Permit Er PER CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
MIT #: MEC2006 -00608
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/29/2006
PARCEL: 2S 102CC -02600
SITE ADDRESS: 13885 SW 102ND AVE ZONING: R -3.5
SUBDIVISION: FRELEON HEIGHTS NO.2 LOT: 012 JURISDICTION: TIG
Project Description: Installation of (3) gas logs and gas piping.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 3
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 3
> 10000 cfm:
Owner: FEES
EDWARD GILL Description Date Amount
13885 SW 102ND AVE
TIGARD, OR 97223 [MECH] Permit Fee 11/29/20C $72.50
[TAX] 8% State Surcha 11/29/20C $5.80
Total $78.30
Phone: 503- 968 -9039
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.
Iss ed By: / ) )4/ / /1 Permittee Signature: (/V /(") � ��j
Call 503.639.4175 by 7:00 a.m. for inspect ions that business day.
Thi'rmit 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.
Mechanicar Application .. roi of l �cc us ONLY .
City of Tigard Received
s Permit No.: e �
IN Y ��ss „,.._696.)0
'� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit.
Date/By.
TI G A R D Inspection Line: 503.639 Date Ready/By: INI El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST '
❑ New construction ❑ 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: $
dwelling 'RESIDENTIAL EQUIPMENT /SYSTEMS FEES* ." • '
❑ 1 - and 2-family g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. Ea. I Total
_ , JOB, SITE INFORMATION. AND LOCATION Heatinglcooling
• Job site address: j 3 gc 6 ' ' / o . �/�,� Air conditioning or heat pump
t t / t�` (requires site plan showing placement) 14.00
City /State /ZIP: ` f ! - p t Furnace 100,000 BTU ( ducts/vents) 14.00
/ ' ! Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: ' f G�
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 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' ' `DESCRIPTION OF WORK Water heater 10.00
, � 1 Gas fireplace 10.00
-1 f E ://14. 3 EA- .F; c 'i y z - S Flue vent for water heater or gas
F �j / 4 - 5 fireplace ) 10.00
Log lighter (gas 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
❑' PROPERTY OWNER,' - ❑, TENANT
Other: 10.00
Name: Ef t, T a Environmental exhaust and ventilation
Address: / 3 g.6 S - 0), /t" .> 2 Range hood/other kitchen
�
/G' -[NJ q �� 9 � equipment 10.00
• / /
City /State /ZIP: Clothes dryer exhaust Co 10.00
q . / p ' y Single -duct exhaust (bathrooms,
Phone: ) /f , 0v3gg Saq_3ot Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT CONTACT PERSON ❑ TERN Attic/crawlspace fans 10.00
Business name: Other: 10.00
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: ( ) Fax:: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR .. Barbecue
Business name: Clothes dryer (gas) r
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) ) Minimum permit fee ($72.50) j 2, r 50
Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee) . , go
/ / TOTAL PERMIT FEE 7g, 3
Authorized si t r :�T/ Th is permit application expires if a permit is not obtained within 180
�- // , . / � days after it has been accepted as complete.
'
Print name :i� /f .ifs /r G� >/ r Date: / (%/ ' j / • Fe e methodology set by Tri- County Building Industry Service Board
I: \Building'.Permits C- PermitApp doc 04 /06/06 440-461 (11/I OM/WEB)
•
Mechanical Permit Application - City of Tigard a
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total. Valuation: a` x ` 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
CITY OF-TIGARD - r.-.
BUILDING DIVISION PERMIT #: MEC2006••0060
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2006
Phone: (503) 639- 4171vNpiiui't
Inspection Requests (24 Hrs.): (503) 639 -4175 =:_..
INSPECTION WORKSHEET FOR DATE: 12/1 1/206 TIME: 7 :00AM PAGE: 3
SITE ADDRESS: 138135 SW 102ND AVE CLASS OF WORK:
SUBDIVISION: FRELEON HEIGHTS NO.2 LOT #: 012 TYPE OF USE:
PROJECT NAME: GILL
DESCRIPTION: installation of (3) gas logs and gas piping. .
OWNER: GILL, EDWARD PHONE #: 603 - 9689039
CONTRACTOR: OWNER PHONE #:
• Inspection Request Scheduled For: Date: 12/1100006 Pour Time:
Code # . Inspection Description Confirm # Contact # Message
699 Mechanical final 040911 -01 603-692-0180 Y
Corrections /Comments /Instructions:
PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS
I I FAIL [ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date: / tj-- - 1�-- &e Phone #: (503) 718- 24--�'J
i
CITY'OrTIGARD 1 _ .
, , ...
BUILDING DIVISION PERMIT #: MEC2006-00608
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2006
Phone: (503) 639-4171 40 11 1 400 , k
_
Inspection Requests (24 Hrs.): (503) 639-4175 Ai. I i.
INSPECTION WORKSHEET FOR DATE: 12/8/2006 TIME: 7:01AIVI PAGE: 58
SITE ADDRESS: 13885 SW 102ND AVE CLASS OF WORK:
SUBDIVISION: FRELEON HEIGHTS NO.2 LOT #: 012 TYPE OF USE:
PROJECT NAME: GILL
DESCRIPTION: Installation of (3) gas logs aid gas piping.
OWNER: GILL, EDWARD PHONE #: 503-968-9039
CONTRACTOR: OWNER . PHONE #:
Inspection Request Scheduled For: Date: 12/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615
Mechanical rough-ira 040814-0°1 -
c eepp,-
Corrections/Comments/Instructions:
QA --
3 A`e..s.s , : 03-968-9039
_ A ,-4 - / dA, ia5-46K (Lt ;71/ di 1-67 044(":
Ai - . ( , ---; :7- ,4 1.5i ,- / /A,/ ., --
14 PASS ri PARTIAL APPROVAL fl CANCEL [7 NO ACCESS
FAIL . CALL FOR INSPECTION
,.,
A 0 ADDITIONAL FEES ASSESSED
Inspector: / - Date: ii--8"—c Phone #: (503) 718-