Permit .7 CITY OF TIGARD MECHANICAL PERMIT
4 COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00126
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/28/2007
PARCEL: 25111 AC -00500
SITE ADDRESS: 14570 SW 91ST AVE ZONING: R -4.5
SUBDIVISION: PINEBROOK TERRACE LOT: 046 JURISDICTION: TIG
PROJECT: SILCOX
Project Description: Replace furnace.
CLASS OF WORK: OTR 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 0
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
STEVE SILCOX Description Date Amount
14570 SW 91ST AVE
TIGARD, OR 97224 [MECH] Permit Fee 2/28/200 $72.50
[TAX] 8% State Surcha 2/28/2007 $5.80
Total $78.30
Phone: 503 -639 -2251
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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: �- Permittee Signature: C
Call 503.639.4175 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.
• 4echlanical Permit Applic - s . � -�
`Jr g FOROFFIC ;USEQNLI
"1 \11:
City o Ti an M u -s 1 Received .
}� Permit No. G
Date/B � _ d � 7 -- Pt r e-- ��Rr�U / * , h
q 13125 SW Hall Blvd., Tigard, OR 97223r t? ') 00 DIVISION Plan Review
® ' Phone: 503.639.4171 Fax: 503.598.11960 t: L Date/By Other Permit:
T I G A R D Inspection Line: 503.639
7 :;
OAH Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY � ' '
gar g ov Notified/Method: Supplemental Information
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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT/ SYSTEMS FEES*
In, 1- and 2- family dwelling ❑ CommerciaVindustrial ❑ 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
sr Air conditioning or heat pump
Job site address: 1
y c� Q , a INIJ ir, (requires site plan showing placement) 14.00
City /State /ZIP: -' ��� o \1 �� y Furnace 100,000 BTU (ducts/vents) i 14.00
Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
p /� Hydronic hot water system 14.00
1A A l O N P a h e 109 I J et t '� Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK - Water heater 10.00
Gas fireplace 10.00
T. S TID" L t� f € , t4.2 Ft-t,4 ,V■ INcZ {s Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY' OWNER .0 TENANT
Chimney/liner/flue/vent 10.00
• iiii�k Other: 10.00
Name: 5 --r---e. v E 5 t Lc t9 < Environmental exhaust and ventilation
- r n Range hood/other kitchen
Address:
S "? t.t9 Q 1 PA U equipment 10.00
City /State /ZIP: ti- A Z _ 10 t Z , ?., L ys Clothes dryer exhaust 10.00
'1 Single -duct exhaust (bathrooms,
Phone: (4r41) ( 0). et , 2, Is- ( Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR . Barbecue
Clothes dryer (gas)
Business name: 0 ‘,9 R_cZ Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP:
Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
has days after it has been accepted as complete.
Print name: , T (✓ .$,) L C • ate Date: 'L t p * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 04 /06/06 440-4617T (I I /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 12/30/05 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEG2007 0012E,
lo 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7128{2007
Phone: (503) 639 -4171 3011
Inspection Requests (24 Hrs.): (503) 639 -4175 - ��
INSPECTION WORKSHEET FOR DATE: 3/5/2007 TIME: 7 :00A1 PAGE: 30
SITE ADDRESS: 14570 SW 91ST AVE CLASS OF WORK:
SUBDIVISION: PINEBROOK TERRACE LOT #: 046 TYPE OF USE:
PROJECT NAME: SILCOX
DESCRIPTION: Replace furnace.
•
OWNER: SILCOX, STEVE PHONE #: 503-639-.2261
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 3/8/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mes_ --
6135 Misc. inspection 044325 -01 503- 639 -2251
Corrections /Comments/ Instructions:
_RA/14e-
•
F PASS P "TIAL APPROVAL n CANCEL Li NO ACCESS
❑ FAIL t FOR INSPECTION LJ ADDITIONAL FEES ASSESSED
Inspector: Date: cTS # Phone #: (503) 718 -