Permit •
!�, n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00199
TIGARD DATE ISSUED: 5/2/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25111 CC - 09400
SITE ADDRESS: 15720 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.2 LOT: 121 JURISDICTION: TIG
PROJECT: BROWN
Project Description: Replace furnace and a /c.
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: 1 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
JEFFREY M. BROWN Description Date Amount
15720 SW GREENS WAY
TIGARD, OR 97224 [MECH] Permit Fee 5/2/2008 $72.50
[TAX] 12% State Surchai 5/2/2008 $8.70
Total $81.20
Phone: 503 -291 -9191
Contractor:
EAGLETON HEATING
2916 N MAIN ST
NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -710 -7803
FAX 503 -538 -0251
Reg #: LIC 160737
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued = y: � ' ! � L Permittee Sign •_� , �I� ,,
Call 503. 639.4175 by 7:00 a.m. for inspections that- I usiness say.
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.
(Me anic 1 Permit Application • FOR O FFICE USE ONLY •
V City of Tigard Receivyd / / ®��� /�
- Da _/ Permit No.: l a 07'9 a.
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review `
Phone: 503.639.4171 Fax: 503.598. 6 � Date/By: Other Permit:
TI GARD Inspection Line: 503.639.4175 Date Ready/By runs. 63 See Page 2 for
Internet: www.tigard- or.gov ���%%%��� 1, 7_0\ Notified/Method. c, Supplemental Information
TYPE OF yitt R � t;,,: 1 , ..ir COMME FEE* SCHEDULE — USE CHECKLIST
❑ New construction DS Addition/al o . feel Cement 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 CONSTRUCT ION Value: $
'E] 1- and 2- family dwelling ❑ Commerciallindustrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Multi- family 0 Master builder For special information use checklist.
❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/ 7 Air conditioning or heat pump
Job site address: 0 n
K �J1.f 1.-.) 4 fr (requires site plan showing placement) I 14.00
City/State /ZIP: t ` 7,z 0 , Q 9 72 Z / Furnace 100,000 BTU (ducts /vents) 1 14.00
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 + 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
Q t Gas fireplace 10.00
n-t Tf (.!J 66e...< 66e...< C�,
•; ' Flue vent for water heater or gas
1( 4- l c_ fireplace 10.00
"Let - Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
PROPERTY OWNER ❑ TENANT Other: 10.00
Name: C T F i(, y, , Environmental exhaust and ventilation
Address: /5 7 Z D 5-c_._) Range hood/other kitchen
equipment 10.00
City/State /ZIP: 4__ - U2 {� . 9 7 2 Z 7 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
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for -`i. 1 additional
Address: Furnace, etc. �'I
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: 1 /� Clothes dryer (gas)
�� /P d� n ` K2� 7
Other
Address: 02 °I ( ✓ A) //A /h ../* - / MECHANICAL PERMIT FEES*
City/State /ZIP: Ne J f ate c - Q � 9 7 / 3 y Subtotal ..,/, 50
Minimum permit fee ($72.50)
Phone: (0) ) O ��7 ? ax: p3 ) S 7,57_ 02 f / Plan review (25% of permit fee) -e
CCB lie.: , C 0 7 7 7 �(� I • State su (12% of permit fee) g. 70
/� TOTAL PERMIT FEE /. AO
Authorized signature: , a /∎ i ► This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: e, Cp � y-. Date: 1I_ Z / — 0 X * Fee methodology set by Tri- County Building Industry Service Board
\ \Ivl
1.\ Bui ldingPermitsEC- PermitApp. doe 0 440 -4617T (11 /02 /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
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 $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I: \Building\Permits\MEC- PermitApp.doc 01/19/07 2
RECEIVE*
071' OF T,"GARD
BUILDING CIVeSICN
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•
•
7' x.. a CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00199
Tl ^ki?' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/2/2008
PARCEL: 25111 CC - 09400
SITE ADDRESS: 15720 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.2 LOT: 121 JURISDICTION: TIG
PROJECT: BROWN
Project Description: Replace furnace and a /c. •
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: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:.
FURN < 100K BTU: 1 AIR HANDLING UNIT S CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
JEFFREY M. BROWN Description Date Amount
15720 SW GREENS WAY
TIGARD, OR 97224 [MECH] Permit Fee 5/2/2008 $72.50
[TAX] 12% State Surchai 5/2/2008 $8.70
Phone: 503- 291 -9191
Total $81.20
Contractor:
EAGLETON HEATING 0 •
2916NMAINST
NEVVBERG, OR 97132 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 710 -7803 •
FAX 503 -538 -0251
Reg #: LIC 160737 •
•
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued y: ! � ,/ L A _I . ' Permittee Sign - ' ,f/
Call 503.639.4175 by 7:00 a.m. for inspections that- • usiness .ay.
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: N4, $ -619/9 REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description I PASS Date I By • ✓ Code I Inspection Description I PASS Date I By
BUP - Building Permit _ ELC - EIectrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab • 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240. Exterior sheathing •
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage .
260 Tilt -up panel 195 Misc. inspection:
265 Masonry - 199 EIectrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical -
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
_ 299 Final inspection _ 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
•
_ 699 Mechanical final .
BUP - Fire Protection System Permit •
•
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain •
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer •
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection: •
205 • Footing 399 Plumbing final
•
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
•
I:\ Building \Forms \InspCard- AOP- Blank.doc 02/02/07