Permit .
A CITY OF TIGARD MECHANICAL PERMIT
w,,, I � DEVELOPMENT SERVICES PERMIT #: MEC2006 -00151
- -- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/14/2006
PARCEL: 1S136AD-04700
SITE ADDRESS: 06611 SW PINE ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Vent fan for bathroom conversion.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
HAYLEY & R HULTENGREN Description Date Amount
6611 SW PINE [MECH] Permit Fee 41141200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 41141200E $5.80
Phone: 503- 347 -9963 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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: . Permittee Signature: l x 4. , ge
_011,,,„,
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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application rol( orrlci usE oNI.Y
•
C of Tigard Received y �f�/ Permit xo.: , , , _„ ODDS/
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.598.1960 k, Other Permit:
I Date/B
Inspection Line: 503.639.4175 _ 1 I� Date Ready/By: h � ® See Page 2 for
Internet: www.ci.tigard.or.us ". Notified/Method Supplemental Information
TYPE OF WORK 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*
ig 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
CI Multi For special information use checklist. •
❑ Master builder 0
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Cob 1 5 W f ;me e f Air conditioning or heat pump
(requires site plan showing placement) 14.00
city / State/Z1P: Po rt1 veld , co 9,, q7 2..2- 3 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg /apt. no.: I Project name: +k 01 Gas heat pump 14.00
Cross street/directions to job site: /... 5 't'0 q q f tq Cr Duct work 14.00
ITW Wet!° ` T hW� � 4 C A r 1 Cj Ili- R esid i i hot water system 14.00
`f t'1"�'� (D r) boiler radiator or
/' I ^ u J i ew r v 4 n e- Unit h ic) 14.00
�D + 5-6p d►1 a IA+ 1� Unit heaters (fuel -type, not electric),
a in -wall, in -duct, suspended, etc. 10.00 •
4 Flue/vent for any of above 10.00
Subdivision: Lot no.:
er: 10.00
Tax map /parcel no.: • Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
` � Gas fireplace 10.00
t Ry a fba` 1-teg -offal * %7 f ° so Qom / 5- •y Flue vent for water heater or gas .
fireplace 10.00
1 v T 0 ( ` .. Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
tir
Chimney/liner/flue/vent 10.00
PROPERTY OWNER I ❑ TENANT Other: 10.00 /
Name: I-4 3 , 1 L {„ R eece _ I-ItA�
' re,r) Environmental exhaust and ventilation
Address: G (o i + 5(.4) P 1 rt e. .5+ Range hood/other kitchen
n equipment 10.00
City /State/ZIP: Po rf l d I o p., 0/ 7 2_2 ' Clothes dryer exhaust 10.00
pA A Single -duct exhaust (bathrooms,
Phone: (5503) 34 7. Cf Cf G 3 Fax: (5o3) 5 98- $ ! b toilet compartments, utility rooms) 1 6.80 CO • 7
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 .
Other: 10.00 _
Business name:
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
CO CTOR Barbecue
Business name:
1 Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City / State/ZIP: Subtotal ( . a0
Minimum permit fee ($72.50) 72...50
Phone:( ) f Fax: l )
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee) 5 • 8 0
- TOTAL PERMIT FEE
`
Authorized signature LiIi -a 4 T hi s permit application expires if a permit is not obtained within ISO
•/ days after it has been accepted as complete.
Print name: I Date: • Fee methodology set by Tr-County Building Industry Service Board
i:\Building \Permits \MEC- PamitApp.doc 12/03 440.4617T(II /O2/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 „‘?,;1
fraction thereof, to and including
$50,000.00. ..: e i . 1 • + .
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 apd. - - I Y ;
$1.25 for each additional $100.00 -
• fraction thereof, to and including 4 ; ` 1 . • +
$100,000.00. Y ° ! 1 . ... ;
$100,000.01 and up $1,396.50 for the first $100,000.Q0 and
$1.10 for each additional $100.00 of .' ' ` 1 ;,•4 • ; ' ' • t °
fraction thereof. - ','1 . : , v
Note: All new commercial buildings require 2 sets of plans.
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i:\Building\Permits \NEC- PennitApp.doc 12/03 2
CITY OPTIGARD
BUILDING DIVISION PERMIT #: MEC2006-00151
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/14/2006
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 '� "'I�
INSPECTION WORKSHEET FOR DATE: 21.2/2007 TIME: 7 :05AM PAGE: 59
SITE ADDRESS: 06611 SW PINE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HULTENGREN
DESCRIPTION: Vent fan for bathroom conversion.
OWNER: HULTENGREN, HAYLEY & REECE PHONE #: 503- 347 -9963 .
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 043216 -02 503-347-9963 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ,(2 Date: 0--/ Z — a ? Phone #: (503) 718 - Z �--