Permit r
IN . CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00452
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/5/2008
PARCEL: 1 S134DC -00500
SITE ADDRESS: 11476 SW TWIN PARK PL ZONING: R-4.5
SUBDIVISION: TIGARD PARK LOT: JURISDICTION: TIG
PROJECT: ALATTAR
Project Description: Furnace conversion, add gas line, venting and new a /c.
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:
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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
ADNAN ALATTAR Description Date Amount
11476 SW TWIN PARK PL
TIGARD, OR 97223 [MECH] Permit Fee 9/5/2008 $72.50
[TAX] 12% State Surch 9/5/2008 $8.70
Total $81.20
Phone: 503 - 521 -1320 ,
Contractor:
RNR HVAC INC
PO BOX 144
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 668 -3399
FAX 503- 668 -3396
Reg #: LIC 166479
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: A // . / Permiftee Signature: G
Call 503.639.4175 by 7:00 a.m. for inspections that business .
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 p FOR OFFICE USE ONLY
City of Tigard �'� DDate/By �I dO Permit No.. ete� � y�a
ill
q 13125 SW Hall Blvd , Tigard, It 1' ' ` ' r n EN E, Plan Review
11 Phone 503 639.4171 Fax. 51 • . ", . 1 Other Permit•
Inspection Line 503.639 4175 DateBy.
T I G A R D p Fill ( Date Ready /By See Page 2 for
Internet www tigard -or goy S EP — r Notified/Method Supplemental Information
TYPE I% l � I T GP D
j DIVISION
❑ COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Additio ter rati 1 on /re p Mechanical permit fees* are based on the value of the work lacement 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*
❑ I- 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
5 w T� 1 vi L Y k Air conditioning or heat pump
Job site address: ?
r }� 1 (� L (requires site plan showing placement) 14 00
Cit y ✓ /State /ZIP: 1 97 22-3 Furnace 100,000 BTU (ducts/vents) I 14 00
Furnace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg. /apt. no.: Project name: R-L A-1T g-. 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
Gas fireplace 10 00
'fa A ^ 1 c C S `1v\Q Flue vent for water heater or gas
fireplace 10 00
Log lighter (gas) 10 00
Wood/pellet stove 10 00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10 00
Other 1 _ 10 00 I
Name: a_� �� 1 � 1 c d Environmental exhaust and ventilation
Address: f ' A Range hood/other kitchen
equipment 10 00
City /State /ZIP: 5G` - ' — •L ! /� �s G,Ndkr-'-- Clothes dryer exhaust 10 00
Single -duct exhaust (bathrooms,
Phone: (603 ) 5 21 1 3 2,0 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. I
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( )
Fax:: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: RN ii V A / TL i ✓L Other
Address: A J. . i Y N MECHANICAL PERMIT FEES*
City /State /ZIP: C re 514 In 0 g ) e2 D Subtotal
Phone: ( 1) 6 p Fax: (�j03) t, r3 5' 5'6, Minimum permit fee ($72 50) 7 .3O
Plan review (25% of permit fee) ,t-
CCB lic.: I '. /64:47 F49/t/ State surcharge (12% of permit fee) $. 70
, TOTAL PEmMsT FEE J. a0
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
-
Print name: Date: • Fee methodology set by Tn -County Building Industry Service Board
1 \Building\Permus\MEC•PermitApp doc 01/19/07 440 -4617T (I 1 /02/COMJWEB)
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.
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I.\ Building\Permits\MEC- PermitApp.doc 01/19/07 2
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CITY OF TIGARD . ,
BUILDING DIVISION PERMIT #: MFC'2(lOp3 OO�i2
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/W2008
Phone: (503) 639 -4171 4 1
Inspection Requests (24 Hrs.): (503) 639 -4175 .. .. F 'll�
INSPECTION WORKSHEET FOR DATE: 10/2/2008 TIME: 7:DOAM PAGE 31
SITE ADDRESS: CLASS OF WORK:
11476 SW TWIN PARK PL
SUBDIVISION: TIGARD PARK LOT #: TYPE OF USE:
PROJECT NAME: ALATTAR
DESCRIPTION: Furnace conversion, :acid gas line, venting and new a /c.
OWNER: ALATTAR, ADNAN PHONE #: 5035,1 -1320
CONTRACTOR: RNR HVAC INC PHONE #: 503668 -3399
Inspection Request Scheduled For: Date: 10/212008 Pour Time:
Code # Inspection Description /Confirm # Contact # Message
699 Mechanical final (� 07619tp02 503 - 8039751 N
Corrections /Comments /Instructions:
. / .. (' -.---v'' --'
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: I b Z Phone #: (503) 718-
CITY OF TIGARD . •
BUILDING DIVISION PERMIT #: Mf_G2008 0(1552
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/:.4 20()B
Phone: (503) 639 -4171 �j�ll►
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' °:_
INSPECTION WORKSHEET FOR DATE: 10/2/2008 TIME: 7:00AM PAGE: 32
SITE ADDRESS: 11476 SW TWIN PARK PL CLASS OF WORK:
SUBDIVISION: TIGARD PARK LOT #: TYPE OF USE:
PROJECT NAME: ALATTAR
DESCRIPTION: Furm.ce conversion, add gas line, venting and new a/c
OWNER: ALATTAR, ADNAN PHONE #: 503-521 -1320
CONTRACTOR: RNR HVAC INC PHONE #: 5'03668.3399
Inspection Request Scheduled For: Date: 10/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message t0 511
610 Gas line 076195 -01 503-803-9751 Y i 0 tom"
Corrections /Comments /Instructions: �� ais, i
14 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ° L I ' 1 6 Phone #: (503) 718-