Loading...
Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2012 -00090 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/16/2012 Parcel: 2S111AC04300 Jurisdiction: Tigard Site address: 14955 SW 92ND AVE Project: SCHIEBOLD Subdivision: LAUNALYNDA PARK Lot: 11 Project Description: Furnace replacement. Contractor: PILOT PLUMBING & HEATING LLC Owner: SCHIEBOLD, HANS & SHARON 6897 SW GREENWICH DR SCHIEBOLD, CELESTE PORTLAND, OR 97225 14955 SW 92ND AVE TIGARD, OR 97224 PHONE: 503 - 367 -9271 PHONE: FAX: FEES Specifics: Description Date Amount Furnaces < 100K BTU 02/16/2012 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 02/16/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/16/2012 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: 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 applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1\11\1 Issued By / - ittee Signature: _ AMP Call 503.639.4175 by 7:00 a.m. for the next available inspection d e. 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 r te,, , „ c ; @,� N Received City of Tigard "� B Permit No.: 1 - C..i dit 4 0 q 1111 13125 SW Hall Blvd., Tigard, • 3 '1 �� Date /By: Y MAMA, t'� Phone: 503.718.2439 Fax: 503.598V] • e. 6 � D Review Other Permit: ® IIIM T1 G A R D Inspection Line: 503.639 `a � . 1 ' d ti Date R eady /By: PI See Page 2 for Internet: www.ti ard -or. o v ( ( ` g g `( � � Notified/Method: Supplemental Information TYPE OF WORK .,,�,�� � ` ' COMMERCIAL FEE* SCHEDULE USE.CHECKLIST i) Mechanical permit fees* are based on the value of the work ❑ New construction - �,Addition/alteration/r placement 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* • M . I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: / Air conditioning Job site address: / 9.9 s5 3 _.) q z ,J <_ (requires site plan showing placement) 46.75 Fumace 100,000 BTU (ducts /vents) 4 46.75 City /State /ZIP: / I S- a —c/ ©f� _ � ZZ Fumace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: 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 6/r*, �� �/'^ r i""‹ J ° Z�� 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 k' e f r . ' , Gas fireplace 33.39 Flue vent for water heater or gas 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 —/� �[ ff Other: 23.32 Name: l / › /€ e, v C1 Q / COL Environmental exhaust and ventilation: Address: /4/ T ( 76,- .5" 2 ." Range hood/other kitchen J equipment 33.39 City /State /ZIPr 7 -. y f J 0 ' 1)7221/ Clothes dryer exhaust 33.39 V G F Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) 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 E -mail: Fireplace Range ,j CONTRACTOR Barbecue Business name: �j P �O / ® /. b/AI g< � t1 / /)� Clothes dryer (gas) Address: e9 7 ...5- ,`E ?',(..)4/ in MECHANICAL PERMIT FEES* City/State/ZIP: ,r 'f/ cj.€ ?-7Z 2. Subtotal Phone: ( 1 3 ?8� o CX) Fax: (c 3 ) 29? 47(;5-. Minimum permit fee ($90.00) Plan review (25 % of permit fee) CCB lie.: / '73 z C`(> id - S f l— State surcharge (12% of permit fee) C. /^ ` TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature. J J days after it has been accepted as complete. Print name: lyC /tp Date: �/ ��1 f * Fee methodology set by Tri- County Building Industry Service Board 0 1:\Building\ Permits \MEC- PermitApp 09 /09/10 _ , \ 440 -4617T (I l /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. I:\Building\Permits\MEC- PermitApp.doc 09/09/10 2