Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00085
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/20/2008
PARCEL: 2 S 103 D B -06 700
SITE ADDRESS: 11310 SW AMBIANCE PL ZONING: R -4.5
SUBDIVISION: GENESIS NO. 2 LOT: 019 JURISDICTION: TIG
PROJECT: CARR
Project Description: Furnace installation
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:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PAUL CARR Description Date Amount
11310 SW AMBIANCE CT
TIGARD, OR 97223 [MECH] Permit Fee 2/20/200E $72.50
[TAX] 12% State Surch 2/20/200E $8.70
Phone:
Total $81.20
Contractor:
MECHANICAL INC
PO BOX 19569
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 244 -1730
FAX 503- 245 -7613
Reg #: LIC 124283
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: � / i� 'ermittee Signature: /`- �ZC� /) C../i(/
Call 51 .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.
Feb. 19. 2008 3:17PM No. 8301 P. 2
1ec3I2anicai rerm A pplication l oR (4'11( p t <mi,v;
City of Tigard n r ,'> vas ��
c 13125 SW Hall Blvd,, Tigard, OR 97223 3 ` ° ° ' ' ' ' l9 ��[ p Al ,
• : Phone: 503.639.4171 Fax: 503,598.1960 Plan Review Phone: Permit:
Inspection Line: 503.639.4175 —� 1 9 2008 Date/B
I' l; A 1.4. [ l P Date Ready/By; 11. ® See Page 2 for
Internet: www.ttgerd- or.aov CITYUF fiGAB Not;fed/Method: Supplemental Information
ill i11 � '����� f111'I!1 11�{ i ill a ' �1l��{''J ° '1 1 ala 1 1 �p� � $ 1�p {j , tn�;�`� y r� p�u�
a a a a� 1.1 !ii i I { l i {31( t L.,',,,',."7::'. , ;i 4 h 1c, i : dli to u 11�� 9S,ii,f E w, ll 111,�#h���bnV 1 3 ," lalsn 7,M a, °
❑ 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 0 Other: °', 2 3: r mechanical materials, equipment, labor, overhead, and profit.
111111111111111 ¢ ai1.�Ei AN NE( ii u i ;' iii qq� IEI?fl ( � ii {i1#� 1 ,10s sic Value: S tttiauat ma 1,
® 1• and 2-fhmilydwelling [] Commercial/industrial building
indnstrial IN ET `i� ,a' iadl, ,1 4t;f, 'all t41 i .,`" � 11
❑ Multi- family ❑ Master builder I: Other:
For special information use checkltet.
111 tp► i�{��1 j# �{ y �" , ggl tl + �f I{ }} 4fI Description J Qty. Ea. 1 Total
[ i tf11���11 15111 111 11 e : ! 231 t i l d aafi>Rti iF �� '' `'+ , i ��'lY l% lt� {3:I Ii i �f Headnq/coolina
Job site address: 11310 SW Ambiance Place Air conditioning or heat pump
(requires site plea ahowina placement) 14,00
City/State/ZTP: Tigard,OR 97223
Furnace 100,000 BTU (ducts/vents) 1 14.00 14.00
Suite/bldg. /apt. no,; Predect name: C fl IQ.-R, Furnace 100,000+ BTU (ducts/vents) 17.90
Cross street/directions to job site: Gas heat pump 14.00
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: 1 Lot no,; Flue/vent for any of above 6.80
Tax map /parcel no.: Other: 10.00
I I11111 1 411 11 11 11111I ? _; E iV Sw i t.�a 111111 11 1 i. Oth er f l appliances 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10,00
Log lighter (gas) 10.00
} ii11 `� 11 ti {1 t�1{�!f1►! 14T y3 �tllili! tf! t��{t111 Wood/pellet stove 10.00
1 11111111atY1H t ek�u S u1a�UM1� Illti ;`,11It111 I1Illitt1;811i8} ,��,Ja,d,,, ,i1111f111i1lfi111 lll�ili himney 1iner/llue/vent 10.00
4 U � a: • „ �� '� ° At ' 1st r!<a� i
Name: Paid Carr Other: - 10.00
Environmental exhaust and ventlladon
Address: Range hood/other kitchen
City/State/ZIP: a uipmcnt 10.00
Clothes dryer exhaust 10.00
Phone: ( CiaMMINE111. Single -duct exhaust (bathrooms,
11 ' 3111111111010211 E 9 �1�`ssontime � manz r;4N� oo Att � W n tilityr°°n>8) .
mess name: Schnauzer Construction Other: 10.00
,Contact name: Mechanical Inc. - Randy Freeman Fuel piping
$5,40 for first four; $1.00 for each additional
Address: PO Box 19569 Pomace, etc.
City /State/ZIP: Fortland,OR. 97280 Gas heat pump
Wall/suspended/unit heater
Phone: (503 -) 244 -1730 Fax :: 4 3) 245 - 7613
Water heater
- mall: sharon {� ( fit{ yi t p��t�� `) �j Fireplace
r 1 hill _ _ __ 8 ItV1JE�� illflillil a� ' „��, 1 2 18 1[lllilkilllt fil r 1 } 11 Range
Btl8ine9s .... _ Barbecue
Clothes dryer (gas)
Address: , Other: cWp��tu
{ i 1 ll " yyi�n W�YalttatWnt Y�11� s 1 q
City/State/ZIP: 311f� 11 uw a "usulcaw,"'°iusleir al�wa'�Jrf fmral 1a d.,1'', ill i {.i
Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) 72,50
CCB lic.: 124283 el. -7(,)-14/or Plan review (25% of permit fee)
nn j Stare surcharge (12% of permit fee) 8,70
Authorized signature: (� ,r„r.,r TOTAL PERMIT FEE 81.20
This permit application expires If a permit is not obtained within 180
Print name: Randy Freeman Date: 249 -
dart after it has been accepted as Completer
r:V3uad ° Fee methodology set by Tn- County Building Industry Service Board
iea\Permita\AEc•Pt¢witapp.d 0ll19/07 4 40- 4417r(11/02/t:OW VSB)
� ` ► � �"/ 9g l d i
v, J
CITY OF TIGARD BUILDING PERMIT
F ' n
COMMUNITY DEVELOPMENT Permit #: MEC2008 -00085
Date Issued: 02/20/2008
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103DB06700
Jurisdiction: TIG
Site address: 11310 SW AMBIANCE PL
Subdivision: Lot:
Project: CARR
Project Description: Furnace installation. 5/18/11 reinstated for final inspection.
Owner: FEES
PAUL CARR Description Date Amount
11310 SW AMBIANCE CT IMECH] Permit Fee 02/20/2008 $72.50
TIGARD, OR 97223 [TAX] 12% State Surcharge 02/20/2008 $8.70
PHONE: Hourly Mechanical Rate 05/18/2010 $90.00
Hourly Mechanical 12% Surcharge 05/18/2010 $10.80
Contractor:
MECHANICAL INC
PO BOX 19569
PORTLAND, OR 97280
PHONE: 503 - 244 -1730
FAX: 503 - 245 -7613
Specifics:
Type of Use: SF
Class of Work: ALT
Dwelling Units:
Stories: Height: ft
Bedrooms: Bathrooms:
Value: $0
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $182.00
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 OA: •52- 001 -0100. Yo • • • • • •y of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
r
Issued By:, `nws.■— rmittee Signature:
ee
Call 51 A175 by 7:00 a.m. for an inspection that business y.
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.
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: • Permit.Fee:
Footing drain - 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54 7,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' 37.52
Valuation: Permit Fee:
Storm &Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other Ins ections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
p and including $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge- 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", Plan Review for Plumbing Installations
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
Fixture Type: Replace greater, except systems designed and stamped by licensed
Previous Capped Added Existing engineer.
Baptistry/Font
Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918- 780 -0040.
- Jacuzzi/Whirlpool
-Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Car Wash -
Each t o l ❑ Any multipurpose fire sprinkler system.
Cuspidor /Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash Isometric or Riser Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
-4"
Car Wash Drain
Garbage - Domestic
Disposal - Commercial
- Industrial Comments regarding fixture work:
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
- Service / increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor 8 plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
I:\ Building \Permits \PLMF - PermitApp.doc 2
Plumbing Permit Application
$. ,
u I OR l am` Ic i wU5H \i i t' �_ s ic
Building Fixtures p . . ° :: ` ° r ,-. � , },.,, �4 t.9 rr . ,r' O ,
City of Tigard R eceived Permit No.:
n 1 3125 SW Hall Blvd. Tigard, OR 97223
, , Date/B
74 y:
0 Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
Date/By: Other Permit No.:
' ' Inspection Line: 503.639.4175 Date Read /B lu ris: ® See Pa e 2 for
:li G i1 It.11, Ready /By: g
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
' TYPE OF WORK FEE* SCHEDULE , ;
•
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
❑ Accessory building Multi-family
SFR (3) bath 500.32
❑ Multi -famil
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE - INFORMATION AND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
City /State /ZIP: Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: 1 Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
' ,DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
® :PROPERTY OWNER I . ❑ . TENANT . Expansion tank /
Name:
Fixture /sewer cap (,J.C� I 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT _ ' 0 CONTACT PERSON .. Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory J 25.02
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
CONTRACTOR Water closet / �■-25.02
' Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 W. 50
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee) 8 , gQ
Authorized signature: TOTAL PERMIT FEE g j , 0
Print name: Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board.
I: \ Building \Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB)