Permit - ii i ' . '''.. CITY OF TIGARD
MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00535
TIGARD . 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/6/2007
PARCEL: 2 S 102 C D -02608
SITE ADDRESS: 09800 SW O'MARA ST ZONING: R-4.5
SUBDIVISION: TWALITY HILL LOT: 008 JURISDICTION: TIG
PROJECT: NIELSON
Project Description: Change appliances from electric to gas, install duct work and a/c unit.
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: 2
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:
CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 1
• FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 5
> 10000 cfm:
Owner: FEES
KEN NIELSON Description Date Amount
9800 SW O'MARA ST.
TIGARD, OR 97223 [MECH] Permit Fee 9/6/2007 $72.50
[TAX] 8% State Surcha 9/6/2007 $5.80
Total $78.30
Phone: 503 -781 -8092 .
Contractor:
OWNER •
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. .
�/ •
J ih Issued = �� � i�/ �J Per Signature: �J / J / A
A , r .
Call 503.639.4175 by 7:00 a.m. for inspection- busine; - day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A t ;t.y,„..d I r FOR OFFICE USE ONLY
i r "' ' Received
City of Tigard ; ; .. . Date/By: r ♦• ►, �/ _ • ♦ / t.
1
13125 SW Hall Tigard,.OR 97223 (, Plan Review
C Phone: 503.639.4171 Fax: 503.59$.196Q u V O v 2001
Date/By: Other Permit:
T I G A li D Ins Line: 503 Date Ready /By: ®See Page 2 for
Internet: www.tigard - or.gov Notified/Method: EN Supplemental Information
Ci.1 I bit' 11.UA D
O � T t s ; '' r' TSIoI�T CKL COMMERCIAL FEE* SCHEDULE - USE CHEMIST
�! �
❑ New construction 7gAddition /alteration/replacement 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1- and -2- family. dwelling ❑ Commercial /industrial ❑ Accessory building
Master builder For special information use checklist.
Multi -famil
❑ Multi-family ❑ ❑ Other: • Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: cr800 S (,_,.) 0 rn Q g . (requires site plan showing placement) 1 14.00 1. • IP _
City/State/ZIP: IG IN -ca e Gi i Z2_3 Furnace 100,000 BTU (ducts/vents) 1 14.00 1. .00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldgiapt. no.: Project name: •
Gas heat pump • 14.00
Cross street/directions to job site: /YI C a ,� 1 c m Duct work 1 10.00 (0.
,,t 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 1 6.80 (,p • SZ
Other: 10.00
•
Tax map /parcel no.: Other fuel appliances _
DESCRIPTION OF WORK Water heater , . 10.00 ' 1p • tit
PE \ �,, 1 Gas fireplace 10.00
PE co �uXLI/. c... C. ga_S ) .�.J� Flue vent for water heater or gas I 10.00 . b0 -- ln) cf� s.6-72.1A-4.4..,= Cp S Cx..04 1 (7� glace
Log lighter (gas) 10.00.
.. -1. « (.1-e-1-.."IL Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 10.00
�� Other: 10.00
Name: V LC S (M Environmental exhaust and ventilation
Q Range hood/other kitchen
Address:
g6 (( s(�) 0me►rn� .e 10.00
City/State/ZIP: 1 6 ,. ,,a c o x -- ci 7 Z2 Clothes dryer exhaust • 10.00
I 1, 1 " Single -duct exhaust (bathrooms,
Phone: ( 3) 75/23)69 2.. 69 X03 to Diva 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. I 6 . it
Gas hear pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : (' ) Water heater I ...---
Fireplace I _
E -mail:
Range 1 . , .
CONTRACTOR _ Barbecue I 1 •b0 _
Business name:
Clothes dryer (gas)
. Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal 4- I, .2.0
Phone: (• ) Fax: ( ) Minimum permit.fee ($72.50) 72 ,so
Plan review (25% of permit fee)
CCB lic.: / State surcharge (8% of permit fee) , £j ISO
TOTAL PERMIT FEE ' „3 n
Authorized sigriatu 40P. . d r/ ��., ♦ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 6-t \ 9 ` -�S' Date: Lir6? • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permits\MEC•PermitApp.doc 01/19/07 •046 (11 /02/COM/WEB)
•
Mechanical Permit Application - City of Tigard � ti •
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 •
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: MEC2007 -00535
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/G170()7
Phone: (503) 639-4171 il j � l
Inspection Requests (24 Hrs.): (503) 639 -4175 ��' °:_..
INSPECTION WORKSHEET FOR DATE: 10/1&/2007 TIM - 7 :01AM PAGE: 48
SITE ADDRESS: 09800 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: TWALITY HILL LOT #: 008 TYPE OF USE:
PROJECT NAME: NIELSON
DESCRIPTION: Change appliances from electric to gas, install duct work and a/c unit.
OWNER: NIELSON, KEN PHONE #: 503-781 -0092
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/1007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 057674 -01 503 -781 -8092 N
Corrections /Comments/ Instructions:
T
PAS / rARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL E, • LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \ Date: r o
�G 7 Phone #: (503) 718- 24
i
CITY OF TIGARD
BUILDING ,DIVISION - PERMIT #: MEC2007 -00635
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/6/2007
Phone: (503) 639 -4171 4mu, u , l
Inspection Requests (24 Hrs.): (503) 639 -4175 : �l
_..
INSPECTION WORKSHEET FOR DATE: 9/19/2007 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 09800 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: TWALITY HILL LOT #: 008 TYPE OF USE: '
PROJECT NAME: NIELSON
DESCRIPTION: Change appliances from electric to gas, install duct work and a/c unit.
OWNER: NIELSON, KEN PHONE #: 503-781-8092
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 055951 -01 503 -781 -8092 N
Corrections /Comments /Instructions:
[ SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 Date: o ti Phone #: (503) 718-