Permit C ITY OF " Ti GARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00393
o''I DATE ISSUED: 8/10/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DB -03400
SITE ADDRESS: 13086 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 072 JURISDICTION: TIG
Project Description: Installation of A/C unit.
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: 1 DOMES. INCIN:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
LILLY NEHIEM Description Date Amount
13086 SW HAZELCREST WAY
TIGARD, OR 97224 [MECH] Permit Fee 8/10/200€ $72.50
[TAX] 8% State Surcha 8/10/200€ $5.80
Total $78.30
Phone: 503- 998 -4553
Contractor:
G L HEINTZ HEATING & COOLING
20871 SW 216TH PLACE
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 625 -6798
Reg #: LIC 102831
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: —27 iz,o , rt.( Permittee Signature: tea" �I
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completio • •. roject.
Approved plans are required on the job site at the time of each inspection.
. % ":4 \) Mechanical Permit Ap licati FO12 OFFICE USE ONLY
, N .. City of Tigard 4 `'"
Receive
Date/By: ive
& /) / 11 Permit No. � Li O : +t'4 .•
v 13125 SW Hall Blvd., Tigard, OR 97223 V v O
0
G Plan Review
> P hone: 503.639.4171 Fax: 50 O� Other Permit:
8.1`�60) �,0 Date/By: Tl G A R D Inspection Line: 503.639.4175 P Date Ready/By: INI 0 See Page 2 for
Internet: www.tigard -ocgov 4 03 Notified/Method: Supplemental information
T OF K+ORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST.
❑ New construction Add 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: $
�J -and 2-family dwellin RESIDENTIAL EQUIPMENT /SYSTEI�IS.FEES*
y g ❑ C ommercial /industrial ❑ Ac cessory 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:l Z 0 75'� SO A r ( C \ f t 0 ... Air or heat pump I
` 1 (requires p
uires site plan showing placement) l 14.00
City /State /ZIP: ( (Ge< Q—AD 9 —7)-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 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 -
DESCRIPTlON OF WORK . .. Water heater 10.00
� Gas fireplace 10.00
/ �� C.)/ Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER to TENANT Chimney /linerlfluelvent 10.00
0 Other: 10.00
Name: L I1 ( (0 6 h (' � !M Environmental exhaust and ventilation
Address: /3 0 t 0 C (,J get" (c-_, yei J / J( Range hood/other kitchen
t I ( equipment 10.00
City /State /ZIP: ( ( ��C1 C�02L Clothes dryer exhaust 10.00
� Single -duct exhaust (bathrooms,
Phone: (�7`) ���� S Fax: ( ) 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: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
C� , (. f �e° V {�- « - t � It �V U' Clothes dryer (gas)
Business name: [' � (-� r ti
,N _ �) Other:
Address: ( S (� l li MECHANICAL PERMIT FEES*
City /State /ZIP: S/ j L� OA Q y CO ' �() Subtotal
Phone: ,,//��,,�� G / Fax: ( ) Minimum permit fee ($72.50)
\Jv� �4� lC� {� Plan review (25% of permit fee)
CCB lic.: ( 32_3 I State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7' 9 iJ
Authorized signature: This Permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: C� L kC i V Date: - �� ` Fee methodology set by Tri- County •
Building Industry Service Board
\ Building \ P \
I:ermitsMEC- PermitApp.doc 04 /06/06 4 -4617T ( 1 /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
AI G 1 0 2006
fl TR
CITY OF TIGARD ..
BUILDING DIVISION PERMIT #: MEC2006- 0039:1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639 -4171 . A ��,�
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_..
INSPECTION WORKSHEET FOR DATE: 8/15/2006 TIME: 7:05AM PAGE: 41
SITE ADDRESS: 13086 SW HAZELCREST WAY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE. LOT #: 072 TYPE OF USE:
PROJECT NAME: NEHIEM
DESCRIPTION: installation of A/C unit.
OWNER: NEHIEM, LILLY PHONE #: 503 - 998 -4553
CONTRACTOR: C L HEINTZ HEATING & COOLING PHONE #: 503 -625 -6798
Inspection Request Scheduled For: Date: 8/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 034969 -01 503 - 313 N
Corrections/Comments/Instructions: .
EL45G�72r CA- - 1 -.i. ' /p-i 5 1/ q 2 - G// C 26 / j&
ASS 1 I PARTIAL APPROVAL n CANCEL I I NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: .,3,,N Date: S = 4 6 P #: (503) ' "
p / ( ) 718 - -