Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2013-00055
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TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2013
Parcel: 2S 110AC01000
Jurisdiction: Tigard
Site address: 11545 SW BEEF BEND RD 34
Project: Wellington Estates Subdivision: 2003-083 PARTITION PLAT Lot: 2
Project Description: (1)gas furnace replacement
Contractor: ROBBEN&SONS HEATING INC Owner: FERN VALLEY PROPERTIES LLC
2214 SE 8TH AVE BY CAMBRIDGE REAL ESTATE SERVICES
PORTLAND,OR 97214 PO BOX 2968
PORTLAND,OR 97208
PHONE: 503-233-5841 PHONE:
FAX: 503-238-8849
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/24/2013 $115.11
Class of Work: ALT Type of Const: Plan Review 01/24/2013 $28.78
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/24/2013 $13.81
Stories:
Project Valuation: $2,000.00
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $157.70
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers':
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 0 Al 4.Pe 04-11 Q l�
•AAA/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
•
Jan. 24. 2013 10:58AM Robben & Sons Heating Inc. No. 2520 P. 1/2 firium Mechanical Permit A lice FoR 011-ICE list:ONLY
City of Tigard �� TT
Recee ive 3 Permit No.:' r -IO S
13125 SW Hall Blvd.,Tigard,OR 9 2 Plan Review Other Pe it:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
T 1 t,n ILLS Inspection Line: 503.639.4175 JAN 2 4 2013 Date ReadyBy: rurir ® See Page 7 tar
Internet: www.tigard•or.gov Notified/Method: ' supplemental Information
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CITY OF TIGARD
• EE•�SC
::: TX.P�'=:OF
• � "�[�'y, °,c. ;;;�.- ��,�: �'.COMMERGiAL.•E SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on thc value of the work
❑New construction (. f ddition/alteration/replacement performed.Indicate the value(rounded to thc nearest dollar)of all
mechanical materials,equipment,labor,overhead.and profit.
❑Demolition ❑Other: value:$ j.QQ•C a '.Y: a F::CONSTRUcTION... •
. ' 0 .. RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1 and 2-family d, lit : L* Commercial/industrial ccessory building For special injornunion use checklist. _ —
❑Multi-family 11 to . •• ❑Other: Description Qty. lia. Total
JOB SITE•:INFORMAT.ON'i. NtY:L OCATION::' ,':::::' .::.
hi eaten t00
Air conditioning %�
n.t tree site Ian showin; laeeme t �III-.-- /
Job silo address: . (� — 1._:)..� `t:
Furnace 100,000 BTU dtrets/vents) 1
City/State/ZIP: ILA', 4 of c\-12_2(k Furnace 100 000+BTU dun vents
Suite/bldg./apt.no.: Project name: Heat pump re uircs site•Ian showm_ •leccment
Cross su•eet/directions to job site: Duct work
Fl dronic hot waters stem
Residential boiler(radiator or
h dronic 23.32 _..
— — Unit heaters(filet-type,not electric),
in-wall in-duct sus.ended etc.
Flue/vent for an of above
Subdivision: Lot no.: -_
Other: 23.32 .
Tax map/parcel no.: an
32
. .. ..... ...... .... . Other fuel appliances:
.. ........:.:...... water heater 23.
. . .. •;.:,•.::AE5CRAF`f10N?:t]F;;1�'ORK'':;: ;' :'::' ;'��°:•''.,;:;:;•-:� :, ' .
♦7X� Gas fire�Iace/insert 33.39
le ' L°_r_;, `car Floc vent for water heater or gas
fire.lace 23.32.111 �`_ __ Log lighter(gas) 23,32
wood/pellet stove 33.39
Wood fireplace/insert 23.32 .-_
:1::':':::.:•:.;
,
vent
31 •ROPEKTWOWNER. •.:i:i:_•':..: :. .,.,:'p:7NA PtT .•.. • .. y mltc /liner flue 23.32
Other: 23.32 _
�� Environmental exhaust and ventilation:
Range hood/other kitchen
Address: \\ .rte ���- �f��� r� equipment • 33.39
City/State/ZI'. & Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:(C501) , •• di + Fax:( ) toilet compartments,utility rooms) 23.32
d:AJPpL1CAlvT:.: ;D: ::t;ONTAGT:-RF,IRSON..':: ..'•
Attic/crawlspace fans 23.32
Other: 23.32 —
Business name'' -ili1.a,kr11. .......+r kkv. Fuel •i in;:
Contact name: ` , $14.15 for first four;$4.03 for each additional
' _ II -1.111111111111=1111111
Address: Furnace,,etc,
1 .1 Gas heatpump
Wall/suspended/unit heater
Phone:( V i 4-� Fax::( Z ,1 tolori I, Water heater -_
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Fireplace
• E-mail: V'► ►∎V N . )P n sQ ange
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• .. i. :C ON TRACT Barbecue
Business name: Clothes dryer(:as
Other:
Address: �� MECHANICAL PERMIT 1rEE5"
City/State/ZIP: Subtotal \‘C-- ,\\
Minimum permit fcc($90.00)
Phone.( ) Fax.( ) Plan review(25%of permit fee). 0.71"-
CCB lie.: \ iy t'z4 \t4- State surcharge(12%of permit feel „`6C_
TOTAL PERMIT 1 f I _ -
This permit application expires if a permit is m l.doinedialfn lair
Authorized signature: days after it has beau accepted ns cowplete.
Fee methodology set by Tri-County Building Industf sm,t1,o,,e)
Print name: ,.,•40.—We IPSO, Date; — 5 �I .
.._ .... ,•••••..... •.•.....n....nn 0 .7TillmlPr)MIWcni C„°