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Permit j' / a CITY OF TIGARD MECHANICAL PERMIT : ° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00552 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/19/2007 PARCEL: 25111 DC -12000 SITE ADDRESS: 15890 SW OAK MEADOW LN ZONING: R -7 SUBDIVISION: SUMMERFIELD NO.11 LOT: 616 JURISDICTION: TIG PROJECT: VVHITEHEAD Project Description: Furnace replace. 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: 1 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: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES GLEN WHITEHEAD Description Date Amount 15890 SW OAK MEADOW LN TIGARD, OR 97224 [MECH] Permit Fee 9/19/2007 $72.50 [TAX] 8% State Surcha 9/19/200i $5.80 Total $78.30 Phone: '503- 670 -1598 Contractor: BULL MOUNTAIN MECHANICAL 13580 SW RHETT CT. TIGARD, OR 97224 REQUIRED ITEMS AND REPORTS • Contact #: PRI 503- 702 -2945 FAX 503 -524 -6533 Reg #: LIC 157814 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. il Issued By: P ermittee Signature: A �i Call 503.639.4175 by 7:00 a.m. for inspections that b iness 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. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard f* Received Date/By: f /9' /d 7 8 8 Permit N c.. 17 ..Oa 5 y 111 Ill • 13125 SW Hall Blvd., Tigard, 0 °' it cEivED Plan Revi Phone: 503.639.4171 Fax: 51 . : - • Date/By: Other Permit: TI G A R D Inspection Line: 503.639 SE P 1 9 ZOO? Date Ready/By: 1uris: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information CITY OF 11611FID TYPE DIVISION COMMERCIAL FEE" SCHEDULE - USE CHECKLIST ❑ 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' .01- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi-family ❑ M builder 0 Other: Description I Qty. f Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: , /�/ 7 -) / Air conditioning or heat pump / S 9lJ V C /a �/ ) V /� �} � c VQ(,v (�- /9l�✓t (requires site plan showing p l ace ment) c _ 14.00 City /State /ZIP: T94 9, es. 0 ,) 9 2� Furnace 100,000 BTU (ducts/vents) `�' 14.00 7 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: I Project name: �h , G 1 ea Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 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. 14.00 Subdivision: Lot no.: Flue /vent for any of above x 6.80 Other: _ 10.00 Tax map /parcel no.: Other fuel appliances DESCRIP'T'ION OF WORK Water heater 10.00 /Yep Gas fireplace 10.00 ep iile e cj/ s /.-W'C f u> r IA Flue vent for water heater or gas /� / fireplace 10.00 /lied qv.%i -* 6 /Is ff i Gt Log lighter (gas) 10.00 C Wood/pellet stove 10.00 Wood fireplace /insert 10.00 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 10.00 Other: 10.00 Name: ( le /0 A.J A / 21 4 ea ea Environmental exhaust and ventilation Address: / 3W '7 S ) O /2T�O ' d sJ 44 N Range hood/other kitchen (/ [ equipment 10.00 / City /State /ZIP: I n 2D 972- 2 /7 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (t.3 Q - /5--g 9 Fax: ( ) toilet compartments, utility rooms) 6.80 11 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: -SLA 1 / /nou ,v y L q i ,.,) /ile j N, a 0. Fuel piping Contact name: �!'g c hiii A/ 5/ A..) $5.40 for first four; $1.00 for each additional Address: 13 0 �t /5.e z , ` a U h , t Furnace, etc. _.� Gas heat pump __/ / City /State /ZIP: ri 240 ©Gt 9' 7 Z 2. Cf Wall/suspended/unit heater Phone: 603) 7c -2 yij' Fax: : 60).6 /6'5--,3,3 Water heater ' 8 r e ) to 1l Q S /0 1 .�' O /'t. Range E -mail: CONTRACTOR Barbecue Business name: // /you A/ 4�. y J `j Irk 9 N ,a , / Clothes dryer (gas) ��')) �/ G Other: Address: is S9 6 S CO e ` G MECHANICAL PERMIT FEES* City /State /ZIP: ---7 f' / . /2 3 4) Q/Z. q 72.2 y Subtotal Phone: (' 7t02 2 f 1... Fax: 6 52 4 C3 Minimum permit fee ($72.50) l Plan review (25% of permit fee) CCB lic.: J3 78 / State surcharge (8% of permit fee) Q TOTAL PERMIT FEE 70,90 Authorized signature: This p ermit application expires if a permit is not obtained within 180 / days after it has been accepted as complete. Print name: - 71- /7 6 ,t) Sr .. I Date: 9 - J 9 - 0 • Fee methodology set by Tri -County Building Industry Service Board 1:\Building\PermitsV�C- PermitApp.doc 01/19/07 440- 4617T(I1 /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. 1:\ Building\ Permits \MEC- PermitApp.doc 01/19/07 2 CITY OF TIGARD - BUILDING DIVISION PERMIT #: MEC2007 -00552 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2007 Phone: (503) 639 -4171 g ? III Inspection Requests (24 Hrs.): (503) 639 - 4175 �: _.. INSPECTION WORKSHEET FOR DATE: 10/22/2007 TIME: 7 :00AM PAGE: 32 SITE ADDRESS: 15090 SW OAK MEADOW LN CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.11 LOT #: 616 TYPE OF USE: PROJECT NAME: WHITEHEAD DESCRIPTION: Furnace replace. OWNER: WHITEHEAD. GLEN PHONE #: 503 -670 -1598 CONTRACTOR: BULL MOUNTAIN MECHANICAL PHONE #: 5Q3- 702 -2945 Inspection Request Scheduled For: Date: 10/22/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message • 699 Mechanical final 058016-01 503 - 702 -2945 Y Corrections/Comments/Instructions: , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: i6 -Z —a> Phone #: (503) 718- 2-4-4-c--