Permit ,.
CITY TIGARD MECHANICAL PERMIT
4 1, DEVELOPMENT SERVICES PERMIT #: MEC2006 -00289
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/26/2006
PARCEL: 1 S134DA -04600
SITE ADDRESS: 11325 SW 108TH AVE ZONING: R -4.5
SUBDIVISION: DOREEN COURT LOT: 003 JURISDICTION: TIG
Project Description: Add AC, replace furnace
CLASS OF WORK: ALT 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: 1 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
KOEHMSTEDT, MATTHEW + PAMELA KAY . Description Date Amount
11325 SW 108TH
TIGARD, OR 97223 [MECH] Permit Fee 6126/200€ $72.50
[TAX] 8% State Surcha 6/26/200€ $5.80
Total $78.30
Phone:
Contractor:
BULL MOUNTAIN MECHANICAL
13580 SW RHETT CT.
TIGARD, OR 97224 REQUIRED ITEMS AND REPORTS
•
Contact #: PRI 503- 702 -2945
FAX 503 -524 -6533
Reg #: LIC 157814
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: i' ✓'✓'� ���`
Call 503 - 639 -4175 by 7:00 a.m. for inspections that z siness 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 _ FOR OFFICE USE ONLY . •
City of Tigard Recei v � Rpri f Datewp ,A,..„ F Permit N JEa....xxg - oZ 1
I N n 13125 S W Hall Blvd Tigar, 972 - Plan R ew L/
0 • Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit:
T I A K D Inspection Line: 503.639.4175 JUN 2 6 2006 Date Ready/By: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: • Supplemental Information
TY1I-EldF WORK ,'`�'_ f "o.�..' COMMERCIAL FEE* SCHEDULE = USE•CHECKLIST
1 II 1 111\11 T - ,d" m •°V t � a 71 ' Mechanical permit fees* are based on the value of the work
❑ New construction to A n/ alteration / replacement 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*
JO 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 / c c 4 ) /D8 /9ve Air conditioning or heat pump /
2 (requires site plan showing placement) x 14.00
T
City /State /ZIP: / l i,4;2, 0 0 9 7 22-3 Furnace 100,000 BTU (ducts/vents) u 14.00
Suite/bldg. /apt. no.: Project name:
•17...., , i / efr 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
Flue /vent for any of above $4.. 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
. • DESCRIPTION OF WORK , Water heater 10.00
j Gas fireplace 10.00
�/I //3 fu Q!1/ /9c y L� 2 �� �C / 7 Flue vent for water heater or gas >C
lie / 1/ C' Rio e--- Q � G1 L CS fireplace 10.00
L: Log lighter (gas) 10.00
Ai S 7 // /�C G iJ7 vy� p Wood /pellet stove 10.00
/ Wood fireplace /insert 10.00 .
❑ PROPERTY .OWNER TENANT, Chimney /liner /flue/vent 10.00
Other: 10.00
Name: i n ,e) ez X v h ,5--"/2. Environmental exhaust and ventilation
Address: 3 �' I v baliiii2 Range hood/other kitchen
a equipment 10.00
1
City /State /ZIP: i / ! /j ®c.t, q 72 23 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON , Attic/crawlspace fans 10.00
Other: 10.00
Business name:
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: g u `! / Me I y2 �,3 7Pcvfj d G / Clothes dryer (gas)
® Other:
Address: )S cg(, �(,/..) hCh / re,i /2 ' M ECHANICAL PERMIT FEES *„
City /State /ZIP: o/ 72 2 `7r Subtotal
Phone: 63) 7�2 2 9 2(3 Fax: Fax: 16,3) S 2 li 6Sr-33 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: ` X711 Z2 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: \' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: J /} -/,4 f -Sij Date: /-' 2 6- e ( • Fee methodology set by Tri- County Building Industry Service Board
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I:uilding \Pen \ mi
nitsMEC- PeitApp.doc 04/06/06 T 440 -4617T(I I /02/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.
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CITY ,OFTIGARD
BUILDING DIVISION PERMIT #: MECP20tl t 0289
13125 SW Hall Ivd., Tigard, OR 97223 DATE ISSUED: 6/2872006
Phone: (503) 639 -4171 7 v ' �a�I mp i l l l
Inspection Requests (24 Hrs.): (503) 639 -4175 _,.
INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7:01AM PAGE: 79
SITE ADDRESS: 11325 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: DOREEN COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: KOEHMSTEDT
DESCRIPTION: Add AC, replace furnace
OWNER: KOEHMSTEDT, MATTHEW + PAMELA KAY, PHONE #:
CONTRACTOR: BULL MOUNTAIN MECHANICAL PHONE #: 503.702 -2945
Inspection Request Scheduled For: Date: 7/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6155 Mechanical rough -in 033699 -01 503 -963-0836 N
•
Corrections/Comments/Instructions: (<
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Z i > " -- °, Phone #: (503) 718 -
CITY O,F TIGARD
BUILDING DIVISION PERMIT #: MEC2006 002139
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/2612006
Phone: (503) 639 -4171 i ii
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7 :01AM PAGE: 78
SITE ADDRESS: 11325 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: DOREEN COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: KOEHMSTEDT
DESCRIPTION: Add AC, replace furnace
•
OWNER: KOEHMSTEDT, MATTHF! + PAMELA KAY, PHONE #:
CONTRACTOR: BULL MOUNTAIN MECHANICAL PHONE #: 503 - 702 -294
Inspection Request Scheduled For: _ Date: 7/28/2006 Pour Time: -
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 033699 -02 503.963 -9836 N
Corrections /Comments /Instructions:
t r aS Z (5 4-71"11 641— 144 i A i 6 st■ 2 /44 Z5 .-.0/ _5 5 -1 g -< .e - CA &L l"T
ASS I 1 PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ,, CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �; Date: - 7--2/3 , ----e76 Phone #: (503) 718- 24-4-z,