Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00471
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/3/2006
PARCEL: 2S109AD -02900
SITE ADDRESS: 14649 SW 130TH AVE ZONING: R -7
SUBDIVISION: WOODFORD ESTATES LOT: 021 JURISDICTION: TIG
Project Description: Wood burning fireplace insert.
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:
OTH 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
RANDY STEWART Description Date Amount
14649 SW 130TH PL
TIGARD, OR 97224 [TAX] 8% State Surcha 10/3/200€ $5.80
[MECH] Permit Fee 10/3/200€ $72.50
Total $78.30
Phone: 503- 620 -3242
Contractor:
A SOLID SOLUTION
101 ASH AVE.
REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 491 -1238
Reg #: LIC 170410
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: IPA i) Permittee Signature: I i der G •
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business da
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 outer USE 'ONLY '
Received
C of �L/ Tigard x _ . 11 % y li r Date/By. / D ') 06 g. i3 Permit No eCa„oO r/ / _,rf0�(
13125 SW HalljBlvd7, Tgard; QR 9L223
Plan Review
.' 0' Phone: 503.639.4171 Fax: 503.598 -1960 pme/gy. Other Permit:
T I C A Ii D Inspection Line: 5103'639.4un753 Dale Ready/By: 1uris: El See Page 2 for
• ov °�
Internet: www.ti andeor. 2006
g g Notified/Method: -1 ---- Supplemental Information
CITY OF TIGARD
i COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
El New construction ❑ 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: $
�
� ' RESIDENTIAL EQUIPMENT,/ SYSTEMS FEES*
ice' I and 2- family dwelling ❑ Commercial /industrial ❑ 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
Job site address: U ) 7 Air conditioning or heat pump
C 9 ( SWC/ O�C . (requires site plan showing placement) 14.00
City/State/ZIP: DYE Fumace 100,000 BTU ducts /vents 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
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. 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
(/,cone 6,Li" 1 t, ' Irk. y � (vt,_Co.�f� Flue vent for water heater or gas
fireplace 10.00
f � 5- y C Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert / 10.00
' ❑, PROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: ( -I Ci ' Jit) C3va— A Range hood/other kitchen
equipment 10.00
City/State /ZIP:` a 1'12`Z E Clothes dryer exhaust 10.00
r J — ` Single -duct exhaust (bathrooms,
Phone: (S ) 1p - 2,Z ) K 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 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
Business name: () sp oot Sbtt>'- Clothes dryer (gas)
Other:
Address: I O ( til //rr 5 4 64 t y MECHANICAL PERMIT FEES*
City /State /ZIP: l,(jeseg- Ur (-C-4 — Subtotal
Minimum permit fee ($72.50) . 57
Phone: ( 553) n "! I _ i. � 3 g F ax: ( ) S � —.
Plan review (25% of permit fee)
CCB lic.: 1) 0 � C 6 Gi -- 7 -- evi State surcharge (8% of permit fee) ��
TOTAL PERMIT FEE 7S .30
Authorized si . re: • This permit application expires if a permit is not obtained within 180
Tl'�! t - days after it has been accepted as complete.
. Print name: ,t /��4 , Date: * Fee methodology set by Tri- County Building Industry Service Board
or
I:\ Building /.Permits\MEC- PermitAppdoc 04 /06/06 440-4617T(II /02JCOM/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.
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• 1: \Building\Permits\MEC- PermitApp.doc 12/30/05 2
�. CITY OF TIG�cRD _ . _ .. �_. _.�._...� _ _� _._...._� ek
__ 1
---- BUILDING DIVISION PERMIT #: M 71 ""
EC2006.0047""
13125 SW Hall Blvd., T OR 97223 DATE ISSUED: 10/3/2006
Phone: (503) 639- 4171µ'� j � l �l 1,
Inspection Requests (24 Hrs.): (503) 639 -4175 ... W `:L.
INSPECTION WORKSHEET FOR DATE: 10/17/2006 TIME: 7 :04AM PAGE: 1
SITE ADDRESS: 14649 SW 130TH AVE CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 021 TYPE OF USE:
PROJECT NAME: STEWART
DESCRIPTION: Wood burning fireplace insert.
OWNER: STEWART, RANDY PHONE #: 503- 620 -3242
CONTRACTOR: A SOLID SOLUTION PHONE #: 503 - 491 -12343
Inspection Request Scheduled For: Date: 10/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final O313343 -01 503 -620 -3242 V
Corrections /Comments /Instructions: �� •
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1 I PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: J6 6746 Phone #: (503) 718 - 2=4'