Permit IN CITY OF TIGARD MECHANICAL PERMIT
II
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00070
T (GAAD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/31/2013
Parcel: 2S103AD02800
Jurisdiction: Tigard
Site address: 12855 SW 107TH CT
Project: Demcak Subdivision: PATHFINDER Lot: 18
Project Description: (1) gas forced air furnace replacement
Contractor: MECHANICAL INC Owner: DEMCAK, DAVID M & KATHERINE B
PO BOX 19569 12855 SW 107TH CT
PORTLAND, OR 97280 TIGARD, OR 97223
PHONE: 503 - 244 -1730 PHONE: 503 - 449 -4281
FAX: 503 - 245 -7613
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/31/2013 $46.75
Type of Use: SF Fuel Piping 01/31/2013 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 01/31/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 01/31/2013 $29.10
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800,332.2344.
Issued By: ;� i t h a t� /� a �' Permittee Signature: 0 O ��(' L ' (170 la
555666ddd .v l L � tit
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Jan. 30. 2013 1:10PM No. 6573 P. 1
Mechanical Permit ApplicationEWE
City of Tigard R31. 1� 3 3 Permit No.: eC, - U
• 13125 SW Hall Blvd., Tigard. OR 97223 JAN 3 0 2013 Plea Review Other Permit
Phone: 503.718,2439 Fax: 503,598.1960 Date/By:
T I CiA R L� Inspection line: 51)3.639.4] 75 CITY OF TIGARD Date RcadyBy: tuns ® See Page Z for
Internet: www.tigard or.gov Notified/Method: . � G, Supplemental Information
BUILDING DIVISION 1 -
, , .. , ... , � ,,. , ., :• .... . 7...777 ..... ..... i� f . _
. ... .7..7 .r ...:. :::.::
•: M han'url permit are d thc al fth work
„v . ....:..........«..:.�..,,,,, .. . .... ... ec , pertttr fees* are based on c v 1)c o c wot
❑ New conslruClion ® Addition /alteration /replacement performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition Q Other: mechanical materials, equipment, luhrrr, overhead, tmd proliL
Value: S
....... .,..,.� ..:.::::.............. , ::::.7 r,,:,:.: ::. . !!'_..:::.,,F,
... ...,.,.x,:..... •-
:.._......... r� .....::. :................ C" A 'SEGOJ,tY,Qi!'.CA1Ri�F,[t:1N- .. � _...... -- - ,r
.�..,,,- - ----- -- ..... .... _.. 7777, r.,.,,..,--. r .., .,....._ . .__. ............... ,. -, „�...,. ,
.717 . ....:::::::::::::.:::....•. - --.......... 1 1.
. ® 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special informaiiunuse checklitl.
❑ Multi- family El Master builder El ()titer: Description I Qty. I Ea I Total
=.... _.... _. .. ..O$ f,F!Isi i O a •.;,i i :: :_: i .:` , _r:-`a :- € €i
..._ • .:::...... ....�..r ....7.....77•.
_.. y _
.... ::::�n.
ir ............ .
......• �- :,�.�..,,. 7..7.....77. ..
. -,... 77.............77...... _�.,,__. ........... ...... .............................. Ai con
Job site address: 12855 SW 107 Ct (r egwies s ite plan shoving placement) 46.75
City /State /ZIP: Tigard OR 97223 - 3901 Furnace 100,000 BTU�ducts/vcnts) I 46.75 46.75
Furnace 100,0004- BTU (ducts/vents) 54.91
Suite/bldg. /apt, no.: Project name: Demeak Heat pump
_. (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
W ulnut/Tiedman/ Right on Fonner St; left 107 Ct Hydronic hot water system 2132
.. Residential boiler (radiator or
hydronic) 23,32
- Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: T.ot nv -: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
.._ ................. ..... 77:7:.:::..................7 . , ... �...,,,.,..,...,.... .
... ........__..... -
.°:.;::.iffitEFa i _:.''i'_:._:i:l''.',4' iii :..... .........:.....•...... .: ... :::•r:: r. ..... _..:,.. .. 1:5;;,.13, -?
- .:- ......... - : - c;:: n :12::•.1;.;•:1 Water heater 23,32
DlE CitQ' ?FiC, N�ii_;, 1'-' �[? _ _ •, , -.,•- �:� ia {;i:i.�i= '�t ?a: €� -12
: �•:•: �:::_.;,, �.,,, ,� ................ .. , , ...12.
Gas fireplace/insert 33,39
Replace Forced Air Gas Furnace
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplacc/inscrt 23,32
,- - = . ...._.,..:......... , ...... .. , .. .. ....: ........ ... ... .----.............. .......,._.;,.....,.,..., .., i _, .1 23.32
.. Chimney/liner/flue/vent
:,iii;;::..-, :::::, s' : l "::E :i - :: :i : :; :ci 1t :1;11 +.' i i :i :�=' : •�; :;r, :. --
........:_: _::::::::,:::.,.,:::.::: :.. :.. :._... :. : . .............. . ... . .... . .... . 23,32
.,,,�r..�r..��r. Other`
Name: Dave & Katie Demeak Environmental exhaust and ventilation:
"34. ,... t Baca SAN t 07th c ' Range hood/other kitchen ` I I
. - equipment 33.39
City /State/7,,1P: Tigard OR 97223 -3901 Clothes dryer exhaust 33.39
_503 449.4251 Fax ( ) - . * Single -duct exhaust (bathrooms,
Phone:
( } toilet compartment~, utility rooms) 23.32
. ........................... ..:.......--......... ...,.,.....,,, --.. � ----_ �....... .._- :_ :::...:....,,.,,,r:.:,,:• „•7 •.712: :.. .
4 : :•, : : : : . : :;i:; :. :, :::t. i _ ...... ......... . fun,
- - - . At#irJcrawlh ace 23.32
....._......... _._........ .. A3' P! I. 7. A x�3'; :1i :ii'='i :: : : : : : : :� :;� ;:' �; ' 1 '. i_"' �.._.. ..__.....---..... ......._ � r := : := : : :- 1212: = :. �'
.... ...........7121_............:,. __ ,..... .. : . .......... ..
... ... ... ...
Business name; Schnauzer Construction dba Mechanical Inc. Other: -_ 23.32
Foci piping: _
Contact name: Janice Dole $14.15 for first tour $4103 for _e_ac_h additional
-
Address; .9-- -t J i3 eta Furnace, I 14.15
-- Gas heat , .
City /State/ZIP; Wall/suspended/unit healer
Phone; ( ) Fax: : ( ) Water heater _ .
i Mace _ w
E -mail; Range
..., 5: ................ ... 7 ... 7 . 77 ... ............... .
Business name: Schnauzer Construction dba Mechanical Inc. Clothe dryer (gas .-
-- - Other.
Address: P O Box 19543 ........:::::::::::,:.:::.,:.: ...................:.•..,._.,._.... .........-_..._-...........--- 12.77.,.,...
_.. ._..........._ .......:....... .:.:_.:.........:...:._.......: � : :......_ :... :_ :. :. : : :.. :._ .�•,;,, 12 7.7,; .....
City/StatetLlP: Portland OR 97280 .? li (, . Subtotal
Phone: (503) 244.1730 Fax (_503) 245.7613 �` f ff Minimum ertnit fee $90.00 90.00
L N Plan review (25% of permit fee)
CCI3 lie.: 124283 7/a.ti / _ r'V`A - 4 - J c., lr'5 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized signature: ` (j,, • a
{1Q This permit applicadon expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Janice K Dole Date: 01/30/2013 • Fee methodology set by'rri.C:uunty Building Industry Service Board
t: uluWIdiape ,aits\MEC- PermiiAop.doc 311)7/, • 440 -4e 17T (I t/a'd/COM/waB)