Permit _,..,a C T
14 IGARD . r
CITY O A MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00261
TIGARD DATE ISSUED: 5/23/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102C6 -03800
SITE ADDRESS: 09975 SW GARRETT ST ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT: 011 JURISDICTION: TIG
PROJECT: JENSEN
Project Description: Furnace conversion.
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:
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
STEVE & LORI JENSEN Description Date Amount
9975 SW GARRETT ST
TIGARD, OR 97223 [MECH] Permit Fee 5/23/200f $72.50
[TAX] 12% State Surchai 5/23/200E $8.70
Phone:
Total $81.20
Contractor:
CENTRAL HEATING & COOLING LLC
10115 NE 6TH DR
PORTLAND, OR 97211 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 774 - 5425
FAX 503 - 517 - 8208
Reg #: LIC 168561
This permit is issued subject to the regulations contained in the Tigard Muniapal 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 • u -stron U NC by
calling 503 246.6699 or 1 800.332 2344
Issue , By: / _ nn � L� g P Signature:
�
y � l r �il•Gl �dL �►� _ si Aillallik
\---- Call 503.639.4175 by 7:00 a.m. for i nspecti • s h b ness .,p �. `�
This permit card shall be kept in a conspicuous place on t ' • • e until 'Metto' of project.
Approved plans are required on the job site at the time o each inspection.
1116hanical Permit Application .- . FOR OFFICE USE ONLY ,
City of Tigard Received n /� / ^ / /
II Date/By , , - 5 db 'IMI Permit No ' 1 t ' e o 4
q 1 3125 SW Hall Blvd , Tigard, OR 97223 Plan Review
Phone 503 639 4171 Fax' 503.598 1960 Date/By Other Permit
TI GARD Inspection Line 503 639 4175 Date Ready/By Igni ®See Page 2 for
Internet' www tigard - gov Notified/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE -, USE CHECKLI
Mechanical permit fees* are based on the value of the work
❑ New construction 10 Addition/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 *_.
El 1 -and 2- family dwelling 0 Commercial/industrial 0 Accessory building = .
For special information use checklist
❑ Multi - family ❑ Master builder
❑ Other:
Description p Qty. Ea. Total
. )
,_ -JOB SITE INFORMATION AND LO �
LOCATION Heating/cooling
Job site address I / /` & v „' �"t Air conditioning or heat pump
� (requires site plan showing placement) 14 00
"�.
City/State /ZIP: 'I rA.®3� 5 — c:::./ '� / Furnace 100,000 BTU (ducts /vents) 1 14.00 "
.� Furnace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg. /apt. no.: Project name: 1 Gas heat pump 14.00
Cross street/directions to job site: , l,l ICICi Duct work 10.00
'f �"� `1 Hydro= hot water system 14.00
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
Gas fireplace 10.00
�,- ;r 'C— lJ.12./$ - 1/,' sit- ' Flue vent for water heater or gas
ill fireplace 10 00
Log lighter (gas) 10 00
Wood/pellet stove 10.00
Wood fireplace /insert 10 00
WPROPERTY OWN I TENANT Chimney /liner /flue /vent 10 00
Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10 00
City/State /ZIP. Clothes dryer exhaust 10 00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) _ 6 80
❑ APPLICANT ❑ CONTACT PERSON 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: ( ) I Fax. : ( ) Water heater
E - mail: Fireplace '
Range
CONTRACTOR Barbecue
Business name: 40, : , Clothes dryer (gas)
1 .�� �. � r - 1 ► Other:
Address. , 1 �,:::.' _ ' le MECHANICAL PERMIT FEES* ,
City /State /ZIP: a r -7,2__, Subtotal
Phone (3 774 S '2 Fax (5 c ( 7 gL_ Minimum permit fee ($72 50) �� ,S-74' Plan review (25% of permit fee)
CCB lic. t s - � 1 gr La ° State surcharge (12% of permit fee) 6 70
TOTAL PERMIT FEE
Authorized signature: 7� This permit application expires if a permit is not obtained within 180
��``�
pj l(i days after it has been accepted as complete.
Print name: Jo a s - e, S Date: '7 01' * Fee methodology set by Tn-County Building Industry Service Board
I \Budd mg\Permtts \MEC- PermitApp doc 01/19/07 440 -4617T (11 /02 /C •M/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 \Buildmg\Permits\MEC- PermttApp doc 01/19/07 2
CITY OF TIGARD
BUILDING PERMIT #: MEC2008-00261
13125 SW Hall Blvd., Tigard, OR 97223
,1440:firolvitt DATE ISSUED: £/2a42008 Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/27/2008 TIME: 7:01AM PAGE: 36
SITE ADDRESS: 09975 SW GARRETT ST CLASS OF WORK:
SUBDIVISION: FREVVINGS ORCHARD TRACTS LOT #: 011 TYPE OF USE:
PROJECT NAME: JENSEN
DESCRIPTION: F urnace conversion.
OWNER: JENSEN, STEVE & LORI PHONE #:
CONTRACTOR: CENTRAL HEATING & COOLING LLC PHONE #: 503-7745425
Inspection Request Scheduled For: Date: 5/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final ' 070342-01 503-774-5425
Corrections/Comments/Instructions:
cm-sr-ifs: ter.‘ ievvl
"-c3
t s 7 e, - 2.77.iscrioe\C
7- ( 7 5
l PASS 02 PARTIAL APPROVAL El CANCEL NO ACCESS
F -GALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: P 46g -- 651 26 /
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: $' /2.3`Og
Phone: (503) 639 -4171 ::111111111%\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5j /� - TIME: PAGE:
SITE ADDRESS: 977s 50-.) CoOQE31 CLASS OF WORK: ° I- I --
SUBDIVISION: LOT #: TYPE OF USE: Sr
PROJECT NAME:
DESCRIPTION: -
OWNER: T3- 3 r' ' .. PHONE #: 5 � 5 "g 6)g -C)56 Z
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions: vi
t C \ct,vV. � . I Tjt,
.•..
•
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: '� Date: 23M Phone #: (503) 718- 2c12,