Permit CI TY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00549
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/9/03
PARCEL: 2S103DC -00813
SITE ADDRESS: 11205 SW GAARDE ST
SUBDIVISION: ZONING: R -3.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of vent fan for bathroom addition to garage.
Owner: FEES
ANDERSON, BRUCE KENNETH Description Date Amount
HELEN ANN CATHERINE
11205 SW GAARDE ST [MECH] Permit Fee 9/9/03 • $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 9/9/03 $5.80
Phone: Total $78.30
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone: Mechanical Insp
Final Inspection
Reg #:
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set fort '• OAR 952 - 001 -00
Issued B j , , Permittee Si •�, ,. `,,��� _ ` , , . `
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mecihanical Permit Application •
FoRofficy, vsE oNLy
Received a , Mechanical I A
Date/By: ( F/o3 Permit No.: Prge,a9.5 --co _53/y
( of Tid Planning Approval
Date/By: Building
ity gar
Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Ayr* .10 ..x Post-Review Land Use
Internet: www.ci.tigard.or.us c jiirillif Date/By: Case No.:
Contact Juris.: E See Page 2 for
24-hour Inspection Request: 503-639-4175 "--"" : Name/Method: - TO Supplemental Information.
kit:WAAAMSV:7 'i. ,: ate.tirn WAVOISM X:e'f.'Ihrtat$,OAE'ffgti
El New construction El Demolition Mechanical permit fees* are based on the total value of the work
0 Addition/alteration/replacement R Other: performed. Indicate the value (rounded to the nearest dollar) of all
MSE+V,WaOrargW:ikr0S-jFArM..kSg::M:.:T:VM mechanical materials, equipment, labor, overhead and profit.
RI 1 & 2-Family dwelling El Commercial/Industrial Value: $ See Page 2 for Fee Schedule
EI Accessory Building 0 Multi-Family M":::RtVillkiWtSatftaDl:sTT::;ISM,TWgiaMMDWRa
Description I Qty Fee(ea.) Total
0 Master Builder Li Other: i*"1:'-'W-MECKSTIFEMOUTIITaaaillelMICTIII50,=:::;4.,'i,ri'l
CSAIMX( Furnace - add air conditioning** 14.00
Job site address: 'I Ii 26,..5: S4.0 4; g4. A.,rel e_ S+ . Gas heat pump 14.00
Suite #: Bldg./Apt.#: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in-duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12.15
ilAIghWIMIWAttOaWU
Tax map/parcel #: Water heater 10.00
raraeSafaM Gas fireplace 10.00
/4 et. •hena 1r Flue vent (water heater/gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
. •
Chimney/liner/flue/vent 10.00
t4 li Oft.00.40rAWSWIFZ E :07STIW.'iillAttaktalli Other: 10.00
„ atiriqfig,0001501444tihiOTONOWN*40451Maanal
IN arne:B us r
Range hood/other kitchen equipment 10.00
Address: i 4 2.0c .W. 6 A 0, v 4 tp, 5"1 •
Clothes dryer exhaust 10.00
City/State/Zip: --- Pc , , po. d. de)v• ql Z241
Single duct exhaust •
Phone: 57e7S 631 Fax: (bathrooms, toilet compartments,
1
g Ei eartiMnatrisia iti;tb.NV741O0.07 -.:Ain: utility rooms) 6.80
Name: Attic/crawl space fans 10.00
Other: 10.00
Address:
0470201TMAILIVII,
City/State/Zip: **($5.40 for first 4, $1.00 each additional)
Phone: Fax: Furnace, etc. **
Gas heat pump **
E-mail: Wall/suspended/unit heater **
kaigiVatAVN.:.l7707:::Mer0RiP:tng*ti*#40<';:4 Water heater ** .
Business Name: -____A )L Fireplace **
Address: Range . **
City/State/Zi BBQ **
p: - Clothes dryer (gas)
**
Phone: : Other: **
CCB Lic. #: '
\ f- Authorize. ir r ./.1/4_,...1,_.a Date: 7 MTO:P4Wakil Total:
ia
Subtotal: $
.t.- -- ... -9,9.--
sign
Minimum Pennit Fee $72.50 $ 9 . ,3'
ivy r e A )clAis-5ex..) Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ 3. VC
TOTAL PERMIT FEE $ 7s- , A
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service Board.
180 days after it has been accepted as complete. **Site plan required for exterior A/C units.
i: \Dsts \Permit Forms \MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
As`s zned 4 a ons er rigl ae l :- ° r , '
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler . 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust • 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656 •
inserts, etc.
Gas piping 1 -4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL - . ' ° `` $
VALUATION:
`• "' 't'
is \Dsts\Permit Forms\MecPermitAppPg2.doc 01/03
CITY OF TIGARD `.
BUILDING DIVISION PERMIT #: MEC2003-00549
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/9/2003 /
Phone: (503) 639 -4171 � �u�. A li, qu
In Requests (24 Hrs.): (503) 639 -4175 1J. fl..... .
INSPECTION WORKSHEET FOR DATE: 4/5/2005 TIME: 7:09AM PAGE: 57
SITE ADDRESS: 11205 SW GAARDE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ANDERSON
DESCRIPTION: Installation of vent fan for bathroom addition to garage.
OWNER: ANDERSON, BRUCE KENNETH, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 003699 -01 603 - 639-0013 N
Corrections/Comments/Instructions:
,,
....,
P49 ,
/ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1/4., y / Date: y -3-- 6 Phone #: (503) 718 -