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Permit
• ''° CITY OF TIGARD �.,_ MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00570 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/28/2007 PARCEL: 2S 104BD -00500 SITE ADDRESS: 12615 SW 136TH CT ZONING: R -7 SUBDIVISION: HUSKE PARTITION LOT: 003 JURISDICTION: TIC PROJECT: HUSKE Project Description: Upgrade gas pipe, review conditions & repair or replace, (1) vent & (1) fan. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: 1 OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1 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 OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Owner: FEES PATRICK HUSKE Description Date Amount 23352 SW MURDOCK RD SHERWOOD, OR 97140 [MECH] Permit Fee 9/28/20W $72.50 [TAX] 8% State Surcha 9/28/2001 $5.80 Phone: 503- 625 -5180 Total $78.30 Contractor: A -TEMP HEATING & COOLING 16000 SE EVELYN ST CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 650 -5014 FAX 503 -557 -2990 Reg #: LIC 71878 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 95_- 001 -0100. You may obiain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. ■ Issue By: L 0 � � ^� PermitteeSignature: A fi� % �J r Call 503.639.4175 by 7:00 a.m. for inspections that • usiness da! . This permit card shall be kept in a conspicuous place on the job site ntil completion of the project. Approved plans are required on the job site at the time o each inspection. Mechanical Permit Application - . ¢ ' -FOR - OFFICE USE°ONLY - j \City of Tigard Date/By: / 4O e 7 Permit No.: nGA / 0 0 7.••O` 70 14 . q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review eLI Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready /By: 1u ® 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: $ IRK 2 famil dwellin ❑ Accessory RESIDENTIAL EQUIPMENT./ SYSTEMS FEES* y dwelling ❑ Commercial /industrial Accesso buildin g Master builder For special information use checklist. Multi -family ❑ y ❑ ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Air conditioning or heat pump Job site address: f/ 26/i— �(/v 56 (requires site plan showing placement) 14.00 City /State /ZIP: / I / 77 77 •J 2 Furnace 100,000 BTU (ducts /vents) 14.00 � Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work I 10.00 Q Hydronic hot water system 14.00 6 ,,,„„ -- I /36 l,('G I i1;,t, a. Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Y 7 Gas fireplace 10.00 /a 6q r 5 1 p. e f�(,11� W (..,,,e/ ri g Flue vent for water heater or gas / . J fireplace 10.00 a(f I Y' or- l`P1 L i e - I )r Prti- (1-fet k t I Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00 III Other: 10.00 Name: r A o, � , , c I tf , Environmental exhaust and ventilation n- g( Range hood /other kitchen Address: �© 'ICJ 1 / 0 P equipment 1 10.00 City /State /ZIP: S a J 2 Clothes dryer exhaust 10.00 I li Single -duct exhaust (bathrooms, Phone: (CJ13) 6 S - y5 Fax: ( .V3) 6z.5 3 7 ra toilet compartments, utility rooms) 1 6.80 77`"'> PLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Business name: F uel 10.00 Gt'1 cA)& -7G-- : Fuel piping i Contact name: $5.40 for first four; $1.00 for each additional Address: n Furnace, etc. C4 Gas heat pump City/State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRALTO Barbecue Business name: � t Clothes dryer (gas) - I e L4 ' V 7 Other Address: /4'ev ' - i . Cc , 7 • MECHANICAL PERMIT FEES* City /State /ZIP: C / q trios �, Subtotal Phone: r��y- � ) !!! 61 r s z6� - Fax: ( ) 2! / , Minimum permit fee ($72.50) 7d 7 �5� Plan review (25% of permit fee) CCB lie.: 7/ , ° = State surcharge (8% of permit fee) 5. 6O / TOTAL PERMIT FEE 78 •30 Authorized s nature: ►,� r This permit application expires if a permit is not obtained within 180 - n n��/� ,V days after it has been accepted as complete. Print name A j�"'-' ,�s ���"`"""CCC � Date * Fee methodology set by Tri- County Building Industry Service Board \ 1.\BuildingP \ ; mitsMEC-PermitApp.doc 01/19/07 440 -4617T (1 I /02 /COM /WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: . Total " 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 $23 1.50 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. l: \Building \Permits \MEC- PennitApp.doc 01/19/07 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007-00570 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/ &2007 Q Phone: (503) 639 -4171 pa,;;4 Inspection Requests (24 Hrs.): (503) 639 -4175 � 'I . INSPECTION WORKSHEET FOR DATE: 4/15!. TIME: 7:02AM PAGE: 26 SITE ADDRESS: '12615 SW 136TH CT CLASS OF WORK: SUBDIVISION: HUSKE PARTITION LOT #: 003 TYPE OF USE: PROJECT NAME: HUSKE DESCRIPTION: Upgrade gas pipe, review conditions & repair or replace, (1) vent & (1) fan. - OWNER: HUSKE, PATRICK PHONE #: 5062E -51B0 CONTRACTOR: A TEMP HEATING & COOLING PHONE #: 503 - 5014 Inspection Request Scheduled For: Date: 4116/2008 Pour Time: Code # Inspection Description Confirm # Contact # Messa• - ? 41. 69 Mechanical final 068387 -01 503 - 939.5565 J / / Corrections /Comments /Instructions: r ---- i - L?::: : ' MI 'ARTIAL APPROVAL ❑CANCEL _ NO ACCESS n FAIL ! CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / ' Phone #: (503) 71a� --- CITY OFTIGARD. . BUILDIN6b1VISION PERMIT #: tiliFC1007-00570 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9128/2007 Phone: (503) 639-4171 avolvoil Inspection Requests (24 Hrs.): (503) 639-4175 A.- ti... INSPECTION WORKSHEET FOR DATE: 10/17/2007 TIME: 7:02AM PAGE: 4 SITE ADDRESS: 12615 SW 136TH CT CLASS OF WORK: SUBDIVISION: HUSKE PARTITION LOT #: 003 TYPE OF USE: PROJECT NAME: HUSKE DESCRIPTION: Upgrade gas pipe, review conditions & repair or replace, (1) vent & (1) fan. OWNER: FIUSKE, PATRICK PHONE #: 503-626-5180 CONTRACTOR: A-TEMP HEATING & COOLING PHONE #: 503 660-5014 Inspection Request Scheduled For: Date: 10117/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 057787-01 503-939-5545 Y Corrections/Comments/Instructions: ASS Ill PARTIAL APPROVAL I I CANCEL I I NO ACCESS fl FAIL I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: . Date: /6' —/ 7-0 - 7 Phone #: (503) 718- -2_9-44sai CITTOF 11IGARD BUILDING DIVISION PERMIT #: C2007 -00570 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/28/2007 Phone: (503) 639 -4171 1 ypn Inspection Requests (24 Hrs.): (503) 639-4175 _Ai'' 1! INSPECTION WORKSHEET FOR DATE: 10/16/2007 TIME: 7:01AM PAGE: 11 SITE ADDRESS: 12615 SW 136TH CT CLASS OF WORK: SUBDIVISION: HUSKE PARTITION LOT #: 003 TYPE OF USE: PROJECT NAME: HUSKE DESCRIPTION: Upgrade gas pipe, review conditions & repair or replace, (1) vent & (1) fan. OWNER: HUSKE, PATRICK PHONE #: 503 G26.5100 CONTRACTOR: A -TEMP HEATING & COOLING PHONE #: 503 - 650.5014 Inspection Request Scheduled For: Date: 10/16/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 6'10 Gas line M77O0 -01 503.9395EA N Corrections/Comments/Instructions: b S ! 5PGcj04/ S .4//z- -S P. 4‘` PASS H PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I I FAIL ( CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /e ----76 ' `� Phone #: (503) 718 -6 CITY- '-OF T-IGARD y B -41 UILDING DIVISION PERMIT #: k�C2tt07 (#0570 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9,12a12.007 Phone: (503) 639 -4171 „q 4 i�lll l�r Inspection Requests (24 Hrs.): (503) 639 -4175 I INSPECTION WORKSHEET FOR DATE: 10/15/2007 TIME: 7:01Am PAGE: 22 SITE ADDRESS: 12615 SW 136TH CT CLASS OF WORK: SUBDIVISION: HUSKE PARTITION LOT #: 003 TYPE OF USE: PROJECT NAME: HUSKE DESCRIPTION: Upgrade gas pipe, review conditions & repair or replace, (1) vent & (1) fan. OWNER: HUSKE, PATRICK PHONE #: 03- 625 -5180 CONTRACTOR: A- TEMP HEATING & COOLING PHONE #: 503-650-5014 Inspection Request Scheduled For: Date: 10/15/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 057612 -01 503-939-5645 N • Corrections /Comments/ Instructions: (7 — ,4Z4) r s - PAS f ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED J Inspector: Date: /d — lJ - d7 Phone #: (503) 718-