Permit / I
4 CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00471
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/19/2008
PARCEL: 1 S135CB -00600
SITE ADDRESS: 11530 SW TIEDEMAN AVE ZONING: I -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: LEAFGUARD
Project Description: Extending ducts and grilles for TI. NO PLAN REVIEW REQUIRED.
Project Value: $1000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
MCCALL PROPERTIES, INC Description Date Amount
808 SW 15TH AVE
PORTLAND, OR 97205 [TAX] 12% State Surch 9/19/200E $8.70
[MECH] Permit Fee 9/19/200E $72.50
Phone:
Total $81.20
Contractor:
WILLAMETTE HVAC SERVICE
3075 SW 234TH AVE. #206
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 628 -6841
FAX 503- 848 -2597
Reg #: LIC 56951
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.
Issue By: • � Permiftee Signature: M
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.
E \JED
PP LlK1St Meci anical Permit A li t ; 1 . FOR OFFICE USE ONLY
City of Tigard P 1 a 7
Date/By: / 9 a> Perm it No.: 1�ge, /r — et, 7
1312
Hall Blvd., Tigard, OR 97223S C��
Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 TIGARP Other Permit:
T I G ARD Inspection Line: 503.639.4175 CM v• I�+I ° Date/By: Date Ready/By: S See Page 2 for
Internet: www.tigard- or.gov V , D1v �7 Notified/Method: Supplemental Information
gI3IL
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction [Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
CATE RY OF CONSTRUCTION Value: $ /av O ( -0
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 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
Job site address: Air conditioning or hcat pump
r 1 .2 0 . r'� (requires site plan showing placement) 14.00
City /State /ZIP: l ?`", 7-47--di O eQ Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg./apt. no.: Project name: ,, Gy ' O d Gas heat pump 14.00 c x
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 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK • Water heater 10.00
�� ? / Gas fireplace 10.00
61��'�,k 3 nl. ., / ' �1� r c,, , J1'�(, Flue vent for water heater or gas
/Q fireplace • 10.00
` 4 its , Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /Flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ 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
CONTRACTOR Barbecue
Business name: `iJ / , ` . //� 4 ., / / / 0 H C Clothes dryer (gas)
— Other:
71
Address: 36 7 r 5 c 9 3 4 , 17 { r � (-) ( MECHANICAL PERMIT FEES*
' 1
City /State /ZIP: #j(6-0,--0 6 C71 C / Subtotal
, Minimum permit fee ($72.50) >'Q3'
Phone: (S6) 6 c q 4 7 C/ / � Fax: ( S-3 }I Z� 2 37 - Plan review (25% of permit fee) —
CCB lie.: s ( 9 S/ State surcharge (12% of permit fee) -?9
TOTAL PERMIT FEE �/ . av
Authorized si natur This permit application expires if a permit is not obtained within 180
g d ays a it has been accepted as complete.
-
' Print name: /(it r • C i1 R P 1 ( (['II-6"k I Date: /) / P * Fee methodology set by Tn-County Building Industry Service Board
I:\ Buildineermits \MEC- PermilApp.doc 01/19/07 • 4404617T ( I /02/COM/WEB)
CITY OF TIGARD ..1.
BUILDING DIVISION #: MEC2008-00471
13125 SW Hall Blvd., Tigard, OR 97223 V DATE ISSUED: 9f1812UUR
Phone: (503) 639 -4171 r: rf
Inspection Requests (24 Hrs.): (503) 639 -4175 r; 4 ,� :I
INSPECTION WORKSHEET FOR DATE: 9r 2008 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 11530 SW TIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LEAFGUARD
DESCRIPTION: Extending ducts and grilles for TI. NO PLAN REVIEW REQUIRED.
Project Value: $1000
OWNER: PHONE #: •
MCCALL PROPERTIES, INC,
CONTRACTOR: WILLAMETTE HVAC SERVICE PHONE #: 508-628 -6841
Inspection Request Scheduled For: Date 9/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
411 3g
Mechanical final 075935-01 971-998-2908
Corrections/Comments/Instructions:
•
• 0 l i Ilfffst ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL z ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /1! Date: (/Z3 Phone #: (503) 718 - 2-- (5=