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Permit CITY OF TIGARD MECHANICAL PERMIT ' ` '� • COMMUNITY DEVELOPMENT 71 f; ". Permit #: MEC2011 00463 13125 SW Hall Blvd Tigard OR 9 7223 503,718.2439 . �� Date Issued: 10/20/2011 TIGARD , 9 Parcel: 1 S134CB03700 Jurisdiction: Tigard Site address: 12510 SW SUMMER CREST DR Project: Seaver Subdivision: SUMMER HILLS PARK Lot: 35 Project Description: Installation of gas for (4) appliances, 1 water heater, 2 fireplaces & 1 range. 1/17/12, adding duct work and (3) registers. Contractor: BUDGET HEATING Owner: SEAVER, DEBORA 13885 SE 177TH CT 12510 SW SUMMER CREST DR DAMASCUS, OR 97089 PORTLAND, OR 97223 PHONE: 503 - 233 -3133 PHONE: 951- 231 -3157 FAX: 503 - 558 -9050 FEES Specifics: Description Date Amount Minimum Fee Adjustment - Mechanical 10/20/2011 $27.58 Type of Use: SF Duct Work 10/20/2011 $23.32 Class of Work: ALT Type of Const: Fuel Piping 10/20/2011 $14.15 Occupancy Grp: 12% State Surcharge - Mechanical 10/20/2011 $10.80 Stories: (manual) Minimum Fee Adjustment - Mechanical 10/20/2011 $24.95 Fuel Fuel Types: Natural Gas 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 applic aw. All wor • I be done in accordance with approved plans. This permit will expire if work is not started within 180 days of iss nce, or if work is suspen.:. for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon tility Notification Center. Those rb es are s- forth in OAR 952- 001 -0010 through OAR 952- -0 0. You may obtain a copy of the rules or direct ques ions to OUNC by calling 511.232.• or ..11. 2.2344. 1 i ■ Issued By: - / J. �� / . Permittee 'i 'ji r � / ' V'-----' Call 503.639.4175 by 7:00 a.m. for the next available inspec '. n 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. CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00463 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Date Issued: 10/20/2011 Parcel: 1 S134CB03700 Jurisdiction: Tigard Site address: 12510 SW SUMMER CREST DR Project: Seaver Subdivision: SUMMER HILLS PARK Lot: 35 Project Description: Installation of gas for (4) appliances, 1 water heater, 2 fireplaces & 1 range. Contractor: BUDGET HEATING Owner: SEAVER, DEBORA 13885 SE 177TH CT 12510 SW SUMMER CREST DR DAMASCUS, OR 97089 PORTLAND, OR 97223 PHONE: 503 - 233 -3133 PHONE. 951- 231 -3157 FAX: 503- 558 -9050 FEES Specifics: Description Date Amount Fuel Piping 10/20/2011 $14 15 Type of Use: SF 12% State Surcharge - Mechanical 10/20/2011 $10 80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/20/2011 $75 85 Occupancy Grp: Stories: Fuel Fuel Types' Natural Gas 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 applicabl- e I work will be done in accordance with approved plans. This permit will expire if work is not started withi 180 days of iss - ce, or if work i uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules . opt:.. /1 the Oregon lity Notification Center. Thos les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You ray ob in a .,ry of the rules or direct questions to OUNC b •: ling 503 232 1987 or 1 800.332 2344 �-' // Issued By: /Pt 1/ L ?: Permittee Signature: • .. J� � , r Ji/ — Call 503.639.4175 by 7:00 a.m. for the next available inspection 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 ONLY City of Tigard d Received petu,itNo g Date By M EC2011 -00463 l ••. 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone. 503 -713.2 439 Fax: 303.598 1960 Date /By Other Permit T Inspection Line: 503.639.417- DateReady/By ?out, Et See Page 2for Internet: www.tigard or.gov Nobtied/Method" Supplemental Information TYPE OF, WORK COMMERCIAL FEE* SCHEDULE — .LiSE'CHEC1( IST <,:, Mechanical permit fees* are based on the value of the work ❑ 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. Value: $ CATEGORY OF.CONSTRUCTION RESIDENTIAL EQUIPMENT ,7Sa•STE113STEES *,: © I- and 2- family dwelling ❑ Conullercialindustlial ❑ Accessory building For special information rase dieeklise ❑ Multi- fartuly ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total 'JOB SITE INFORMATION. AND LOCATION : • Heathng/(ooling: Air conditioning Job site address: 12510 SW Summer Crest Drive ( requres site plan thawing placement) 46 -75 Furnace 100,000 BTU (ducts /vents) 46.75 City /State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg,. /apt. no. : Project name: SEAVER Heat pump (requires site plan showing plac ement) 61.06 Cross street /directions to job site: Scholls Ferry to 121 st R on Summer Crest Drive Ductwork 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' Summer Hills Park Lot no.: 35 Flue vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: 1 S134C803700 Other fuel appliances: . DESCRIFTION;OF'R'ORK: ;." Water heater 23.32 Gas fireplace 33.39 add heating / cooling duct and 3 registers to existing permit MEC2011 -00463 Flue vent for water heater or gas install in New Dining and lower studio space fireplace 23.32 Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 ©'PROPERTY:OWNER. TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: Debora Seaver (Reynolds) Environmental exhaust and ventilation: Range hood/other kitchen Address: 12510 SW Summer Crest Drive equipment 33.39 City /State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39 P Single -duct exhaust (bathrooms, Phone: ( 951) 231 - 3157 Fax: ( ) toilet compartments, utility rooms) 23.32 • APPLICANT 0 ''CONTACT PERSON Attir /crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended /unit heater Phone: ( ) Fax: • ( ) Water heater E Fireplace Range • CONTRACTOR Barbecue • Business name: Budget Heating Clothes dryer (gas) Other: Address: 13885 SE 177th CT NIECILINIC.aI: PERMITFEES "', ' City /State /ZIP: Damascus, OR 97089 Subtotal Minimum permit fee ($90.00) Phone: ( 503 ) 233 -3133 Fax: ( 503 ) 558 -9050 Plan rev (25% of permit fee) COB tic.: 147995 State surcharge (1_% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: John Seaver Date: 1 -17 -2012 Fee methodology set by Tit Building Industry Service Boat d I113toldtng\ Frrnn5ll/EC- PeemttApp doc 59 /52 /15 440g617T (11 /02 /Cn1.SwEE) Mechanical Permit Applic .;r'' to EIVED F O R OFFICE use ` :ONLY `J Tigard Date/By /Q i M .� Permit � fi/J / / �f� City of Ti !/ " 1 3125 SW Hall Blvd., Tigard, 92$( 2 2011 Plan Review Other Permit i 7 Phone. 503 718.2439 Fax. 503.598 1 6 - Date/By Inspection Line: 503 639.4175 TIGARD Date Ready/By: y: luris See Page 2 for Internet' www tigard -or goy CITY OF TIGARD Notified/Method Supplemental Information BUILDING DIVISION T3PE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction E Addition /alteration /replacement performed Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 1 and 2- family dwelling ❑C ommercial /industrial ❑ building For special information use checklist. ❑ Multi - family ❑ Master builder El Other: Description Qty. Ea Total Heating/cooling: JOB SITE INFORMATION AND LOCATION Air conditioning • Job site address: � 2. Gl 570 S ul of c, 37 d / (requires site plan showing placement) 46 75 � , �? / v (�M,� Furnace 100,000 BTU (ducts /vents) 46.75 City /State /ZIP: / / r � 7 72_2-3 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: ! Project nam C3 / t Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: 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 � � - / �/ ' Flue vent for water heater or gas S ' ° 6 f/A / d i& L,z;3 37 fireplace 23.32 Log lighter (gas) 23 32 /) f / ,t ef 11 C Wood /pellet stove 33.39 Wood fireplace /insert 23 32 PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23 32 Other. 23 32 Name ah /1 1. Environmental exhaust and ventilation: Address: 2 `Q c c Oi eC 0 dPIP1 e7 ('0 f di' Range hood/other kitchen , equipment 33.39 City /State /ZIP: v 0 d 4 y / 7 z z8 Clothes dryer exhaust 33 39 Single -duct exhaust (bathrooms, Phone) �-- 1577 ax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other 23 32 Fuel piping: Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace a" E -mail: Range CONTRA TOR _ Barbecue Business name: v �� /9 Clothes dryer (gas) � �/ Other Address: / �Y /1/ 7 MECHANICAL PERMIT FEES* City/State/ZIP: ti(j5,'( C9( y 76 fY Subtotal s Phone: v / Minimum permit fee ($90.00) f) �� j Fax: (, �Q Plan review (25% of permit fee) '`------'' CCB lic.: / V? ?,5 C /7 / State surcharge (12% of permit fee) /? .g d /A / 18 TOTAL PERMIT FEE /On . Q Authorized si n ature: This permit application expires if a permit is not obtained within 180 g days after it has been accepted as complete. Print name: CO hit e Data' ®rte * Fee methodology set by Tri- County Building Industry Service Board I \Bu tding\Permits\MEC- PermitApp doc 09/09/10 441 -4617T (11/02 /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. 1 \Building\Pennits\MEC- PenniApp doc 09/09/10 2