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Permit
i " ]3 CITY OF TIGARD MECHANICAL PERMIT ry} COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00595 DATE ISSUED: 10/15/2007 TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 102 C D - 03600 SITE ADDRESS: 13900 SW 100TH AVE ZONING: R -4.5 SUBDIVISION: SHILO LOT: 005 JURISDICTION: TIG PROJECT: CAFFALL Project Description: Gas line & fireplace. Previously installed. 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: DOMES. INCIN: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: REPAIR 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 CAFFALL, VERION 0 TRUSTEE Description Date Amount 13900 SW 100TH TIGARD, OR 97223 [MECH] Permit Fee 10/15/20C $72.50 [TAX] 8% State Surcha 10/15/20C $5.80 Total $78.30 Phone: Contractor: ADVANCED HEATING & AIR COND 5825 SE FOSTER PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 774 -0161 FAX 503- 774 -4391 Reg #: LIC 98573 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 .� :% Permittee Signature: w ct Call 503.639.4175 by 7:00 a.m. for inspections that'business day. y This permit card shall be kept in a conspicuous place on the job site until completion .f the project. Approved plans are required on the job site at the time of each inspec '.n. I t t b '! M � 1 r '1 t IA ". rh.� + �� i '" �'� sE+5 q 7'� r rr'�" rct�v h�,.`�' V � a�' .n � � i M � � �+ u,rr Mechanical Permit App p , f • � V FOR OFFICE USE ONLY � . '4, � , "� 4..,, y Yl yr , .1 A... •.'Cyrrtmei t:r r, 44.4 r� k�'a�f:. N<'? ! ,9i _ " „ City of Ti R y DateBy: /` �V Permf\' &tax213// CC) 59 j 1 114 Ill a 13125 SW Hall Blvd., Tigard, OR 97223 OCT �� 2007 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 DateBv: Other Permit: . I C A It.0 ;! Inspection Line: 503.639.4175 Cl I date Ready /By: Inrir El See Page 2 for Internet: www.tigard- or.gov � �` BUILDING DT 1�A i 'btified/Method: Supplemental Information � TYPE OF WORK COMMERCIAL FEE* SCHEDULE _ USE CHECKLIST ❑ New construction ❑ Addition /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* ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total ' JOB SITE INFORMATION AND LOCATION. Heating/cooling I ? A l 0 J L� t ®®' Air conditioning or heat pum Job site address: - d (requires site plan showing placement) 14.00 City /State /ZIP: - I - / 4 qt) e „ C Fumace 100,000 BTU (ducts /vents) 14.00 ( Fumace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: 1004 y, @c_ DD• -e et t.../.. 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 Subdivision: Lot no.: Flue /vent for any of above 6.80 Other: _ 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK. Water heater 10.00 ) C Gas fire lac 10.00 A. 'i (� -t 9 ? •fC t- a r'62 a LD t t� t,l S l .( 1 Ps 1 - 5 o 1 1 e U c 9? Flue vent for water heater or gas C �+ ) fireplace 10.00 rab `1 4.--% `Q 9- I1'1'L9 ?taco Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 1' PROPERTY OWNER ❑ TENANT . Chimney /liner /flue /vent 10.00 Other 10.00 Name: \le .. 10.y..f Cate t ( Environmental exhaust and ventilation C, _ Range hood/other kitchen Address: t 3 [ ©0 j L � (0U equipment 10.00 City /State /ZIP: ( kceit - 6 - LD ©''2 en �3 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) CO Z O ��7 Fax: ( ) toilet compartments, utility rooms) 6.80 APPLICANT / CONTACT PERSON . Attic /crawlspace fans 10.00 • ('� `� Other: 10.00 r Business name: 1 l C © -T-4. , Y Lt e_ �.t r .� Pin + C e. Fuel piping g Contact name: c._14_ ( $5.40 for first four; $1.00 for each additional Fumace, etc. Address: vs 5 5 ,r- a, t I-- • Gas heat pump City /State /ZIP a k ._, ,.,- 4 l -2 ql -Dr>l Wall /suspended/unit heater Phone: ( g3'5 3 ' 7 to c d Fax:: ( ) Water heater Fireplace / E -mail: Range CONTRACTOR • - Barbecue f Clothes dryer (gas) Business name: p\i a - -r-(C Je 14 f ci Vr ••� Other Address: 5 5 Pc6 4'e - 2_ MECHANICAL PERMIT FEES *' . . City /State /ZIP: l ©-czt Ls ., , D la 12.._ Subtotal Minimum permit fee ($72.50) 7a 3-'0 Phone: ( ) t , Fax: ( ) `�'� �� . Plan review (25% of permit fee) CCB lic.: 7 3. State surcharge (8% of permit fee) � ', KO :_ TOTAL PERMIT FEE 1 , . -� permit application expires if a permit is not obtained within 180 Authorized • 1.. • ture: . - Thi s perm , - days after it has been accepted as complete. Print name: l Lt --rt D 5. C i , l ( Date: t C ! 6) ' Fee methodology set by Tri- County Building Industry Service Board 1:\Building\Permits \NEC- PermitApp.4. 01/19/07 440- 4617T(1l /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:\ Buildin \Permits\MEC- PennitApp.doc 01/19/07 2 . .. , CITY OF TIGARD BUILDING !DIVISION PERMIT #: MFC2007-00695 I r I . 13125 SW Hall Blvd., Tigard, OR 97223 itentiot,hIllt DATE ISSUED: 10/15/2007 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 „,NIP - 11. AIE Ao 0 7- DO 5 - 5 - INSPECTION WORKSHEET FOR DATE: 10/24/2007 TIME: 7:00AM PAGE: 67 SITE ADDRESS: 13900 SW 100TH AVE CLASS OF WORK: SUBDIVISION: sHILO LOT #: OM TYPE OF USE: PROJECT NAME: CAFFALL DESCRIPTION: Gas line & fireplace. Previously installed. OWNER: CAFFALL, VERION 0 TRUSTEE, PHONE #: CONTRACTOR: ADVANCED HEATING & AIR COND PHONE #: 5037740151 Inspection Request Scheduled For: . Date: 10/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 058222-01 603-577-6970 Y Corrections/Comments/Instructions: 165 145 CP ( (---- . 7 i) 1 . . . \\ 1 ' V V 1 . PASS PARTIAL APPROVAL fl CANCEL I I NO ACCESS I I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: -2 - . Date: /C., — 2..4-- > Phone #: (503) 718- - •,