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Permit CITY OF TIGARD MECHANICAL PERMIT 11 11 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00057 TIGAft D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2011 Parcel: 2S103BA00140 Jurisdiction: Tigard Site address: 12035 SW LYNN ST Project: METZLER Subdivision: LERON HEIGHTS NO. 2 Lot: 30 Project Description: Replacing furnace and installing gas line to furnace and water heater. Contractor: MPS HEATING & COOLING LLC Owner: METZLER, ERIC G PO BOX 5597 12035 SW LYNN ST BEAVERTON, OR 97006 TIGARD, OR 97223 PHONE: 503 - 319 -7798 PHONE: FAX: 503 - 746 -6117 FEES Specifics: Description Date Amount Furnaces < 100K BTU 02/08/2011 $46.75 Type of Use: SF Fuel Piping 02/08/2011 $14.15 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/08/2011 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 02/08/2011 $29.10 Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports (Conditions) 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.;1 r � Issued By: ittee Signature: f a -ukt) AZ—) Call 503.6 "" ".y 7:00 a.m. for the next available inspe tion 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. Mechanical Permit Application FOR OFFICE USE ONLI City of Tigard V�� Received `J gC� Date/By: //) %_ Perm No. 4 13125 SW Hall Blvd., Tigard, OR 97i �•/ �` '� • Phone: 503.639.4171 Fax: 503.598. 60 Plan Review `1 \` Date/By: Other Permit: / /1 �, — 0 • Inspection 503.639.4175 �8 y e FIG A R [) p Date Ready/By: la See Page 2 for Internet: www.tigard- or.gov 't1Gp Notified/Method: r „ Supplemental Information TYPE OF W O iii. W4N-, COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction Zi Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ and 2-family dwelling C RESIDENTIAL EQUIPMENT / SYSTEMS FEES* .L-1- y g ❑ ❑ 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 \ Air conditioning Job site address: 9,O 3 5 5 W � Y , r (requires site plan showing placement) 46.75 City /State /ZIP: 1 C60, v tP © C'x ` j) 3 Furnace 100,000 BTU (ducts/vents) i✓ 46.75 /1 75 _ Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: I Project name: Heat pump 61.06 Cross street/directions to job site: ( l S\ - Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: _ 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 ` Gas fireplace 33.39 . C �kCS! C e �c 1 ry a C e, 0„.,,, I.. C Q S Flue vent for water heater or gas fireplace 23.32 L\v" \\I. Fv vvl.q(e , QM Wc. r / - r h7' Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER l ❑ TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen equipment 33.39 City /State /ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 _ Business name: ''€5 - t \. \ c C 4 cy QC C\' - J Lj a Fuel piping l P.Pn . 1; Contact name: tn sw vQ 0-C l 0 $14.15 for first four; $4.03 for each additional Address: Po BC�X 6 5 ok� Gas h ea t etc. u ✓ %H r � - C 1 (' Gas heat pump - City /State /ZIP: 15CONe Y��/ � 97 ©©1C Wall/suspended/unit heater / Phone: z-.)`3) 3 \ \ - TA_ C t S Fax :: 3) W: -- 6 (( 7 Water heater 1/ r Fireplace E -mail: VY es\ e Gl VAC} G jWVlC(t k c O vv.\ Range JJ CO OR Barbecue r Business name: Clothes dryer (gas) Other: Address: SCOAtk MECHANICAL PERMIT FEES* City/State /ZIP: Subtotal C • f 0 Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) elf), Uv Plan review (25% of permit fee) CCB lic.: ! q 17 .f. q State surcharge (12% of permit fee) 0 6- `' ,_ TOTAL PERMIT FEE /0r1 D C Authorized signature: �,�t � / //� - This permit application expires if a permit is not obtained within 180 [ Print name: jyl Y ii��WW days after it has been accepted as complete. \ \ * Fee methodology set by Tri- County Building Industry Service Board � t f) I:\BuildingPermitsM C-- P Y-� ,f � � � Date: z ermitApp.doc 10/01/09 l 440- 4617T(1 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building \Permits \MEC- PermitApp.doc 10/01/09 2