Permit ' z! CITY O F 11 AI,4 R `) MECHANICAL PERMIT
c '' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00250
TI 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/2/2007
g PARCEL: 1S134DA
SITE ADDRESS: 11163 SW 106TH AVE ZONING: R -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: LIU
Project Description: Replace furnace and duct work, add gas fireplace and gas piping.
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: BOILERSICOMPRESSORS 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
GE LIU Description Date Amount
11163 SW 106TH
TIGARD, OR 97223 [MECH] Permit Fee 5/2/2007 $72.50
[TAX] 8% State Surcha 5/2/2007 $5.80
Total $78.30
Phone: 503- 292 -1668
Contractor:
POLYTECH HEATING LLC
2263 SE 85TH AVE SUITE 2A
PORTLAND, OR 97035 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 888 -7999
FAX 503- 788 -2688
Reg #: LIC 162238
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 ` 1/14.4A.rj. Permittee Sign ure: %/ f / / (
Call 503.639.4175 by 7:00 a.m. for inspections at business . ay.
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.
Iffachanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
i- d Permit No.. i /JM'7f c �yj � 956
IIIII • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �/�
Ii Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Read /B )uric ei
and - or. ov Ready /By: S upplementalluforma See Page 2 for
g g Notified/Method: r Supplemental Internet: www.ti on
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction 0 Addition/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*
( l -a nd 2-family dwelling ❑ C ommercial /industrial ❑ Accesso buildin
b For special information use checklist.
Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / i / //)? 4 t-�J (0 � I Air conditioning pl or heat pump
b l (/ y' V� (requires site plan showing placement) 14.00
City/State/ZIP: ---7- ij 0,i-a, ek 7 2.i 2 — Furnace 100,000 BTU (ducts/vents) ` 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: / / ti je1'.1 P F f� Gas heat pump 14.00
Cross street/directions to job site: r 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
4 oW Gas fireplace ! 10.00
f -le ai V( 9 L) 4 evvi . 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 I ❑ TENANT Chimney/liner /flue /vent 10.00
Other 10.00
Name: (R4 C,( f 1(,1 �J Environmental exhaust and ventilation
Address: e ( 7 p5 f u tv y ,, 17 A, e c--� Range hood/other kitchen
G 1 t o equipment 10.00
City /State /ZIP: 041, 6R . 63 72_ Clothes dryer exhaust 10.00
/ Single -duct exhaust (bathrooms,
Phone: (c03 ) �? 7 _/ (�(7 / Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT f ❑ 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.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax:: ( )
Water heater
Fireplace 1 _
E -mail:
Range
CONTRACTOR Barbecue
Business name: Po/ " e " " v V ( l tor, , L LC Clothes dryer (gas)
Other:
Address:
O 7� ���� ve MECHANICAL PERMIT FEES*
City /State /ZIP: p ( 19R q 7 2 p Subtotal
/ Minimum permit fee ($72.50) �-
Phone: (c,, g p lJ gS — 7 l Fax: ( Q3) 7p_ 3 (j b Plan review (25% permit fee)
/ CCB lic.: f �Z 0 / / ) State surcharge (8% of permit fee) 6, go t / TOTAL PERMIT FEE ?,, 3,-) Authorized signature:
��— This permit application expires if a permit is not obtained 180
days after it has been accepted as complete.
Print name: . , d'i * i A Date: _ `2 ' Fee methodology set by Tri- County Building Industry Service Board
t. \Building \ Permits \MEC- PermitApp.doc 04 /06/06 440- 4617T(I I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
'Total Valua 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 12/30/05 2
.`7 -9 .' ,I) ,A Pe_J 0
,,,t q ' ' [ B Y OF TD /Um Ij MECHANICAL PERMIT
4_.
y ' ° " °'` COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00250
DATE ISSUED: 5/2/2007
&W RD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S134DA -01600
SITE ADDRESS: 11163 SW 106TH AVE ZONING: R -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: LIU
Project Description: Replace furnace and duct work, add gas fireplace and gas piping. 7/9/07, RELOCATING RANGE HOC
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: 1
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 NIT
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
GE LIU Description Date Amount
11163 SW 106TH
TIGARD, OR 97223 [MECH] Permit Fee 5/2/2007 $72.50
[TAX] 8% State Surcha 5/2/2007 $5.80
Total $78.30
Phone: 503- 292 -1668
Contractor:
POLYTECH HEATING LLC
2263 SE 85TH AVE SUITE 2A
PORTLAND, OR 97035 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 888 -7999
FAX 503- 788 -2688
Reg #: LIC 162238
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 :y: V // (l �2 Permit Signature. � �� ,1 'r r J-
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.
CITY OF TIGARD .,
# - /
BUILDING DIVISION ,
PERMIT #: MEC2007-00250
13125 SW Hall Blvd., Tigard,'OR 97223 DATE ISSUED: 60/2007
Phone: (503) 639-4171 ,_ :940 1i ti T i ‘
Inspection Requests (24 Hrs.): (503) 639-4175 /ti ge - A a 0 7 - dOP- S : 9
INSPECTION WORKSHEET FOR DATE: 12117/2007 TIME: 7:01Am PAGE: 14
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LIU
DESCRIPTION: Replace furnace and duct work, add gas fireplace and gas piping. 7/9107, RELOCATING RANGE
HO,OD.
OWNER: LIU, GE PHONE #: 603-292-1668
CONTRACTOR: POLYTECH HEATING LLC PHONE #: 603403.7999
Inspection Request Scheduled For: Date: 12117/2007 Pour Time:
Code # 4spection Description Confirm # Contact # Message
616 . Mechanical rough-in
R I .
061654-01 360 N
Corrections/Comments/Instructions:
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ASS n PARTIAL APPROVAL 0 CANCEL El NO ACCESS
V FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
V. C1'
Inspector: Date: 2 Phone #: (503) 718- 22124
�
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CITY ��
��w m m OF TIGARD . . ^ 1
BUILDING DIVISION ~�~°.~~~°""°~° °=,~.~,.~~"� - PERMIT #: kAEC2007'00250
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2/2007
Phone: (503) 639-4171 ' ' iattk
Inspection Requests (24 Hrs.): (503) 639-4175 ���� /ice a oo 7- 0 0 .25
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7:00AN} PAGE: 27
SITE ADDRESS: 11163fW18GTHAVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LW
DESCRIPTION: Replace furnace and duct work add gas fireplace and gas piping, 7/9/07. RELOCATING RANGE
HOOD.
OWNER: In, GE PHONE #: 503-392-1688
CONTRACTOR: p[)LyTBCH HEATING LLC PHONE #: 603-888'7099
Inspection Request Scheduled For: Date: 1119/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G\U Gas line 069481-01 503-292-1608 Y
•
Corrections/Comments/Instructions:
•
1 El PARTIAL APPROVAL ri CANCEL ri NO ACCESS
| I FAIL �� CALL FOR INSPECTION I | ADDITIONAL FEES ASSESSED
Inspector: . Date: /1- -O Phone (503\718' 1-�^��,
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CITY OF TIGARD ,•
BUILDING DIVISION PERMIT #: MEC2007 -00250
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5.'2p007
Phone: (503) 639 -4171 / vu �IW'�Il
Inspection Requests (24 Hrs.): (503) 639 -4175 :.. _...� & o 7 - 9Oas
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7 :00AM PAGE: 25
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LW
DESCRIPTION: Replace furnace and duct work, add gas fireplace and gas piping. 7/9/07, RELOCATING RANGE
HOOD.
OWNER: LIU, GE PHONE #: 603 - 292 -1668
CONTRACTOR: f'OLYTECH HEATING LLC PHONE #: 603-888-7999
Inspection Request Scheduled For: Date: 11/912007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
62.5 Duct work 059401-03 503-292 -1668 N
Corrections /Comments /Instructions:
r'
ASS n PARTIAL APPROVAL CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /1 -9'—G7 Phone #: (503) 718 - 2.4-46
CITY OF TIGARD „ .
.
BUILDING DIVISION PERMIT #: mEr,2007.00260
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/712007
Phone: (503) 639-4171 Jill / t
Inspection Requests (24 Hrs.): (503) 639-4175 A7 EC 07.- 00 0750
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7:00AM PAGE: 26
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LIU
DESCRIPTION: Replace furnace and duct work, add gas fireplace and gas piping. 7/9/07, RELOCATING RANGE
HOOD.
OWNER: LIU, GE PHONE #: 503-292-1668
. CONTRACTOR: POLYTECH HEATING LLC PHONE #: 603-888-7999
Inspection Request Scheduled For: Date: 11/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 059401-02 503-292-1668 N
Corrections /Comments/ Instructions:
- / ,',...i ,,,-„ ■,--' — - L• - /".., . • -,... Joh— -
l PASS PARTIAL APPROVAL - CANCEL El NO ACCESS
—
I j FAIL r CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: /c/
Date: h — Phone #: (503) 718-
•
C
. CITY-OF ,, TIGARD
1 BUI PERMIT #: MEC2007 -00250
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 512/2007
Phone: (503) 639 -4171 aillii
A
Inspection Requests (24 Hrs.): (503) 639 -4175 :. .. /t 7E - C,Aeo7 (J11 .ZJ e
INSPECTION WORKSHEET FOR DATE: 7/3/2007 TIME: 7:03AM PAGE: 16
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LIU
DESCRIPTION: Replace furnace and duct work, add gas fireplace and gas piping.
OWNER: LIU, GE PHONE #: 503 -292 -16613
CONTRACTOR: POLYTECH HEATING LLC PHONE #: 503.888 -7399
Inspection Request Scheduled For: Date: 7/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
625 Duct work 051392 -03 503 - 577 -7361 N
Corrections/Comments/Instructions:
❑ PASS, n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
1,-� CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: %' Date: 7- - 2.--c> Phone #: (503) 718-
V_
CITY.- ,OF.TIGARD .
BUIL: NG -D IVI S ION PERMIT #: MEC2007 -00260
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2/2007
Phone: (503) 639 -4171 / ' Muni l��I
Inspection Requests (24 Hrs.): (503) 639 -4175 :_.. �1 7t.2� � 7O 5e
INSPECTION WORKSHEET FOR DATE: 7/3/2007 TIME: 7 :03Ah1) PAGE: 17
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LIU
DESCRIPTION: Replace furnace and duct work, add gas fireplace and gas piping.
OWNER: LIU, GE PHONE #: 503 292 - 1668
CONTRACTOR: POLYTECH HEATING LLC PHONE #: 503 -888 -7999
Inspection Request Scheduled For: Date: 7/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough - in 051392 - 02 503 - 577 - 7361 N
Corrections /Comments /Instructions: l
S P —I l' :—..= a -i;: e/ , L i . - -
CXi7 ' Le ,• -_-_. , 5',C ' L _
, - ff../ /+c:= he c q-M ' i...s _ r,., z r..i ges l- :S'/.-1 . / io■-.
-. Cv r rCa) P"--���� 77 L e
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 7--:3 07 Phone #: (503) 718 - 2..q -c-I-SJ
CITY
• .
BUILDING DIVISION PERMIT #: MEC2007 -00250
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/2/2007
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 _�' F 'IIa /Va OO -D0 -Cd
INSPECTION WORKSHEET FOR DATE: 7/3/2007 TIME: 7:03
AM PAGE: 18
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LIU
DESCRIPTION: Replace furnace and duct work, add gas fireplace and gas piping.
OWNER: LIU, GE PHONE #: 503 - 292.1668
CONTRACTOR: POLYTECH HEATING LLC PHONE #: 503 -8138 -7999
Inspection Request Scheduled For: Date: 7/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 051392 -01 503 -577 -7361 N
Corrections /Comments /Instructions:
I I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ L ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: 4 Date: Phone #: (503) 718-