Permit CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00064
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/10/2011
Parcel: 2S110AC01000
Jurisdiction: Tigard
Site address: 11545 SW BEEF BEND RD 7
Project: Wellington Estates Subdivision:'VELLINGTON ESTATES APARTMENT: Lot: 0
Project Description: Furnace replacement.
Contractor: ROBBEN & SONS HEATING INC Owner: FERN VALLEY PROPERTIES LLC
2214 SE 8TH AVE BY CAMBRIDGE REAL ESTATE SERVICES
PORTLAND, OR 97214 PO BOX 2968
PORTLAND, OR 97208
PHONE: 503 - 233 -5841 PHONE:
FAX: 503 - 238 -8849
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/10/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/10/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/10/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.19$2 . :1 I -
.. \
Issued By: —for - _ Permittee Signature: �` "
Call 503.. by 7:00 a.m. for the next available inspection date.
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.
Feb. 10. 2011 11:07AM Robben & S Seating Inc. No. 2569 P. 1
Mechanical Permit Agplic I (n; 01 i It l t ,i UM
City of Ti a nd Received
13125 $W Hal) Blvd., Tigard, 012 3 � O P �9 btetBy: 1 Penn t No.• '�,/
. . -- ' Phone: 503.639.4171 Fax: 503.598.1960 `s� G � m F1'°R"r' °"
�l5 Date/By; Other Permit:
I I! ;.\ k I ., Inspection Line: 503.639.4175 6 1
Internet: www.tigard-or.gov G � Date Ready/By: facie: Si See Page 2 for
CS‘ N ��� Notified/Method: 9uppt■m ental Information
T`YP l? W' 0` J t . i�0 'Cj. S�/J1� i� Y S ,! SY� 7 1 0 a
�NeW Construction ,. Q, a . rr;�., . s �) i•,., : k. ,? ,r:t'a�t'�".,r�z,`t� ��: N �, �� ,C z :���� 00 411) 4 4 ti 1113E.CHEGKI,I3T.
L Addition /alteration/replacement Mechanical permit fees are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
ill Demolition ❑Other: mechanical materials equipment labor, overhead and .cofit,
.%' .;' ° , CATidOJA"1! 9040, . ;�`l( 11 .. Y i / � ' Y(r ! '' 'A ' d �))iXr .: Value
Y f.i I (Y� :; ^.�� y NV ,YY !.. e.. � SEMI f''�J !' i b hl
2 1- and 2-family dwelling r�+('4 ,' , ,� ; ,,t NT /S'ST MS,FEES"
y g 0 Commercial/industrial ❑ Accessory building W
❑ Multi - family 0 Master builder ❑ Other: Far special i>FforNtrrllan use checklist,
Description I Qty. 1 Ea. 1 Total
. , r n JT$t I ' JO .. ,n'I WP . t ' ..`. ° t ... 0 ' ` : A R '),f': w'a'r ' Heating/cooling —
Job site address: 131 -' ti fJ I. w _ Air Conditioning
� - 41/� (required site plan showing placement) 46.75
City /State/ZIP: * 1 f Furnace 100 000 BTU ducts/vents 46.75 �� ti1♦
�� Furnace 100,000+ BTU (duck/vents) 54.91
Suite/bldg. /apt.no.: Il k Project name: I'(r./d f4 4/ b - r Heat 'urn. 61. 06
Cross street/directions to job site: - Duct work 23.32
Hydronic hot water system _ 23,32
Residential boiler (radiator or
hydronicl_ 23.32
- Unit heaters (fuel -type, not electric),
in -wall, in -duct, sus nded etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: MI 21.32 MI
Tax map /parcel no.: Other noel appliances
''' ',, .;!q A „09.. ° .„2 'd ; � F.sf L<;'us..,, Water heater I I 23.32
.� �
Gas fireplace 33.39
- 1 � Flue vent for water heater or gas
fireplace _ 23.32
Log lighter (gas) - 23.32
Wood/pellet stove 31.39
Wood fireplace/insert 23.32
Chiron /line
v rj p*°, 70# '0*SiER " ,;s'' . ;: N a, . y } to r /tluc/vant 23.32
,, nt.,,, , �,:�, ..t'�, e t�. 3va,�t,Ci,,'.. i d � � ;01/Ai,. � ° �' Other:
_ 23.32
L 1•���i�t trlairell, ~�
_Other
exhaust and ventilat
Address: l \ - L. 1r to a l Range hood/other kitchen
a1 1r ► `- s equipment 33.39
City /State/ZI • . - 1 ik •I I _ Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax ( )
���sy�y. toilet compartments utility rooms) 23.32
^ ''Rt' ;041. I:.s. ,e e is e' t n{ 3 l t g , _ 17114 'a ' ' 0 Attic/crawls Y ace fans 23.32
_ Other: r 23.32
IC��' +,�. �j °� �t�n�a I MI Fuel piping _
Contact name. 4111 $14.15 for first four; $4,03 for each additional
Address: - a. �.� Furnace, etc. -
Gas heat pump
City/State /Zip: � F�t:��_J� i ` • ` WelVauspended/unitbeater
Phone: • ;sip = 1 . 1 , 4% , z.: 6 Water heater _
—
a
.4:411 '0 '► `1' '.a _ , Fireplace .
r �1►vis ,. Range
i v ! �;. :i d� U;JC�F r$��l`j o jtS '� ^
" <aa ,. � t "'x� a
. sr,Y. ` ► '' t -n Y a ue
awl, Y Barbec I.
� r l♦. I G a .� Lt*160) �a r ar'`r Clothes dryer (gas)
Address: «, Others
City /State/ZI' . _ ` , ;' t + u; H ,, , 1 - «, ! F g!. : .;
�• v .its Subtotal MIIM
Phone.. sj 1 , +, , Minimum permit foe ($90.00) �!
4141.4,-, �� � r l�'slt Plan review (25% of • canit fee
CCB Lic„ \
, l f State surcharge (12% of ' ermit fee) itaVt
TOTAL PERMIT FEE MIA
Authorized signature: � /'
. . _ 11, •
This permit application expires if a permit Ia not obtained within 180
.e�!1
t, � days after It has been accepted. as complete.
# l ei, I) 1 Date -, • Fee methodology set by Td- County Building Industry Service Board
I: 1 Euildi „ a'parmilsVec- PeYmilApp.d°e tomuop �en.�,•.o ..................�_.