Permit „ CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2008 -00582
'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/25/2008
PARCEL: 1 S133DC -15300
SITE ADDRESS: 13045 SW TAMERA LN ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT: 008 JURISDICTION: TIG
PROJECT: CROWLEY
Project Description: Replace gas furnace.
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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
LENA CROWLEY Description Date Amount
13045 SW TAMERA LN
TIGARD, OR 97223 [MECH] Permit Fee 11/25120C $72.50
[TAX] 12% State Surch 11/25/20C $8.70
Total $81.20
Phone: 503 -590 -7595
Contractor:
MECHANICAL INC
PO BOX 19569
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -244 -1730
FAX 503- 245 -7613
Reg #: LIC 124283
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.
l
Issued By: ,1��vv - Permittee Signature: � --------- Call 503.639.4175 by 7:00 a.m. for inspections that b 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.
Mechanical Permit Application � FOR.OFFICE , USE�ONLY
' v 01 25 SW Ha Blvd., OR RECEIVED Da � G , Permit No.: /- 200 --ej
Tigard
Date b; �� fl
Plan Review
Phone: 503.639.4171 Fax: 503.598.1 960 2 DateBy: Other Permit:
i T1G N tRD Inspection Lin 503.639.417 � 2 5 2008 Date Ready /By: funs. ® See Page 2 for
Internet: www.tigard- or.gov Notified /Metho• -7.7&_ Supplemental Information
CITY OF TIGARD
TYPIBtablO ki DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ► j 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: $
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I- and 2-family g ❑ 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 or heat pump
Job site address: 13 y 7 T4 olz.0 It `# (requires site plan showing placement) 14.00
City /State /ZIP: " T(cuj L 02 q 722. Furnace 100,000 BTU (ducts /vents) I 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: 1 Project name:
C R ow LE t-( Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Subdivision: Lot no.:
Flue /vent for any of above 6.80
Other: 10 00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
R e p i k 4. F/ n ct t Q_ 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
❑ PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: L eAei` C4 0,0 I e v Environmental exhaust and ventilation
Li t Range hood /other kitchen
Address:
3 o g- S w f *i E..1?a L,i equipment 10.00
City /State /ZIP: T q , 4j_ G 2 q 7 Z � Clothes dryer exhaust 10.00
1 Single -duct exhaust (bathrooms,
Phone: (Sc. 3 ) Sqo — 7 J Fax: ( ) toilet compartments, utility rooms) 6 80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: m EC 4 Jkv t c4 L T pc_ Fuel piping
Contact name: L '1 ' I / L6) $5.40 for first four; $1.00 for each additional
Address: Po Qv x ('S -ie( Furnace, etc.
Gas heat pump
City /State /ZIP: Po'n , U A c' 7.. c_-3 0 Wall /suspended/unit heater
Phone: ( 5D 3) 1-(L.4 —1-73 O Fax: : (5'4 ) ,24-c_. 76 (_ Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: 5 /M £ Other:
Address: MECHANICAL PERMIT FEES* -
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) .. , .j 6
Plan review (25% of permit fee)
CCB lic.: 1 z t - ( ;Z g3 State surcharge (12% of permit fee) ,f, '76
� TOTAL PERMIT FEE , ,, j 0
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: T. h/t C R Kly e S Date: 11 -2 c•—..),,E" * Fee methodology set by Tri- County Building Industry Service Board
1.\ Building \ Permits \MEC - PermitApp doe 01/19/07 440 -4617T (11 /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.
I:\ Building \Permits \MEC- PenmitApp.doc 01/19/07 2
CITY OF TIGARD
, BOIL' ZING DIVISION PERMIT #: MFC2000-00582
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/25/2008
Phone: (503) 639- 4171 -
Inspection Requests (24 Hrs.): (503) 639 -4175 'I L #
INSPECTION WORKSHEET FOR DATE: •12/2/2008 TIME: 7 :00AM PAGE: 29
SITE ADDRESS: 13045 SW TAMERA LW CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #: 099 TYPE OF USE:
PROJECT NAME: CROWLEY
DESCRIPTION: Replace gas furnace.
OWNER: CROW.-EY, LENA PHONE #: 503-590-7595
CONTRACTOR: MECHANICAL INC PHONE #: 503-244 -1730
Inspection Request Scheduled For: Date: 12/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 078666 -01 503 -590 -7595 N
Corrections/Comments/Instructions:
__ c_ZQ Cu v 1 -ra E o JJ.4 - > <` P7
4(PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /-- Z — 0 Phone #: (503) 718 - �-4–(1.,-----'
CITY OF TIGARD
,...
EithibIN G DIVISION PERMIT #: MEC20013-00582
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/25/2008
Phone: (503) 639-4171 Akiti,;1,
Inspection Requests (24 Hrs.): (503) 639-4175 '
INSPECTION WORKSHEET FOR DATE: 1112612008 TIME: 7:00AM PAGE: 31
SITE ADDRESS: 13045' SW TAMERA LW CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: CROWLEY
DESCRIPTION: R ep l ace
r. gas furnace.
OWNER: CROWLEY, LENA PHONE #: 503-690-7595
CONTRACTOR: MECHANICAL INC PHONE #: 5B-2441-1730
Inspection Request Scheduled For: Date: 11/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 078541 503-590 N
Corrections /Comments/ Instructions:
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,
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i ii5C. -- -L - Ce 4,44a.. -7te 5- j •?5" -,ed / e.,171 i-"
PASS --n PARTIAL APPROVAL 7 CANCEL Li NO ACCESS
FAIL I I CALL FOR INSPECTION , I I ADDITIONAL FEES ASSESSED
/5e
Inspector: Date: 1/— "2-5 Phone #: (503) 718- Z---'-r-K
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