Permit CITY OF TIGARD
MECHANICAL PERMIT
° COMMUNITY DEVE LOPMENT PERMIT #: MEC2008 - 00451
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/4/2008
PARCEL: 1 S133DA -03200
SITE ADDRESS: 12665 SW GLACIER LILY CIR ZONING: R -
SUBDIVISION: , AMART SUMMERLAKE LOT: 054 JURISDICTION: TIG
•
. PROJECT: SVICAROVICH
Project Description: Installing gas furnace.
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:
NAT 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
GARY & SUSAN SVICAROVICH . Description Date Amount
12665 SW GLACIER LILY CR
TIGARD, OR 97223 [MECH] Permit Fee 9/4/2008 $72.50
[TAX] 12% State Surch 9/4/2008 $8.70
Total $81.20
Phone: 971 - 409 -8560
Contractor:
THE HEATING SPECIALIST INC
9300 NE HALSEY
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS •
Contact #: PRI 503 -257 -7000
FAX 503- 257 -7702
Reg #: LIC 56628
•
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: C 7 __ c __ P _- Permittee Signature: r AO i
f 503.639.4175 by 7:00 a.m. for inspections that business d4.
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: 7F -� REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description PASS Date By j ✓ Code I Inspection Description PASS Date I By
BUP - Building Permit ELC - Electrical 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 Electrical 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:
X 699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab • PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
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
From:The Heating Specialist 503 257 7702 09/04/2008 10:48 11833 P.001/002
�A I
Mechanical Permit Applica EIVE 1 FOR OFFICE 1ISE': ()N1.1
City of Tigard eived Aril = a 13125 SW Hall Blvd., Tigard,OR 97223 c r�
Date/BY:
ew a -'
Phone; 503.639,4171 Fax: 503.598.1960 5 F P— 4 2 C G Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
• Internet: www,tigard- or.gov CITY OF TIGARD Notified/Method: IriM Supplemental Information
9IJILDING DIVISION
TYPE OF WORK: - COMMERCIAL _ FEE *•SCHEDULE := USE CHECKLIST
❑ 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
.. Value: S
CATEGORYOF CONSTRUCTION., ;
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
® 1 - and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑Master builder
❑ Other: Description Qty. Ea. 1 Total
JOB SITE' INFORMATION`AND>LOCATION Heating/cooling
Job site address 12665 SW Glacier Lilly Circle Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: Tigard, 011 97223 Furnace 100,000 BTU (ducts /vents) x 14.00 14.00
Suite/bldg. /apt. no.: Project name: Svicarovich Furnace 100,000+ BTU (ducts vents) 17.90
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
Flue /vent for any of above 6.80
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
;DESCRIPTION- OF WORK- .
Water heater 10.00
Install gas furnace Flue vent 10.00
e nforr water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
. . . , y iner /flue /vent
Chimne /1" 10.00
® PROPERTY- OWNER ill TENANT ,
Other: 10.00
Name: Gary Svicarovich Environmental exhaust and ventilation
Address: 12665 SW Glacier Lilly Circle Range hood /other kitchen
_ equipment 10.00
City /State /ZIP: Tigard, OR 97223 Clothes dryer ethaust 1 0.00
Single -duct exhaust (bathrooms,
Phone: (971) 409 -8560 Fax: ( ) toilet compartments, utility rooms) 6.80
rM APPLICANT. ❑ CONTACT PERSON:: , . Attic/crawlspace fans 10.00
Business name: The Heating Specialist, Inc Other: 10.00
Fuel piping
Contact name: Mary S5.40 for first four; S1.00 for each additional
Address: 9300 NE Halsey Furnace, eta
Gas heat pump
City /State /ZIP: Portland, OR 97220 Wall /suspended/unit heater
Phone: (503) 257 -7000 Fax: : (503) 257 -7702 Water heater
Fireplace
E -mail: mary@theheatingspeciaiist.com Range
CONTRACTOR - Barbecue
Business name: The Heating Specialist, Inc Clothes dryer (gas)
Other:
Address:.NECHANICAL PERMIT FEES *. - , -
City /State/ZIP: Subtotal
Minimum permit fee (872.50) 72.50
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB Iic.: 56628 State surcharge (12% of permit fee) * 70
TOTAL PERMIT FEE �.Se - � I.
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Mary Brent Date: 9- 4-2008 • Fee methodology set by Tri -County Building Industry Service Board
1:\ Building \Permitst'EC- PermilApp.doc 01/19/07 440.4617T (11/02/COM/WEB)