Permit a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 - 00648
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/20/2006
PARCEL: 1 S136DD -01200
SITE ADDRESS: 11600 SW 69TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 002 JURISDICTION: TIG
Project Description: Installation & gas line to new generator.
CLASS OF WORK: OTR 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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
SEAN MATHEWS Description Date Amount
11600 SW 69TH
TIGARD, OR 97223 [MECH] Permit Fee 12/20/20C $72.50
[TAX] 8% State Surcha 12/20/20( $5.80
Total $78.30
Phone: 503- 804 -7642
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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: � s � 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.
•
i.
*Mechanical Permit Application rOlz OFf•lCI•:1i S l OI.1
City Received Permit No. G
. q 131 of Tigard R �
SW Hall Blvd., Tigard, OR 9 �( �� Date/By /�o Z0 0 � u G ('
Plan Review
■ • Phone: 503.639.4171 Fax: 503.59 .1 Date/By. Other Permit:
T 1 < A 1t 1) Inspection Line: 503.639 DEC 2 0 2006 Date Ready/By: ® See Page 2 for
Internet: www.tigard -or.gov Notified/Method Supplemental Information
CITY OF TIVAAD
TYPE OF WHIPINU 1i1riiStON COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction - El 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*
j'1 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
Job site address: I ( J Q C so„) E l 4 4 1 Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP: 9 7223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: ai e Q;l -pt710 Gas heat pump 14.00
Cross street/directions to job site: Bo 7 / 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: f 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
,^ / / Gas fireplace 10.00
/ 1' 1 Ski/ // S i-U kbe (y ene4 M- Next k boa le 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
)
ROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
— , Other: 10.00
y
Name: Sea in /'I a.i.4 a c , s Environmental exhaust and ventilation
/ g �1 Range hood/other kitchen
Address:
I /606 f W G 4.4 equipment 10.00
City /State/ZIP: -�-, q c ,l z q7 2.) Clothes dryer exhaust 10.00 ,
J Single -duct exhaust (bathrooms,
Phone: (5113 ) oq.� 7 'L C� Fax: ( ) toilet compartments, utility rooms) 6.80
PLICANT 0 CONTACT PERSON Attic/crawlspace fans 10.00
f /// Other: 10.00
Business name:
Fuel piping
Contact name: S5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace ,
E-mail: Range
CONTRACTOR Barbecue
Business name: U WO Clothes dryer (gas)
Other: /
Address: MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB Iic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7y 7 8
Authorized signature: This permit application expires if a permit is not obtained within 180
!'� / G d ays a i t bas been accepted as complete.
Print name: Date: • Fee methodology set by Tri- County Building industry Service Board
1:\ Building \Permits \MEC- PermitApp.doc 04/06/06 440-4617T(1I /07/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:\ Building \Permits'MEC- PermitApp.doc 12/30/05 2
CITY`O TIGARD _.`' ..'
BUILDING DIVISION PERMIT #: fviEC2006.00648
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2006
Phone: (503) 639-4171 ■ �1'
Inspection Requests (24 Hrs.): (503) 639 -4175 ..:1 +� ` ..
INSPECTION WORKSHEET FOR DATE: 12/27/2006 TIME: 7 :00AM PAGE: 10
SITE ADDRESS: 11600 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 002 TYPE OF USE:
PROJECT NAME: MATHEWS
DESCRIPTION: Installation & gas line to ncivr generator.
OWNER: MATHEWS, SEAN PHONE #: 503-804-7642
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 12/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 04/539-01 503-804 -7642 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL T CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
../.4 .
Inspector: Date: /- — 7 G<, Phone #: (503) 718- 7 4—ei
CITY -e - TIGARD e_: Tt
BUILDING DIVISION PERMIT #: MEC200G -00648
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2006
Phone: (503) 639 -4171 1 MA,
Inspection Requests (24 Hrs.): (503) 639 -4175 !,r-
INSPECTION WORKSHEET FOR DATE: /2/26/2006 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 11600 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 002 TYPE OF USE:
PROJECT NAME: MATHEWS
DESCRIPTION: Insiallation & gas line to new generator.
OWNER: MATHEWS, SEAN PHONE #: 503 - 804 - 7642
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 12,26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 041504 -01 503 - 804 -7642 N
Corrections /Comments/ Instructions:
0 Za -20 r c)
❑ PAS,S -- ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
2 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /0 Date: /L-'6 - & Phone #: (503) 718-
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