Permit CITY TIGARD MECHANICAL PERMIT
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DEVELOPMENT SERVICES PERMIT #: MEC2006 -00258
AA �'f-� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/7/2006
PARCEL: 2S 104AB - 13700
SITE ADDRESS: 12407 SW 133RD AVE ZONING: R -
SUBDIVISION: MORNING HILL NO. 7 LOT: 165 JURISDICTION: TIG
Project Description: Extend gas line to stove, BBQ & dryer. Add pellet stove.
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:
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: 0
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
GRANT YOZAMP Description Date Amount
12407 SW 133RD AVE
TIGARD, OR 97223 [MECH] Permit Fee 6/7/2006 $72.50
[TAX] 8% State Surcha 6/7/2006 $5.80
Total $78.30
Phone: 503- 481 -0240
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 -• I I. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Jr-'o L ._) Permittee Signature: " / Ifs
Call 503 - 639 -4175 by 7:00 a.m. for inspection,hat businesOF
This permit card shall be kept in a conspicuous place on the ' b site until completion of the project.
Approved plans are required on the job site at a time of each inspection.
:Mechanical Permit Application , 1 OFFICE USE ONLY
Received , _
City of Tigard "' C E IV E Date /By: b� : - 1. i Permit No. • • • / L , �1
li
4 1 3125 SW Hall Blvd., Tigard, OR 97 -
111 _.: , ' Ph one: 503.639.4171 Fax: 503.598.196Q Plan Review
JUN 7 2�Qi6 Date/By. Other Permit:
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: MI ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
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: $
1 - and 2-family dwelling RESIDENTIAL EQUIPMENT/ SYSTEMS'FEES*
y g ❑ Commercial/industrial 12 Accessory building
❑ Multi - family 0 Master builder For special information use checklist.
❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: h ,r- Air conditioning or heat pump
4/ 7 � S ltj 3 7 f��(.• (requires site plan showing placement) 14.00
City /State /ZIP: l ; V 4l) ® k c. . g ") '5 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg./apt. no.: Project name: �` Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
L / I 133 Hydronic hot water system 14.00
✓`7 L y� l � 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 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
- / 1 - a .. * , ..; c'. Flue vent for water heater or gas
/ f {, / /j fireplace 10.00
K 6` — / " " ` E-T2� `
P , , B l 6e7 , / fle.0 d Log lighter (gas) 10.00
Q ood /pellet stove r 10.00
o Wood fireplace /insert 10.00
PROPERTY OWNER ❑TENANT
Chimney/liner/flue/vent 10.00
Other: 10.00
Name: 6 gA-A.IT $'o Z ` , Environmental exhaust and ventilation
.� Range hood/other kitchen
Address:
M y6 9 SZti /33 / j, , equipment 10.00
City /State /ZIP: j 7 7) 0 l 72.9 Clothes dryer exhaust 10.00
O Single -duct exhaust (bathrooms,
Phone: (6ji) f�� .- 0011/6 Fax: ( ) toilet compartments, utility rooms) 6.80
. " CC APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: "( , az - $5.40 for first four; $1.00 for each additional
Address: /d yo ? 61,e) /33 7 Furnace, etc.
Gas heat pump
City /State /ZIP: ? j 1_ 14.42._ 70v, Wall /suspended/unit heater
Phone: ..JJ�� ��
(C� )S / 2 t, 5— F ax: ( ) Water heater
Fireplace
E -mail: Range i
CONTRACTOR Barbecue i
Business name: Clothes dryer (gas)
)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
' /may q TOTAL PERMIT FEE ''n , ,3 O
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 � Date: • Fee methodology set by Tri- County Building Industry Service Board
1: \ Building \Penn its\MEC- PermitApp.doc 04 /06/06 440-461 7T (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.
•
I:\Building\Permits\MEC- PermitApp.doc 12/30/05 2
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CITY ����v�^ _. r ._ -
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BUILDING DIVISION PERMIT #: MEC2006-00258
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/7V2006
Phone: (503) 639-4171
Inspection Reque�u(24Hm�:(SO3)83A'4175 .�&�- ^� J�
INSPECTION WORKSHEET FOR DATE: 8 TIME: '7:09AM PAGE: 71
SITE ADDRESS: 12407 SW 133RD AVE CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 7 LOT #: 165 TYPE OF USE:
PROJECT NAME: YOZAMP
DESCRIPTION: Extend gas line to stove, 13B0 8 dryer. Add pellet stove.
OWNER: YOZAMP, GRANT PHONE #: 5034181'0240
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8V18/2006 Pour Time:
{}ode # Inspection Description Confirm # Contact # Message
699 Mechanical final 035200-01 503-521'8489 N
Corrections/Comments/Instructions:
.
' —,
.
F4S8 n PARTIAL APPROVAL 0 CANCEL E NO ACCESS
0 FAIL | CALL FOR INSPECTION l] ADDITIONAL FEES ASSESSED
Inspector: ../.2, � Date: 5—/6 -- CV Phone #: (503) 71B' 2.44-/�'
CITY OFTIG RD `_ _O?e -c_1
BUILDING DIVISION PERMIT #4,2666 9 C �5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADD S: r a, (Q 7 l 334,L CLASS OF WORK:
IVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: C- z 8 0 Pour Time:
Code # Inspection Description Confirm # Contact # Message
L a 0 y d
Corrections /C. ments /I structions: ' 5
✓i n,
.i PASS PARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 2-a.6 Phone #: (503) 718-