Permit C 11 - 1 OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00477
DATE ISSUED: 10/5/2006
°---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S134AB -01200
SITE ADDRESS: 11334 SW IRONWOOD LP ZONING: R -4.5
SUBDIVISION: ENGLEWOOD LOT: 011 JURISDICTION: TIG
Project Description: Gas fireplace insert. Gas to fireplace, waterheater and barbeque.
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:
GAS 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
GAS OUTLETS: 3
> 10000 cfm:
Owner: FEES
FREEMAN, LINDA M Description Date Amount
11334 SW IRONWOOD LOOP
TIGARD, OR 97223 [MECH] Permit Fee 10151200E $83.00
[TAX] 8% State Surcha 10/5/200E $6.64
Total $89.64
Phone:
Contractor:
WOLFERS, INC
290 YOUNG ST
WOODBURN, OR 97071 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 981 -0801
PRI 503- 981 -4511
Reg #: LIC 1911
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 obt in copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: a la Permittee Signature: v`
Call 503 - 639 -4175 by 7:00 a.m. for inspections that b sines day.
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.
OFFICE Permit Application FoR oiiic L ISE ONLY , Received
11111 City of Tig d f ` ` ` . Date/By. �D 1(7 v . Permit N. . ` i✓ -d7 Q !
13125 SW Hall Blvd., Tigard; 6R,9.7223. ."
C Other Permit
Plan Review
Phone: 503.639A17 Fax: 503.598.1960 Date By
Inspection Line: 503 .639 . OCT 0 ) 2006 b 4175
TIGARD A R D k 2006 Date ReReady/By: t ® ee Page 2 for
Internet: www.ti ard - or. ov Notified/Method: ti Supplemental Information
' ':' 'AP . :CIF -RrOR kifi: ,_ - • ' COMMERCIAL "FEE* `SCHEDULE USE
❑ New construction �i= Addttton/a eratton/r
1 T1frt. T" Yom'. 's tepla' / A ceme Q'? % nt 9 i '. 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: $
l� I - and 2-family dwelling - .RESIDENTIAL EQUIPMENT' /'SYSTEMS,FEES*
y g ❑ Commercial /industrial ❑ A ccessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. Total
' SITE ,INFORM ATION AND LOCATION . Heating /cooling
�� �' Air conditioning or heat pump
Job site address:
�� + �� ,4/� J(, l �i 1 (requires site plan showing placement) 14.00
•
City /State /ZIP: Tic G Ir ,J) C�� 5 72,2-S Furnace 100,000 BTU (ducts/vents) 14.00
J Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: F; M.6i'"-' 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
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
. Tax map /parcel no.: Other fuel appliances
- DESCRIPTION OF `WORK. ' ° Water heater _ / 10.00 V
Gas fireplace L...x..Acw.t 1 10.00 tr, ..A`'
`i 5 r /iz.� N Cc
e , Rep c_c e /ec 4 G e Flue vent for water heater or gas /
A--1-1, fireplace 10.00
C,Jcc - [e'1 (,�.r- f a L t....1 .0 r / Log lighter (gas) 10.00
j /16 : C (L,t/ . , f n �, 'z ,(L f / Z -Pe.,, Wood /pellet stove 10.00
I f / _ Wood fireplace /insert 10.00
i
I Chimney /liner /flue/vent
Other: 10.00
,L'PROPERTY' OWNER ' " 0
" 10.00
Name: .. pp L ") °ems' Fae..Q. M, CI .0) Environmental exhaust and ventilation
Address: / / ,..e._/ �' ^:,-,S .0 ih r-3 C9 \ J j Range hood/other kitchen pv equipment 10.00
City /State /ZIP: j b c- '� ' r -�� Clothes dryer exhaust 10.00
J Single -duct exhaust (bathrooms,
Phone: (5 / ) 7 y _ 53 6 a Fax: ( ) toilet compartments, utility rooms) 6.80
_ �' L,;L J AP PL ICANT' ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: AJ ( n� y IN ' J r` Other: 10.00
Fuel piping
Contact name: n
Cs ks-- L U ^J $5 for first four• ' $1.00 for each additional
� / v o Furnace, c tJ ` � �� `7 Fuace, etc.
Z / f Gas heat pump
City /State /ZIP: CA ),„ I) (._)6 , C, Wall /suspended/unit heater
Phone: (�J) 5- , 7 -(! F ax : ( ) W heater `1' � 5'`t C'�
( Fireplace 1 6 ' ,� _ h
E -mail: Range
CONTRACTOR Barbecue j -, / ;---/ c....
name: NO ( 4-e R -5 e--, l l'3 Clothes dryer (gas) V
/1 �. Other:
v G �N
Address: � 11 f' � MECHANICAL PERMIT � FE * , ' ,
S`
City /State /ZIP: mod` 0 /` 5 ') f - Subtotal � 3 .
• c ) Minimum permit fee ($72.50)
Phone: (5 j) l C v� ���11 ` ( Fax: ( b �� �� 4' 4' U U ' Plan review (25% of permit fee)
CCB lic.: i 7 // a / . Pr - State surcharge (8% of permit fee) 49 ,&4
TOTAL PERMIT FEE 9. (pL.�
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 - 1 (.... U ,rJ e ve Date: /CD Q J * Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Pennits 'NEC- Penrii.doc 04 /06/06 440 -4617T(II /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
CITY-OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00477 ,
13125 SW Hall Blvd., Tig'kcl, OR 97223 DATE ISSUED: 10/5/2006 c
Phone: (503) 639-4171 I Am i
. ri Ili
Inspection Requests (24 Hrs.): (503) 639-4175 .,..„Amfr --...
INSPECTION WORKSHEET FOR DATE: 10/1012006 TIME: 7:06AM PAGE: 23
SITE ADDRESS: 11334 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: oi , 1 TYPE OF USE:
PROJECT NAME: FREEMAN
DESCRIPTION: Gas fireplace insert. Gas to fireplace, waterheater and barbeque.
OWNER: PHONE #:
CONTRACTOR: WOLFERS, INC PHONE #: 503-981-4511
Inspection Request Scheduled For: Date: 10/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 037936-01 503-710-1336 Y
k ef I F1(0\t-/ I : CZ) •
Corrections/Comments/Instructions:
Al fr,
___ ..
AU ■y
15111,
Aaa -•
I I "
1111Wir _Ilk
ISM
r e
,...---7 ,
, PASS E] PARTIAL APPROVAL I I CANCEL 0 NO ACCESS
I I FAIL 1 I CALL OR IN PECTION I I ADD ITIO AL EES ASSESSED
. .11111111A
Inspector: AWA.V& Date: (6 % Phone #: (503) 718-
.• • • . • • , •