Permit CITY TIGARD MECHANICAL PERMIT
: 4 641111 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00131
° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/25/2005
PARCEL: 25111 AC -04000
SITE ADDRESS: 14985 SW LESLIE CT ZONING: R -4.5
SUBDIVISION: LAUNALYNDA PARK LOT: 008 JURISDICTION: TIG
Project Description: Replace furnace & add A/C.
CLASS OF WORK: OTR 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: 1 DOMES. INCIN:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BRUCE, GEORGE W + VIRGINIA D Description Date Amount
14985 SW LESLIE CT
TIGARD, OR 97224 [MECH] Permit Fee 3/25/200E $72.50
[TAX] 8% State Surcha 3/25/200E $5.80
Total $78.30
Phone:
Contractor:
HAROLD HOAG HEATING & AC
19930 SW DELINE
ALOHA, OR 97007 REQUIRED ITEMS AND REPORTS
Phone: 503- 642 -5115
Reg #: LIC 13859
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: 1/T j , Permittee Signature: -
Call 503 - 639 -4175 by 7:00 a.m. for inspectio • s that business day.
This permit card shall be kept in a conspicuous place on th - job site until comple • • n of the project.
Approved plans are required on the job site at the time of each in . • ection.
Mechanical Permit Application FOR OFFICE USE ONLY
r — \ b _ _
City f Tigard Received
Date /By: , ) Q Permit No.�� L� { i�/y� )�/
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review JJ �
Phone: 503.639.417 I Fax: 503.598. . .. ,�, „ Date /By: Other Permit:
Inspection Line: 503.639.4175 T' 1 Date Ready /By: Juns ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 'i Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST.
❑ New construction Addition/alteration/replacement Mechanical permit tees* 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
yri I and 2 dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: q (/ S v L ,� S L C Air conditioning or heat pump f
jJ / (requires site plan showing placement) 14.00
City/State /ZIP: �,7,,,c, Furnace 100,000 BTU ( ducts/vents) 1 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 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
Flue vent for water heater or 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
❑ PROPERTY ❑ TENANT Other: 10.00
Name: /o( 4/'' G I B- u s-e— Environmental exhaust and ventilation
( . f -• Range hood/other kitchen
Address: / / q S / �� b j� C , / equipment 10.00
City/State /ZIP: ,L� Clothes dryer exhaust 10.00
� Single -duct exhaust (bathrooms,
Phone: (r a) f l f _ G . 3 Fax: ( ) toilet compartments, utility rooms) 6.80
0' APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
/ Other: 10.00
Business name: y� d `
.d 4i_
o �ee2icr e G - Fuel tin
P�P h
Contact name: , 4/ `, e... ,,Gd /1... $5.40 for first four; $1.00 for each additional
Address: / G,?7„,? // ,.2_ Furnace. etc.
C 1 �L .4e.. Gas heat pump
City /State /ZIP: G'L Le.."‘ 9�9 ' Wall /suspended/unit heater
Phone: (c ) 3. 5 - 7 _7 6 7 Fax: : ( ,) Water heater
Fireplace
E -mail: Range
CONTRACTOR . Barbecue _
Business name: /lc,/ ` G t- ,(< -� �� Fi ' 'Other: dryer (gas)
[. � r� 'Othe
Address: / C,. f l N Ce , 7 - / °n a MECHANICAL PERMIT FEES*
City/State /ZIP: ( e i G v , ...,,/ Subtotal
Minimum permit fee ($72.50)
Phone: (s ) 3 S 7 7697 Fax: ( ) Plan (25% of permit fee)
CCB tic.: / 3 t9 .5-_, Q >, i ( -�jp State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7D . 3 d
Print n m signature: This permit application expires if a permit is not obtained within ISO
_ days after it has been accepted as complete.
Print name. Date — Z6-- • Fee methodology set by Tri- County Building Industry Service Board
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.
is \Building \Permits \MEC - PermitApp.doc 12/03 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00131
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/25/2005
Phone: (503) 639 -4171 i��,� i il�i�
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 3/30/2005 IME• 7:11AM PAGE: 10
S'Av rc - ‹
SITE ADDRESS: 14985 SW LESLIE CT CLASS OF WORK:
SUBDIVISION: LAUNALYNDA PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: BRUCE
DESCRIPTION: Replace furnace & add NC.
OWNER: BRUCE, GEORGE W + VIRGINIA D, PHONE #:
CONTRACTOR: HAROLD HOAG HEATING & AC PHONE #: 503.642 -5115
Inspection Request Scheduled For: Date: 3/30/2006 Pour Time:
Code # Inspection Description Co irm # Contact # Message
699 Mechanical final 3232 -01 503 -351 -7677 Y
Corrections /Comments /Instru tions: /
A'o Z.os' /sseJ 6
c o ov► re rr�77
ASS _ ❑_PARTIALAP_P_ROVAL ❑_CANCEL ❑_NO_ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
3 - SO
Inspector: Date: Phone #: (503) 718 -