Permit I CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00366
r � 4 ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/2/2006
PARCEL: 1 S 134AC -01200
SITE ADDRESS: 11410 SW IRONWOOD LP ZONING: R -4.5
SUBDIVISION: ENGLEWOOD LOT: 040 JURISDICTION: TIG
Project Description: (2) gas fireplace inserts w /piping.
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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm:
GAS OUTLETS: 2
Owner: FEES
BILL TATE Description Date Amount
11410 SW IRONWOOD LP
TIGARD, OR 79223 [MECH] Permit Fee 8/2/2006 $72.50
[TAX] 8% State Surcha 8/2/2006 $5.80
Total $78.30
Phone: 503- 267 -2342
Contractor:
GAS PRO, INC.
7603 SE LOUNSBERRY LN
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
•
Contact #: FAX 503- 775 -7014
PRI 503- 775 -7020
Reg #: LIC 167493
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 • ese
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
/ (
Issued By: //.. Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections; busines d.
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.
.c lltleehanical Permit Applica l ° � . - i . IOR OFFICE U SE ONLY y -
City of Tiga � ' Date/By � � Permit No. �� '
° 1 3125 S W H all Blvd., Tigard, OR 97223 ' �� , '
Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 AUG 0 Plan Review
. C 2 ',, Date /By.
T:I:G'A R D Inspection Line: 503.639 Date Ready/By: FiRi ® See Page 2 for
Internet: www.tigard or.gov y N o ti 6 ed/Method: Supplemental Information
TYPE ✓ 0WRI COMMERCIAL FEE* SCHEDULE -- USE CHECKLIST
E] 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: $
• RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
*1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description . Qty. I Ea. I Total
°° -: JOB, `
SITE' INFORMATION. AND LOCATION - - Heating /cooling
`
Job site address: I (V /� � 61�� (7 / ' /� Air conditioning or heat pump
� Y�r/0 J T / 1 ' \ d (requires site plan showing placement) 14.00
City /State /ZIP: 7 ' 6 44 � j q 2 � d Furnace 100,000 BTU (ducts /vents) 14.00
L �s 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
e . ' ° - DESCRIPTION OF WORK . " ' Water heater 10.00
Gas fireplace e 2., 10.00 ,2 6
5 1115E4 /- Flue vent for water heater or gas
fireplace 10.00
6 4 s ' p , 19 Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
ROPER_ TY OWNER . � El ' TENANT, ._
" - - Other: 10.00
Name: j3 TA /t- Environmental exhaust and ventilation
Range hood/other kitchen
Address: S /T el (, equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
y Single -duct exhaust (bathrooms,
Phone: ( 312. Fax: ( ) toilet compartments, utility rooms) 6.80
' / P ❑ CONTACT„PERSON Attic/crawlspace fans 10.00
� • , 10.00
/_
Other: 0
Business name: A c ,,,, .Z n C Fuel piping
Contact name: 0 ��,1 /�n $5.40 for first four; $1.00 for each additional
Address: 2 b /_ 1V 3 5 ( 2 OU � `' L 14 t Furnace, etc.
/ f ` Gas heat pump
City /State /ZIP: b/( (- 04 g `� — / Wall /suspended/unit heater
Phone: ( 9rJ 9 S.- 20; 0 Fax: : (joy ) 9 9S^ 7 � I Water heater
/ / / _ Fireplace _ 5 . /
E - mail: b f v.ZnC ( (U' J :4f /4 E 7 L Range
CONTRACTOR Barbecue •
Business name: /9/) ' f . Clothes dryer (gas)
Other:
Address: ' • MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lic.: 4 7 ! r f ' / / State surcharge (8% of permit fee)
i
r TOTAL PERMIT FEE
Authorized signature: T his permit application expires if a permit is not obtained within 180
,:".- days after it has been accepted as complete.
/��
Print name: 4 ki E / i -- 1 t f" ��40
Date: ,.2 -`f Fee methodology set by Tri- County Building Industry Service Board
\ B
1:uilding \Permits \MEC P 04 /06/06 / 4440 -4617T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
rTotal
Valuation: a ° , Permit: Fee,:r
$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 $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\BuildinePermits\MEC- PermitApp.doc 12/30/05 2
CITY OF TIGARD A . -.
BUILDING DIVISION PERMIT #: MEC 0fli� -f�4 36$
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2/2006
Phone: (503) 639 -4171 i��llro��"'�) (
Inspection Requests (24 Hrs.): (503) 639 -4175 ,...' - ...
INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7:04Am PAGE: 80
SITE ADDRESS: 11410 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 040 TYPE OF USE:
PROJECT NAME:. TATE
DESCRIPTION: ( gas fireplace inserts IN/piping,
OWNER: TATE, BILL PHONE #: 503 -267 -2342
CONTRACTOR: GAS PRO, INC. — PHONE #: 503.775.7020
Inspection Request Scheduled For: Date: 0/4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 034369-02 503 - 347 -9115 N
Corrections /Comments /Instructions:
' PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL C LL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: `=¢ �� Phone #: (503) 718 - `<= -
CITY OF TIGARD . _.
BUILDING DIVISION PERMIT #: MEM006 -00366
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/212005
Phone: (503) 639- 4171 ��d�4@ A.
Inspection Requests (24 Hrs.): (503) 639 -4175 '' L..
INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7:04Ami PAGE: 81
•
SITE ADDRESS: 11410 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 040 TYPE OF USE:
PROJECT NAME: TATE
• DESCRIPTION: ( gas fireplace inserts w /piping.
OWNER: TATE, BILL PHONE #: 503-267 - 2312
CONTRACTOR: GAS PRO, INC PHONE #: 503.775 -7020
Inspection Request Scheduled For: Date: 8/4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 034369.01 503.347 -9115 Y
Corrections /Comments/ Instructions:
_./. Ai- S ( ; -r- = ? 1 II l,-S" Alviti v �--
PASS PARTIAL APPROVAL CANCEL I I NO ACCESS
I FAIL I I ALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: % Date: F—¢ -467 Phone #: (503) 718 -