, OR 97223 [MECH] Permit Fee 8/7/2006 $72.50
[TAX] 8% State Surcha 8/7/2006 $5.80
Total $78.30
Phone:
Contractor:
THE REILLY CO
PO BOX 882
BATTLEGROUND, WA 98604. REQUIRED ITEMS AND REPORTS
Contact #: PRI 360 - 387 -6848
Reg #: LIC 119062
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: _ _j LS¢ Permittee Signature:
Call 503- 639 -4175 by 7:00 a.m. for inspections that business y.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
' Permit Applicatio�ln • FOR OFFICE USE ON 1,1
of Tigard I" 1. - ve d ` b l P erm it N o.: ` • ;
125 SW Hall Blvd., Tigard, OR 97223 ateJBy. ' Y `- fI u ! ��
Al AI'^ Plan Review
' . Phone: 503.639.4171 Fax: 503.598.1960 "VD 0 `- Other Permit:
Inspection Line: 503.639.4175 ° 20 � c D atrJBy
T I G A R D p �� y Date Ready/By: ilifil ®See Page 2 for
Internet: www.tigard- or.gov 1 a 1a. Notified/Method Supplemental Information
atig
TYPE OF WORK F - a COMMERCIAL FEE* SCHEDULE — USE CHECKLIST •
El New construction & Addition/alterati ,, replacement v Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ L SiS'O , m
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 g ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
�± Air conditioning or heat pump
Job site address:
�, 4 21 43 C) )/l4 4 i. (requires site plan showing placement) 14.00
City / State/ZIP: i 1 Furnace 100,000 BTU ( ducts/vents) /V
14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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. '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
Gas fireplace 10.00
FQ Al/ % v V of r_Q Flue vent for water heater or gas
�J . e.4 SnZ c:. rg(/ C.,..- fireplace 10.00
Log lighter (gas) 10.00
t ", Wool/pellet stove 10.00
Wood fireplace/insert 10.00 •
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: /�q ,��T r- / /t - € � c Environmental exhaust and ventilation
Address: / Range hood/other kitchen
equipment 10.00
City /State/ZIP: , • Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) _ toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other: 10.00
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
�� Clothes dryer (gas)
Business name: 7,1,0 / e L Other:
7
Address: , 0 - 6 c' e- L MECHANICAL PERMIT FEES*
City /State/ZIP A,774 (t 6,1, ....j. `4, 1 6 5' Subtotal
��
Phone: j) 6' g-7 6g - I Fax: ( ) Minimum (25% fee ($72.50)
fee
Plan review (25% of permit fee)
CCB lic.: J 7 fe 6 . State surcharge (8% of permit fee)
% /��'L✓` This TOTAL PERMIT FEE C
is permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
I Print name: 70.24 - /L4 , l/ Date: -- 7 O tj • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \PermitsVMEC- PetmitApp.doc 04/06/06 440.4617T(II /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 $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
•
I:\Building\Permits\MEC- PermitApp.doc 12/30/05 2
CITY: OF TIGARD .
BUILDING DIVISION PERMIT #: MEC2006 -00379
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/7/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _-' `'I I..
INSPECTION WORKSHEET FOR DATE: 8/11/2006 TIME: 7 PAGE: 81
SITE ADDRESS: 09680 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: Q10 TYPE OF USE:
PROJECT NAME: FRANCIS
DESCRIPTION: Convert oil furnace to gas w /piping.
OWNER: FRANCIS, MARTY PHONE #:
CONTRACTOR: THE REILLY CO PHONE #: 360-387 ..6848
Inspection Request Scheduled For: Date: 8/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 034773 -01 360- 904 -8117 N
i
Corrections /Comments /Instructions: i
i D Cd77 4, Ad G G ec- t 6 A- 4 - 1c ,.. -.:-r1 .2- ,- lAw.1 -4-0 -, -- t.A. - /),_
l ' I r 2 CAS ti,j$ -�r — r7.5 - s: = Zd fl _( .off 15' /tei,c. ic.7
A ;; J
PASS EL PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ef Phone #: (503) 718 - Z—#44--