Permit lir. "CI "TY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00167
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/2/2008
PARCEL: 2S110AB -00600
SITE ADDRESS: 14295 SW 112TH AVE ZONING: R -4.5
SUBDIVISION: COLE'S ACRES LOT: 007 JURISDICTION: TIG
PROJECT: MORRIS
Project Description: Relocate pellet stove to woodstove location and woodstove to pellet stove location.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
LELAND MORRIS Description Date Amount
14295 SW 112TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 4/2/2008 $72.50
[TAX] 12% State Surch 4/2/2008 $8.70
Total $81.20
Phone: 503- 639 -8089
Contractor:
MR CHIMNEY .
3051 N ADAIR CT
CORNELIUS, OR 97113 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 357 -9394
Reg #: LIC 171698
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 B • _ I �I // ' ,/ , P ermi tteeSignature: 4 / A � i.
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.
Mechanical Permit Application FOR OFFICE USE ONLY
s . C 1 ;tyt of Tigard R Da e/Bed ■ bib Permit No.: /1€,C M ". pb (p
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
111 .: ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T I G A RD Inspection Line: 503.639 Date Ready /By: ii 0 See Page 2 for
Internet: www.tigard - or.gov 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: $
1- and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ y g ❑ Commercial /industrial ❑ Accessory building
Master builder For special information use checklist.
Multi -family ❑ y ❑ 0 Description Qty. Ea. Total
. JOB SITE INFORMATION AND LOCATION , Heating/cooling
Job site address: _ Air conditioning or heat pump
! Z / , n iLA) ) /j- f (requires site plan showing placement) 14.00
City /State /ZIP: i ' ( 6t 9 7 2- 'F Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: (V) a 44 IS / G .n1 Gas heat pump 14.00
Cross street/directions to job site: J 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
//// Gas fireplace 10.00
G,,)Ds /..r 4, v'- . ,,Lz�c, e .,,,_ / ,, lv 11.4o_ Flue vent for water heater or gas
4 h c�Os' fireplace 10.00
f�
Log lighter (gas) 10.00
Wood /pellet stove pV 10.00
Wood fireplace /insert • 10.00
. ❑ PROPER TY OWNER. ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: ( ‘r , jC=jj' Environmental exhaust and ventilation
Address: Range hood/other kitchen
l v L4c J- W l /Z� equipment 10.00
City /State /ZIP: / L 5 , , C d 77 2 2 4e Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( c.3) 6, 3 y , ex's' Fax: ( ) toilet compartments, utility rooms) 6.80
. 0 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
CONTRA C TOR . Barbecue
Business name: I ,,, Os Clothes dryer (gas)
Y" r- r 2 rmyfi1 Other:
Address: 3 6<7 Al aU i - MECHANICAL PERMIT FEES* .
City /State /ZIP: C--- c.,ZAT f OZ q1 7/ Subtotal
Phone: (g ) 7_4 3�8!�% Fax: ( ) Minimum permit fee ($72.50) la. 5
Plan review (25% of permit fee) -&—'
CCB lic.: i -, 731 State surcharge (12% of permit fee) g. 70
TOTAL PERMIT FEE j , a0
Authorized signatur/ This permit application expires if a permit is not obtained within 180
! days after it has been accepted as complete.
Print name: / a! ✓. Dat; . ` / 2 . 0 47 . Fee methodology set by Tri- County Building Industry Service Board
1 \Building\Permits\MEC- PermitApp doc 01/19/07 440 -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.
C\ Building \Permits\MEC- PermitApp.doc 01/19/07 2
CITY OF TIGARD
BUILDENG'DIVISION PERMIT #: MEC200B- 00167
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 41212008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 i __..
INSPECTION WORKSHEET FOR DATE: 6/18/2008 TIME: 7 :02AM PAGE: 52
SITE ADDRESS: 14295 SW 112TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 007 TYPE OF USE:
PROJECT NAME: MORRIS
DESCRIPTION: Remove pellet stove and replace with woodstove.
OWNER: MORRIS, LELAND PHONE #: 503-639-8089
CONTRACTOR: MR CHIMNEY PHONE #: 503 - 357 -9334
Inspection Request Scheduled For: Date: 611812008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6Th N3ec:hanical lough -in 071543-01 503639-8089 V
61 ct IM4cti,...o=c L F,....
Corrections /Comments /Instructions: / ��)
.0/ • _ . /G!/I.c.P4s t..4.11 eJ/� -K. - (`� ATTIC– 4- fi - �i .
-7z-- 4 pt,i / i AP-,c
1- PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: —49- - . Phone #: (503) 718-