Permit CITY OF TIGARD
/1
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00584
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/26/2008
PARCEL: 2S111 BC - 03300
SITE ADDRESS: 10375 SW VIEW TER ZONING: R - 3.5
SUBDIVISION: DOUGLAS HEIGHTS LOT: 008 JURISDICTION: TIG
PROJECT: JOHNSON
Project Description: Replace and relocate existing wood stove.
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:
WOD 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES: 1
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
DOUGLAS & SUE JOHNSON Description Date Amount
10375 SW VIEW TERRACE
TIGARD, OR 97223 [MECH] Permit Fee 11/26/200 $72.50
[TAX] 12% State Surch 11/26/20C $8.70
Phone: 503- 639 -0737
Total $81.20
Contractor:
R & D INSTALLATIONS
, 62ND
OR 97206
PORTLAND, REQUIRED ITEMS AND REPORTS
POR
Contact #: PRI 503- 774 -7142
FAX 503- 774 -7142
Reg #: LIC 95236
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 -! - 00. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue. By: !r ,/ i Permittee Signature: J`i ! -.1■111/�'
i i
Call 503.639.4175 by 7:00 a.m. for inspections that b iness day. /
This permit card shall be kept in a conspicuous place on the job sit/ ntil comple on of the project.
Approved plans are required on the job site at the time of each ins. ction.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/By Received / /�Dg NM Permit No Hg ) , ..„ A
i llii q 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
' III Phone 503 639 4171 ' Fax 503 598 1960 DateBy Other Permit
TI G A It D Inspection Line 503 4175 Date Ready /By Fra ® See Page 2 for
Internet: www tigard- or.gov Notified/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction 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*
J$,( 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist
❑ Multi- family 0 Master builder 0 Other:
Description Qty. I Ea. I Total
JOB SITE INFORMATION AND. LOCATION Heating/cooling
Job site address: I c 7 5vv1 \/t€».) I I=2tZp,C Air g condrt e plan or heat pump
((requires site plan showing placement) 14 00
City /State /ZIP: TvAEe„ 6::2 972.24- Fumace 100,000 BTU (ducts/vents) 14 00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: C�,_PL[s,ce Vinot> E. Gas heat pump 14 00
Cross street/directions to job site: i o3 eo 4_ VE --
EeQ �� 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
eimaACe, p,_-,D w oop `JevE_. Flue vent for water heater or gas
fireplace - 10.00
II fl FLU C--
Log lighter (gas) 10 00
Wood/pellet stove ( 10 00
Wood fireplace /insert 10.00
$i PROPERTY OWNER I ❑ TENANT Ot y/liner/flue /vent 10 00
Other. 10 00
Name: VZ U6 LAS J ob4 t‘D Environmental exhaust and ventilation
Address: / Range hood/other kitchen
1 n S S W V1 �lJ CE.CLP_ equipment 10 00
City /State /ZIP: - 727 3 ,A,21) O 97 ZZ Clothes dryer exhaust 10 00
Single -duct exhaust (bathrooms,
Phone: (5p3) ‘„3 ', —tD - 1 37 Fax: ( ) 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: l? 4. D I � -�� 0 _� Clothes dryer (gas)
Other
Address: G Z4-e .. a 6=.Z. 13 t ' . At\ia_- MECHANICAL PERMIT FEES*
City /State /ZIP: CD p_-• 9720G, Subtotal
� x � �� p Minimum permit fee ($72 50) 7' -
Phone: (�3) / / `i-___ 14-2_ Fax: ( ) Plan review (25% of permit fee) -
CCB lic.: 9 S -2: / j / 9 State surcharge (12% of permit fee) $. 7 v
� �� TOTAL PERMIT FEE $l , .po
Authorized signature: Vii' / ��j, This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: t/V LA S E..- jo r .. Date: 1 t/ ,'c'g • Fee methodology set by Tn- County Building Industry Service Board
I \Budding\Permos\MEC- PermiApp doe 01/19/07 440 -4617T (I I /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 $1 0,000.00 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: \Bwldmg\Permits\MEC- PermitApp doc 01/19/07 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200800584
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/26/2008
Phone: (503) 639 -4171 : aua�l�i�lin
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/8/2008 TIME: 7 PAGE: 24
SITE ADDRESS: 10375 SW VIEW TER CLASS OF WORK:
SUBDIVISION: DOUGLAS HEIGHTS LOT #: 008 TYPE OF USE:
PROJECT NAME: JOHNSON
DESCRIPTION: Replace and relocate existing wood stove.
OWNER: JOHNSON, DOUGLAS & SUE PHONE #: 603.639 -0737
CONTRACTOR: R & D INSTALLATIONS PHONE #: 503.7747142
Inspection Request Scheduled For: Date: 12/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 070852 -01 503 -633 -0737 N <
Corrections/Comments/Instructions:
0 /1
\,A/ (/
AS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 7180 J4
C F TIGARD 53c,
SUILDIVG DIVISION PERMIT #: MFC2008 005134
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/26/2008
Phone: (503) 639 -4171 Gr p
Inspection Requests (24 Hrs.): (503) 639 -4175 ... IL .
INSPECTION WORKSHEET FOR DATE: 12/4/2008 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 10375 SW VIEW TER CLASS OF WORK:
SUBDIVISION: DOUGLAS HEIGHTS LOT #: peg TYPE OF USE:
PROJECT NAME: ,JOHNSON
DESCRIPTION: Replace and relocate existing wood stove.
OWNER:' JOHNSON, DOUGLAS & SUE PHONE #: 603.639 -0737
CONTRACTOR: R & D INSTALLATIONS PHONE #: W3-774-7142
Inspection Request Scheduled For: Date: 12/4/2008 Pour Time:
Code # Inspection Description Confirm # . Contact # Message
699 Med tanical final 078763 -01 503 -639 -0737 Y
Corrections /Comments /Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t
Inspector: Date: ( k I CS Phone #: (503)' 718 - 2-4\23fr,