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Permit p CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00553 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2006 PARCEL: 2 S 114 B D -01500 SITE ADDRESS: 09800 SW RIVERWOOD LN ZONING: R -4.5 SUBDIVISION: COPPER CREEK STAGE 2 LOT: 044 JURISDICTION: TIG Project Description: Gas line - fireplace insert. 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: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 GAS OUTLETS: 1 > 10000 cfm: Owner: FEES LARRY CHURCH Description Date Amount 9800 SW RIVERWOOD LN TIGARD, OR 97224 [MECH] Permit Fee 11/9/200€ $72.50 [TAX] 8% State Surcha 11/9/200E $5.80 Total $78.30 Phone: 503- 352 -5547 Contractor: HEAVENLY HEAT DBA P. SHAMBERG PO BOX 647 DONALD, OR 97020 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 678 -3089 FAX 503- 678 -2405 Reg #: LIC 147952 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: ^ - -� `(.P.l -?' L/ 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 Aronhe oil OFF IC USE o\ 1 City of Tigard �� ® Received — /� I Pem it N ; . , /4., ' 00 q 13125 SW Hall Blvd, Tigard, OR 97223 , Phone: 503.639.4171 Fax: 503.598.19�'p! DPI. ew Other Permit: ' Inspection Line: 503.639.4175 14 `� 20 Date Read B rye ® See Page 2 for • • TIGARD Ready /By: � / B Internet: www.tigard - or.gov CITY OF TIGARD • Notified/Method ) Supplemental Information . Bill fING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction is 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" igi 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory 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 Air conditioning or heat pump Job site address: 7g3 00 S 24 zeo IS t _rJ . (requires site plan showing placement) 14.00 City /State /ZIP: -- 7l� ArZi r) 9 7.-9, y Furnace 100,000 BTU (ducts/vents) 14.00 1 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 ' b' L k#riv\ --1 1C)" A_ - ' S 1\) - EF21BL 'C '-r0 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 ' Gas fireplace / 10.00 Z , j f't 1— t` C s 1 k,R �t ('— - - PL.0csc..t� . Flue vent for water heater or gas fireplace 10.00 a \--q Ili v VT ds � o . Log lighter (gas) 10.00 Wood/pellet stove • 10.00 Wood fireplace/insert 10.00 ti PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: � > ZRi C #02c.4 Environmental exhaust and ventilation Address: Cy 8 u) erel t) co \--10 . Range Pmt d/other kitchen 10.00 equi City /State/ZIP: P y}.,/1�, Ora_ S 7V-'9. Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: 003 ) 3 7 7 5-5 it. 7 Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans '10.00 Other: 10.00 Business name: V //+��■ W [42_. Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Furnace, etc. Address: , Gas heat pump ' City / State/ZIP: Wall/suspended/unit heater ' Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: ' Range CONTRACTOR Barbecue Business name: ‘A,-..- / tf0t, EAT Clothes dryer (gas) Other: 'Address: 'I] al< (o 4 MECHANICAL PERMIT FEES* City /State /ZIP: vb N.AI..T.) D2 . a . " 9 " 9 j > ) f ) Subtotal (5a3 ) 6 Fax: ( p3) 7 Minimum permit fee ($72.50) . Phone: 3 5 � ,2 4 OS- Plan review (25% of permit fee) CCB lic.: I if 7 g ` j oZ State surcharge (8% of permit fee) • l TOTAL PERMIT FEE Authorized signature: "" ✓ 6 t•(AS f� l This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1-4x. C4 c I Date: j � bk, • Fee methodology set by Tn- County Building Industry Service Board I:U ildinglPennitsV�C- PemaitApp.doc 04/06/06 44L46frrW/02/Convwenl ■ Mechanical Permit Application - City of Tigard = ; .' -0 ,' - . Page 2 - Supplemental Information ' - Commercial Fee Scheduled 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 . . • , t, $1:80 for each additional $100.00 or . , fraction thereof, to and including , • $10,000.00: • $10,001.00 to $50;000.00 ' $23 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 or . - - - fraction thereof. • Note: All new commercial buildin require 2 sets of plans. , . . • • , . . I:\ Building \Permits\MEC- PermitApp.doc 12/30/05 2 n CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC200E -00553 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/9/2006 Phone: (503) 639 -4171 41 "otP e Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7:01AM PAGE: 79 SITE ADDRESS: 09800 SW RIVERWOOD LN CLASS OF WORK: SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE: PROJECT NAME: CHURCH DESCRIPTION: Gas line - fireplace insert. OWNER: CHURCH, LARRY PHONE #: 503 - 352 -5x47 CONTRACTOR: HEAVENLY HEAT DBA P. SHAMBERG PHONE #: 503 -676 -3069 Inspection Request Scheduled For: Date: 11/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 039812 -03 503. 253-5547 N Corrections/Comments/Instructions: • I .. L_`►'i I V 4 W .. Iv ''T / PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL Fgcl INSPECTION ❑ ADDITI NAL , ES ASSESSED Inspector: � ,�� Date: I ` R 8 Phone #: (503) 718 - ?A-72j 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2006 -00553 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006 Phone: (503) 639 -4171 AditPw0110 Inspection Requests (24 Hrs.): (503) 639 -4175 & '' INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7 :01AM PAGE: 80 SITE ADDRESS: 09300 SW RIVERWOOD LW CLASS OF WORK: SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE: PROJECT NAME: CHURCH DESCRIPTION: tzar: line - fireplace insert. OWNER: CHURCH, LARRY PHONE #: 503 --M2 -6 CONTRACTOR: HEAVENLY HEAT DBA P. SHAMBERG PHONE #: 503.61B -3088 Inspection Request Scheduled For: Date: 11/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechariical rough -in 039812 -02 503.253.5547 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL A C L FOR I SPECTION ❑ ADDITI NAL ES ASSESSED Inspector: AL Date: (( L 4 1� Phone #: (503) 718 - \ �� CITY OF TIGARD V BUILDING` DIVISION PERMIT #: MEC2006-00553 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006 Phone: (503) 639 -4171 ��, Inspection Requests (24 Hrs.): (503) 639 -4175 .�' F' __.. INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7 :01AM PAGE: 81 SITE ADDRESS: 09800 SW RIVERWOOD LN CLASS OF WORK: SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE: PROJECT NAME: CHURCH DESCRIPTION: Gas line - fireplace insert. OWNER: CHURCH, LARRY PHONE #: 503-352-5547 CONTRACTOR: HEAVENLY HEAT DBA P. SHAMBERG PHONE #: 503- 679 -3089 Inspection Request Scheduled For: Date: 11/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 039812 -01 503-253-5547 N Corrections /Comments /Instructions: ____ r - _ L i- - . r� ` f Fir We • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL I CALL FOR INSPECTION ❑ ADDITI NAL F ES ASSESSED Inspector: \ Date: C Cl Phone #: (503) 718-