Permit C ITY OF TIGARD MECHANICAL PERMIT
ru DEVELOPMENT SERVICES PERMIT #: MEC2005 -00260
22
' ' I " 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/19/2005
PARCEL: 2S 104AA -00600
SITE ADDRESS: 12720 SW BELL CT ZONING: R -4.5
SUBDIVISION: BELLWOOD LOT: 055 JURISDICTION: TIG
Project Description: Furnace install
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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
BARTELL, JEFF Description Date Amount
15002 ROB I N ETTE CT. [MECH] Permit Fee 5/19/200f. $72.50
MILWAUKIE, OR 97222 [TAX] 8% State Surchaq 5/19/200` $5.80
Phone: 503 - 522 - 8830 Total $78.30
Contractor:
PIONEER GAS FURNACE
3615 NE BROADWAY REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97232
Phone: 503 249 - 5000
Reg #: LIC 36102
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: AP- - - ,24 Permittee Signature: ‘ 7 7 2/24
7:00 a.m. for inspections that business day.
a
Call 503 - 639 -4175 b
Y pe Y
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 _ _ koR.01.1..1( 1.. 1 si:, ()NL) .._
•
City of Tigard EN 5) A Received . . o 5 18
Date/By: Permio.h , 05 _—c20A 6
., 13125 SW Hall Blvd., Tigard, OR t N
lellii Plan Review
' Phone: 503.639.4171 Fax: 503,e6 P / I Nlo, , , 1., , ,-,, Date/By: Other Permit:
.. ,. Inspection Line: 503.639.4175 .A101111
TO .44 11 .., Date Ready/By: El See Page 2 for
Internet: www.ci.tigard.or.us VkM 1 ,_ _
Notified/Method: En
. Supplemental Information
.. .
..,, - c ARD
' , "': YiUsnrdtNV4r';' ' , ' • ' . .(#?geF MAIji0 ' COMMERCIAL .FEE# SCTIEDilik4g*A0iiiii*Tii
to mmiG
0 New construction Mechanical permit fees' are based.on the value of thework
,. .
riAlthtron/alteration/replacement .
- performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition . 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
.. . :: ..,.-• -. . ,,,- ...v`: - .:.. - •;v
RESIDENTIAL
:;ir 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
.0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
, '' • „„,._,...„,,,, ,„' „.,„,. _ ,,,,,,,,,,,,,, .._.„.
OC,WM7 t AND LOCATION Heating/cooling
Ipb-site address: / 27 20 s i g e fi ("ear-71- Air conditioning or heat pump
(requires site plan showing placement) 14.00
*
city,staCity/State/ZIP: Tir ,,...,, , 0 , e _ q 72 _ 2 3 Furnace 100,000 BTU (d / 14.00 / —
Furnace 100,000+ BTU (ducts/vents) 17.90
- Suite/bldg./apt. no.: Project name: & .. . . 14.00
Gas heat pump .
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 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
R e / t kl'i •to ,5' 7arnori Flue vent for water heater or gas
. t fireplace 10.00
Log lighter (gas) . io.ob
Wood/pellet stove 10.00
• • Wood fireplace/insert 10.00
. .
. ,
rritIWIPirchiaPileifitAOWNEII. . I 0 TENANT ' Chimney/liner/flue/vent 10.00
Other: 10.00 •
,.. Name: j &A,/ // • Environmental exhaust and ventilation
Address: /5)) 2- hin e ft. Coct.ri- Range hood/other kitchen
equipment 10.00
' ..
City/State/ZIP: in4, ft(Zi / oe 9 222 2 ._ Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
..... : Phone: (( ) ; 9,1 ...is 0: Fax: ( ) toilet compartments, utility rooms) 6.80 ,
kigiyrrianitzi7,';AileANT --
Attic/crawlspace fans 0 CONTACT PERSON 10.00
Other: 10.00
• . • ' Business name: e,jr220.--/Cr---
,!. 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: ( ) 1x : ( ) Water heater
Fireplace
. E-mail: Range
. . it.051 .:':::'....': ''i • • - . 4 - CONTRACTOR . . .„ . Barbecue
' Business name: /3,2 as A-24 #-z'a e Clothes dryer (gas)
I I .
,,. Address: 3 e 4 . roczo/ ,
, Cl
Other:
MECIIANICALPERMITYEES4
, . City/State/ZIP: 6 k. 7 1/ and i " A R '?2'2 Minimum Subtotal
-' permit fee ($72.50) 7 2. • 5-0
Phone: ( 5 2 '7-9 5 Fax: (5)3 249 g
Plan review (25% of permit fee)
CCB lic.: 36 /O State surcharge (8% of permit fee) S. gin
/ '7 V. 30
• Authorized signature: .0'
'A, ArifrAm.dik....... This permit application espires it a permit is not after it obtained within 180
days has been accepted as complete.
Print name: . Ca / e_z9t 4 e/ nate-.5_ / 7 5"1 Fee methodology set by Tri-County Building Industry Service Board
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
To tal 4aluationf r='~ '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.
•
•
• is'Building\Pennits MEC- PermitApp.doc 12/03 • 2 .
CITY OF TIGARD w
BUILDING DIVISION PERMIT #: MEC200S 00260
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/13/2006
Phone: (503) 639 -4171 1, i.„i , / /Jm
Inspection Requests (24 Hrs.): (503) 639 -4175 I
II �
INSPECTION WORKSHEET FOR DATE: 5/23/2005 TIME: 7 :08AM PAGE: 116
SITE ADDRESS: 12720 SW BELL CT CLASS OF WORK:
SUBDIVISION: BELLWOOD LOT #: 055 TYPE OF USE:
PROJECT NAME: BARTELL
DESCRIPTION:(Furnace rn a'
OWNER: BARTELL, JEFF, PHONE #: 503.522 -8830
CONTRACTOR: PIONEER FURNACE P HONE #: 3• 500
NEER GAS URN E 50.. 243~ 0
Inspection Request Scheduled For: Date: 5/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007416 -01 503 - 249.5000 Y
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
____
Inspector: f Date: j " 2-- --- Phone #: (503) 718-