Permit CITY O F 4I GARD MECHANICAL PERMIT
PERMIT #: MEC2006 -00237
DEVELOPMENT SERVICES DATE ISSUED: 5/25/2006
--- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 105D D - 04200
SITE ADDRESS: 13510 SW SANDRIDGE DR ZONING: R -7
SUBDIVISION: PACIFIC CREST LOT: 018 JURISDICTION: TIG
Project Description: Install gas line for dryer.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
•
JONATHAN RUIZ Description Date Amount
13510 SW SANDRIDGE DR
TIGARD, OR 97224 [MECH] Permit Fee 51251200E $72.50
[TAX] 8% State Surcha 5/25/200E $5.80
Total $78.30
Phone: 949 - 683 -7849
Contractor:
HOLMES INSTALLATION SERVICE
33535 NW VADIS ROAD
CORNELIUS, OR 97113 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 267 -7974
Reg #: LIC 102473
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: � . 1 i j Permittee Signature: y-
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.
Me hanical Permit Application roll UrrlcF us': oNL.v
_ ,
I City of Tigard ti" Received - ,...1 Op . i Permit No.: f . / , / .--•(1J 5j
rt 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
II • Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit:
T I G A it D Inspection Line: 503.639 Date Ready/By: MI ® See Page 2 for •
Internet: www.tigard or.gov Notified/Method Supplemental Information
PE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ddition/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*
- and 2 family dwelling ❑ 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
Job site address: / 35/ 0 5.I s � R 40 ei Air conditioning or heat p pump
�-./ (requires site plan showing placement) 14.00
City /State/ZIP: --7 0i.VV V ✓� Furnace 100,000 BTU (ducts/vents) 14.00
/J
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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
er: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
� t C Q l/9 r Gas fireplace 1 0.00
` P - A
Flue vent for water heater or gas
fireplace 10.00
n Log lighter (gas) 10.00
-S �, ` Wood/pellet stove _ 10.00
Wood fireplace/insert 10.00
PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
,s Other: 10.00
Name: (--/ /40 n/ ie v i Z_ Environmental exhaust and ventilation
Address: /31 � �+ Range hood/other kitchen
t../ J a M,/) J �S ./J equipment 10.00
City /State/ZIP: / ( 0 , r -) 0 re Clothes dryer exhaust 10.00
Phone: / cf ,- b�3- 7 ax: t Single-duct exhaust (bathrooms,
( ) toilet t 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: ( ) Fax: : ( ) Water heater
Fireplace •
E -mail: Range
CONTRACTOR Barbecue
Business name: tAivyt. r 5 r7 V .37 / r V /L Clothes dryer (gas)
� J f l / v -
Address:3 35,---- / q V v/ � 0 � 1 5 9 er MECHANICAL PERMIT FEES"
City / State/ZIP: `Q erNe 1, V 0 e Subtota ' ,
\ / ` Minimum permit fee ($72.50) - .Q�
Phone g )2\3 7 7 t Fax: ( ) Plan review (25% of permit fee)
CCB lic.: / 1' 0 , 7 Z State surcharge (8% of permit fee) 5 'O
( TOTAL PERMIT FEE Jig ,30
Authorized signature: This permi application expires if a permit is not obtainell within 180
days after it has been accepted as complete.
Print name: at �/ ^ ( ifk A 0 R y5 I Date: S Z S 17 • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \PenninllEC- PdmitApp.doe 04/06/06 f 4 617T(II /o7/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 /6r , , � �
fraction thereof, to and including`' ..1
$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.
r�
'1 0 A C 1 n \�
•
■
.•
I:\ Building \Permits\MEC- PermitApp.doc 12/30/05 G � 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MF.C200& 00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/25/2006
Phone: (503) 639- 4171�f1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/26/2006 TIME: 7:00AM PAGE: 14
SITE ADDRESS: 13510 SW SANDRIDGE DR CLASS OF WORK:
SUBDIVISION: PACIFIC CREST LOT #: 010 TYPE OF USE:
PROJECT NAME: RUIZ
DESCRIPTION: Install gas line for dryer.
OWNER: RUIZ, JONATHAN PHONE #: 949
CONTRACTOR: t IOLIVIES INSTALLATION SERVICE PHONE #: 503
Inspection Request Scheduled For: Date: 5126/ 2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 030679-01 503-846 1788 Y
Corrections /Comments /Instructions:
rA
pr • =
i I
/ I
j
A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Pi V Date: __ ° (7/ Phone #: (503) 718 2 L 5",