Permit ■ CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00073
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/20/2009
PARCEL: 2S114AA -00200
SITE ADDRESS: 16285 SW 85TH AVE 103 ZONING: I -P
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT: JURISDICTION: TIG
PROJECT: GATA FOODS
Project Description: Gas line and venting for boiler. Valuc,4∎dr4t Li8S0.°O
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: 1 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
BIRKEMEIER, BRENT T /JANET D TRS Description Date Amount
BY THE BIRKEMEIER FAMILY TRUST
10573 SW NAEVE ST [MECH] Permit Fee 2/20/200. $139.20
TIGARD, OR 97224 [TAX] 12% State Surch 2/20/200c $16.70
Phone: Total $155.90
Contractor:
DETEMPLE COMPANY INC
1951 NW OVERTON ST
PORTLAND, OR 97209 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 227 -2641
FAX 503- 274 -7686
Reg #: LIC 2510
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.
o
Issued By: a a Permittee Signature: 4 ,4—
Call 503.639.4175 by 7:00 a.m. for inspections that busines 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 Application ��r 1 FOR OFFICE USE ONLY
City of �a Ie�t�. 3- a . o q Permit No.. i 7 .00 O7
1111
- • 13125 SW Hall Mt, Tigard, OR 9 7123 Review
Phone: 503.639.4171 Fa: 503.598.1960 FEB 2 0 2009 Plan Dat Rey: Other Permit:
T 1 G A R U Inspection Line: 503.639.4175 Date Ready/By: Juris: el See Page 2 for
Ind www.figard•ar.gov crr OFTfO - 1 , � Supplemental Information
. `'-` : T t. OF WOI ?A`' S =' COMMER AL a' :t +o, - USE'. KI.J
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t ION
Mechanical permit fees* are based on the value of the work
- ❑ New construction ❑ Addition /alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
CATEGY` CONSTCTIONS 4.:.i. Value S `1 ,f S
OR RU „
JIiF,$1lD�1VTI?l. } "
l ;.. TEMSFF�)F�S *=
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory buildin
F or spec i nformation w e checklist.
❑ Multi - family ❑ Master builder ❑ Other. Description I Qty. I Ea. { Total
"
irON • -t
;: � JOB:gtE;INFORh'><ATIONsAIY� Heating/cooling •
Air conditioning or heat pump
Job site address: fl tiottc " %L+ (5 S -a` ac 1113 (requires site plan showing placement) 14.00
City/State/ZIP: qr t y 9 _ 0 o � �� 11'3 Furnace 100,000 BTU (duets/vents) , 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: I Project name: ';o.�>= c to 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 ,
Subdivision: I� : Flue/vent for any of above 6.80
Lot Other: 10.00
Tax map/parcel no.: Other fuel appliances
i 7 .� i t t . :140.4,,,,..4::,!.' T: ,:,!?.F Z Water heater 10.00
Gas fireplace 10.00
Co sS Pt .P.— c,, p,,,,, VF—T, t., F. A `ao,a..EG 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
,: 5 .�, � ##fi�'r . Chimney/liner/flue/vent 10.00 ,
,, • ` Other: 10.00
Name: Eg.e.ik Q p, , C Environmental exhaust and ventilation
Range hood/other kitchen
Address: 11/4) - t I S 0 S ✓ 1 t A-re equipment 10.00
City /State/ZiPP: .11(, < , 4 _0 d C `'r '21 1 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (9) 3 ) 511 1 iol Fax: ( ) toilet compartments, utility rooms) 6.80
_ 1444CA '`= s `ra ,t G: 0 c i rs T: PE RSQ N ^ , '"r Attic/crawlspacefcns 10.00
Other. 10.00
Business name: Fuel piping
Contact name: 55.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump ,
City/State/ZIP: WalUsuspended/unit heater
•
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
k : ° 4 Y CONTRACTOR '' ' ., ,s ,. 1 Barbecue
,., . Clothes dryer (s)
Business name: co, is ' e L
Other
Address: _ ` h) Cl *,t* PERMTI FSE$"
City/State/ZIP:
Subtotal N:I.20
M6timum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie: State surcharge (12% of permit fee) t
_ TOTAL PERMIT FEE 1 S .RO
9�� This permit application expires If a permit is not obtained within ISO
Authorized signature : / �Ki/"' days after it bas been accepted as complete.
Print name: ( � l a 7 Date: Z - e _0 • Fee methodology set by Tri- County Building Industry Service Board
1: BuadtngUPermibtMEC P itApp.doe 01/19107 440-4617T (11/07/COM/WER)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC1009.00073
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2009
Phone: (503) 639 - 4171 Vitt
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/26/2009 TIME: 7 :03AM PAGE: 7
SITE ADDRESS: 1628; SW 85TH AVE 103 CLASS OF WORK:
SUBDIVISION: DURHAM HALL BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: GATA FOODS
DESCRIPTION: Gas line and venting for boiler. Project value $4850.00.
OWNER: BIRKEMEIER, BRENT T /JANET D TRS, PHONE #:
CONTRACTOR: DErEMPI..F_ COMPANY INC PHONE #: 503- 227 -2641
Inspection Request Scheduled For: Date: 212 &3009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas; line 080868 -01 503.8609364 N
Corrections /Comments / Instructions:
Fo mit°
l _
II► PAS % PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL // CALL FOR INSPECTION [l A FEES ASSESSED 46107 Inspector: Date: Phone #: (503) 718 - z91