Permit B t �i� ai h 4
CITY TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00031
TIGArAg 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/12/2007
��� "' "'� g PARCEL: 2S110AC -01000
SITE ADDRESS: 11545 SW BEEF BEND RD 50 ZONING: R -40
SUBDIVISION: WELLINGTON ESTATES APARTMENTS LOT: JURISDICTION: TIG
Project Description: Gas furnace install.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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:
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:
> 10000 cfm:
Owner: FEES
PRINCETON PROPERTIES Description Date Amount
7831 SE LAKE RD
PORTLAND, OR 97268 [MECH] Permit Fee 1/12/200i $72.50
[TAX] 8% State Surcha 1/12/200i $5.80
Total $78.30
Phone: 503- 794 -9004
Contractor:
ROBBEN + SONS HEATING
2214 SE 8TH AVE
PORTLAND, OR 97214 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 233 -5841
FAX 503- 238 -8849
Reg #: LIC 1884
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: .�72fi Permittee Signature: 4 e L IN al
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.
" Mechanical Permit A�pp�gatk , fl - ,, FOR OFFICE USE ONLY
City Tigard L �� 'l I- o 1 11 : � Received
<, - I � \ ' � Date/By: �t7� `� �j Permit No.: c .. oV3 1
1312 W Hall Blvd., Tigard, OR 4722S' ��) ` ) ._ - � tl f y
Plan Revie Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 /,, 401 ,` Date/By: ,
'F�1
Inspection Line: 503.639.4175 ' j , �; 1 ;) g . I 1 Date Ready/By: Juris: gi See Page 2 for
Internet: www.ci.tigard.or.us " G t Notified/Method: Supplemental Information
P
� 1F R . r Vp 'F �'s`1a��A�a ��� �� � 7i - r S 1 1 � t P
. �` �' w''l ..,. ,�, 1. z . �:a k,,. w.` -��a s �GbMN S �+I�lDfJVE� a USE �HECKLIST�
�(yl�.l'�il�! Pip _ � 7 „t...ne» - nv� r ar._- * „ '� r,� ,_..,w .
❑ New construction 4 � ��Atldittonlalteration /replacement Mechanical perinit 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.
1. rwr 1 ( i,t F 71 - Value $
' 1ekif Geiiii iii4O14S` iiiik TI, r. " "a;4 �Li 5g,C
1o NTrotgoutimEIiT MS!T�
/SYSTEEES*
❑ 1- and 2- family dwelling ❑ Conunercial/industrial ❑ Accessory building , �.
For special information use checklist.
dMulti- family ❑ Master builder ❑ Other:
Description E
� Qty. Ea. Total
J0, SI# ,I0 yU1�' IKD,1 �'r O t 1'fl �F ,,t,� t , j Heating,,/cooling
Job site address: /,...5-4/5- } L`O�CAT)'ONC / J y� Air conditioning or heat pump
/ S � / / /fie /14,.. ///'.fir • (requires site plan'showing placement) 14.00
City/State /ZIP: (L` „...eif C3 ? 7 ZzV 3 9 - Furnace 100,000 BTU (ducts/vents) ( 14.00 /y'
Suite/bldg. /apt. no:: V Project name: / Furnace 100,000+ BTU (ducts /vents) 17.90
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
Subdivision: Lot no.: Flue /vent for any of above 1 10.00 (a
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPXIo1*' I`Y'}W "-� °h
�R ' ' ' 1 t . 4 PA a ` ia Water heater 10.00
Gas fireplace 10.00
/ � fi,;4 Iril LC_ 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
r 1 r it ,H,, K - r F5 c. .o., a � ., it r Chimney /liner / /vent 10.00
❑ PROPERTI' OWNER i , m tl1 ® fi ENA1V t .: , , .. ;.; , ,..., .
- Other: 10.00
Name: fir 0,e6-) ?�', ��, 7 5 Environmental; exhaust and ventilation
7 Q 2 �_ i1 / � �, iequipment 10.00
Range hood /other kitchen
Address:
U ./ vT /,d
City/State /ZIP: / 07- L , � j Z ' Clothes dryer exhaust . 10.00
7 � lL Single -duct exhaust (bathrooms,
Phone: 633) , 7 ?e Fax ,� q C toilet compartments, utility rooms) 6.80
., ,� i �d4 ) - * F { k 4`' a td � 1 + r sr 1 ? �'F Attic/crawlspace fans 10.00
APPLIC 7 � T , r a � 1 CUN C , PE �N , d l P .
: L .. °'r', �f 'Ii' r :. :�.r . r.,.+ - r_`Y� .... 5, ,.'i` �`a �r., Business name: f� f,� <7;1..--' t Other: 10.00
��/ �/ S Fuel piping
Contact name: � esn $5.40 for first four; 51.00 for each additional
Address: ����/ (� ,./ '' �" Furnace, etc.
r r c J' / Gas heat pump
City/State /ZIP: � v ,, a (Yt ?72/4 Wall/suspended/unit heater
Phone: '3) 23 3 SVC /7 Fax: : .23' got, Water heater
Fireplace
E -mail: Range _
1L ; 1~ I u r l P '✓ 1 1 k 1 " ' Barbecue
,CANT CiT9R ::',1,;14,, ." a' 'l , , r 1 , i
,. . �.,, � .. �, 1 ,;., .,�. 1_. J� . 1; % ,.It_ r �, is ,. -
Business name:
Clothes dryer (gas)
Address: ' Other "f* t M..'h%IEGH_A4NIC_ A hRMIT
City/State/ZIP: Subtotal
) Minimum permit fee (572.50) 74
( ) Fax Phone: ( Plan review (25% of permit fee)
CCB lic.: / c C d V State surcharge (8% of permit fee) 5 VC)
TOTAL PERMIT FEE . 77 j-
Authorized signature: / / T his p ermit application expires if a permit is not obtains whin 180
s days after it has been accepted as complete.
I Print name: �� it to ` 7 t/ ` 2Y /7 Date: I / � 7 � Fee methodology set by Tri-County Building Industry Service Board
. 1'C6.
l33 Lk-.eL r1 i Wvim,;1
°' y`' CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00031
t" w DATE ISSUED: 1/12/2007
�T[G_ARD^ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AC -01000
SITE ADDRESS: 11545 SW BEEF BEND RD 39 ZONING: R -40
SUBDIVISION: WELLINGTON ESTATES APARTMENTS LOT: JURISDICTION: TIG
Project Description: Gas furnace install.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PRINCETON PROPERTIES Description Date Amount
7831 SE LAKE RD
PORTLAND, OR 97268 [MECH] Permit Fee 1/12/2007 $72.50
[TAX] 8% State Surcha 1/12/20M $5.80
Total $78.30
Phone: 503- 794 -9004
Contractor:
ROBBEN + SONS HEATING
2214 SE 8TH AVE
PORTLAND, OR 97214 REQUIRED ITEMS AND, REPORTS
Contact #: PRI 503- 233 -5841
FAX 503- 238 -8849
Reg #: LIC 1884
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:
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.