Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00486
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/10/2006
PARCEL: 1 S134CD -06200
SITE ADDRESS: 11680 SW SUMMER CREST DR ZONING: R -4.5
SUBDIVISION: BURLWOOD NO.3 LOT: 022 JURISDICTION: TIG
Project Description: Installation of wood stove.
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: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
KEVIN & HO CAPELLE Description Date Amount
11680 SW SUMMER CREST DR
TIGARD, OR 97223 [MECH] Permit Fee 10/10/20C $72.50
[TAX] 8% State Surcha 10/10/20C $5.80
Total $78.30
Phone: 503 -524 -4262
Contractor:
HOT SPOT FIREPLACE & PATIO
11525 SW CANYON RD
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 626 -4652
FAX 503- 626 -9138
Reg #: LIC 71782
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: �� �e� Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that busin :: s day.
This permit card shall be kept in a conspicuous place on the job site un • completion of the project.
Approved plans are required on the job site at the time o, each inspection.
�.. r' ,i , 1 l • it o.i
• Me�ha Permit Application • t - ; ; , soli O1� 1�•ICL list. ONl
City of Tigard ., Received p � Permit No..
° 13125 SW Hall Blvd., Tigard, OR 97223 y / '/ ( ` • �� ,�
' Phone: 503.639.4171 Fax: 503.598.1960 0 2006 Plan Review Other Permit:
Inspection Line: 503.639.4175
Date/By.
I GAR!) p Date Ready/By. Ilin RI See Page 2 for
Internet: www.tigard or.gov Notified/Method
� Supplemental Information
�,u!t ti ll[ �llti.
PE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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.
,.,� CATEGORY OF CONSTRUCTION Value: $
Lld't -and 2-family dwellin RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
y g ❑ Commercial/industrial ❑ A ccessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: i I GS 0 S LJ St) IS , d f DI'j„ , Air conditioning or heat pump
q (requires site plan showing placement) 14.00
City /State/ZIP: `"T C.� O 02. - / 72-23 Furnace 100,000 BTU ( ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: 1142 "'fl6 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
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: _ 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
1J t• $ (N s 41 Gas fireplace vent for 10.00
4 J � l ��- Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pelletstove i , 10.00 1C. ° '
,,---
,, Wood fireplace/insert 10.00
Q
' 6ROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: 40110 V f - COQ Ji� Environmental exhaust and ventilation
Address: Ste. a S t25 - 8 J� Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
2 Fax: 7
Phone: ( Sb?) 6 'I . ( 12.6 ( 12.6 2
Single-duct comp rtme nts (bathrooms,
( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
• Business name:
`) P4 Clothes dryer (gas)
Other:
Address: /45— r S IA) (cvt44'O ,/ ,2 - MECHANICAL PERMIT FEES*
City /State/ZIP: . vt2 7 7j 5 Subtotal
Minimum permit fee ($72.50)
Phone: (S`p 3) 6 26 ii‘, 5 - - Z Fax: ( ) Plan review (25% of permit fee)
. CCB lic.: 7 / 77 Z. State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized SlgnatU This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: I Date: /U -/U -- • Fee methodology set by Tri County Building Industry Service Board
1:\Building\Pe ni C- PermitAp ' oc 04 /06/06 440- 4617T(II /02/COM/WEB)
. /
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.
1:\Building\Permits\MEC- PermitApp.doc 12/30/05 2
CITY OF TIGARD _ -
BUILDING DIVISION A PERMIT #: G3006004 6
, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2006
Phone: (503) 639 -4171 A alilgjil
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/8/2006 TIME: 7 :03AM PAGE: 25
SITE ADDRESS: 11680 SW SUMMER CREST DR CLASS OF WORK:
SUBDIVISION: BURLWOOD NO.3 LOT #: . 022 TYPE OF USE:
PROJECT NAME: CAPELLE
DESCRIPTION: Installation of wood stove.
OWNER: CAPELLE, KEVIN & HOLLY PHONE #: 503- 524 -4262
CONTRACTOR: HOT SPOT FIREPLACE & PATIO PHONE #: 503 - 626 -4652
Inspection Request Scheduled For: Date: 11/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 039444 -01 503 -524 -4262 N
Corrections /Comments/ Instructions:
•
I
PA' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . Date: //-8- Phone #: (503) 718-