Permit 74 u CITY OF TIGARD MECHANICAL PERMIT
'. • COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00598
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/16/2007
PARCEL: 2S 110BA - 03900
SITE ADDRESS: 14400 SW MCFARLAND BLVD ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT: 026 JURISDICTION: TIG
• PROJECT: POLSON
Project Description: Vent neew hood, gas line to range and BBQ. •
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: .
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 2
> 10000 cfm:
Owner: FEES
POLSON, JAMES C AND ELIZABETH A Description Date Amount
14400 SW MCFARLAND BLVD
TIGARD, OR 97224 [MECH] Permit Fee 10/16/20C $72.50
•
[TAX] 8% State Surcha 10/16/20( $5.80
Phone: 503- 624 -9164
Total $78.30
Contractor:
PYRAMID HEATING
PO BOX 1502 •
SANDY, OR 97055 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 786 -9522
FAX 503- 786 -3432
Reg #: LIC 59382
I
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.
1
Issued B r /
Y _�, , ft -AR
I! Permittee Signature: �
Call 503.639.4175 by 7:00 a.m. for inspections that siness day.
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.
•
• Niechaaical Permit ApplicatioI ECEIVE ), . FOR OFFICE USE ONLY
City of Tigard OCT ,
c T 1 6 l UU / Received Date/By: ) / (0 Permit All _ oo•7 _ er 51v
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
11111
C : Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
CITY ®F f rGARD y.
Inspection Line: 503.639.4175 B urt nl��Dlur Date Ready/By: lugs ID See Pa e 2 for
- I I G A R D LU g
Internet: www.tigard or.gov sr Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction A Addition/alteration/replacement Mechanical permit fees* 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*
`dl- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
,AA C'� j Air conditioning or heat pump
Job site address:
/ 4/4 / Ua 6, L[J / Gr ( ia,fr A /L/d. (requires site plan showing placement) 14.00
City/State /ZIP: --r-, '1 �,q � e , 2/2 Furnace 100,000 BTU (ducts/vents) 14.00
/ /� / Furnace 100,000+ BTU (ducts/vents) 17.90
U S72a
Suite/bldg. /apt. no Project name: ld(Jt� A /cs Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
B ut m� fa w►, p d. # 0 ' #-.rr f ,6/uriJ. Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
// Lot no.: Flue /vent for any of above 6.80
Subdivision:
�h fir:!/ 7/s Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
U p, t , - di -< y � Flue vent for water heater or gas
fireplace 10.00
bey ll jj/ /7 .t€ p 4 hg,, (444 44 ,� � gib a Log lighter (gas) _ 10.00
1 Y J �J Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
Name: —{ 1 tz r J„ pl I Environmental exhaust and ventilation
Address: o f y r t,` Range hood/other kitchen
ddress:
�p IJ.S GLh/ equipment 1 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (Z3) 6 ,:1,14.,,,q1/0 e' Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT (ZI CONTACT PERSON Attic /crawlspace fans 10.00
) Other: 10.00
Business name:
i-I 2,01,1 Ahr- / Fuel piping
Contact name: p-eizii 6 [),4( $5.40 for first four; $1.00 for each additional
Address: (9a) J' �, , J C V Gas Furnace, heat etc.
_
r/ ' eat pump
•
City/State /ZIP: 7 " a ,OR / 11 2/23 U ' �f �� Gas h Wall /suspended/unit heater
Phone: (5 3 ) 3 � g 7 9 Fax:: ( . ( 3 ) 1 6 7 Lf6 / Fireplace
!J P l ce
E -mail: Range
CONTRACTOR Barbecue
i /� Clothes dryer (gas)
Business name:
�YQ2N I! 1 L'l� Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
7 At30
Authorized signet This p ermit application expires if a permit is not obtain within 180
days after it has been accepted as complete 144.. . Print name: Date: 0 - 1 6 -ci7 ' F ee methodology set by Tri- County Building Industry Service Board
J iP�
1:\Building\Pennits - PermitApp.doe 01 /1 i ymAt i f
4 404617T(11/02/COM/WEB)
C -
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 fust $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
I:\Building\Permits\MEC- PermitApp.doc 01/19/07 2
7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00599
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1612007
Phone: (503) 639 -4171°
Inspection Requests (24 Hrs.): (503) 639 -4175 G 'I I i ..
INSPECTION WORKSHEET FOR DATE: 11/8l2007 TIME: 7 :00AM PAGE: A2
SITE ADDRESS: 14400 SW MCFARLAND BLVD CLASS OF WORK:
SUBDIVISION: SHADOW BILLS LOT #: 026 TYPE OF USE:
PROJECT NAME: POLSON
DESCRIPTION: Vent new hood, gas line to range and 880. 11/2/07, ADDING GAS FURNACE AND NC.
OWNER: POLSON, JAMES C AND ELIZABETH A, PHONE #: 503 - 6249164
CONTRACTOR: PYRAMID HEATING PHONE #: 503 - 786.9522
Inspection Request Scheduled For: Date: 11/8 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 059261 -01 503-786-9522 N
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
nspector: Date: /1 8- ? Phone #: (503) 718- �-
CITY OF T.IGARD
•
BUILDING; DIVISION PERMIT #: Mf:C2007.00S98
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/1G12007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 `'ll�
INSPECTION WORKSHEET FOR DATE: 10/19/2007 TIME: 7:01AM PAGE: 38
SITE ADDRESS: 14400 SW MCFARLAND BLVD CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: Q26 TYPE OF USE:
PROJECT NAME: POLSON
DESCRIPTION: Vern neew hood, gas line to range and BBC).
OWNER: POLSON, JAMES C AND ELIZABETH A, PHONE #: 503-62691E4
CONTRACTOR: PYRAMID HEATING PHONE #: 503-786-9522
Inspection Request Scheduled For: Date: 10/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 057938 -01 503-319-5878 Y
Corrections /Comments /Instructions:
Q) t� �? —5; = 2a 175 ,- / s G
I
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /6 — / 9 -G 7 Phone #: (503) 718- 2, 'S'