Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00095
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/13/2013
Parcel: 25111 DB04700
Jurisdiction: Tigard
Site address: 15222 SW ALDERBROOK PL
Project: Kaufman Subdivision: SUMMERFIELD NO.7 Lot: 413
Project Description: Replace (1) furnace and (1) heat pump
Contractor: TRANTEL HEATING & COOLING Owner: KAUFMAN, ELVIRA B TRUST
2616 SE 17TH AVE 15222 SW ALDERBROOK PL
PORTLAND, OR 97202 TIGARD, OR 97224
PHONE: 503 - 553 -9066 PHONE: 503 - 206 -1307
FAX:
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/13/2013 $46.75
Type of Use: SF Heat Pump 02/13/2013 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/13/2013 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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 y (44 u/ r Permittee Signature: 1111►
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.
Mechanical Permit Application FOR OFFICE USE ONLY
RECEIV Received Permit No.: E f 3 4
lig - City of Tigard Date/By: 3 13 g-t / GaD
13125 SW Hall Blvd., Tigard, OR 97223 y �� I
Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 FEB 13 2013 Date/By:
TIGARD Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: . ( Supplemental Information
BUILDING DNISION
TYPE 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.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
I. and 2- family dwelling ❑ Commercial /industrial ❑ Accessory 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:
Air conditioning
Job site address: 1 S,.2 a a 3 W k Aa-r - 'l cnv K., P f, (requires site plan showing placement) 46.75
City /State /ZIP: Furnace 100,000 BTU (ducts/vents) I 46.75 1 / 4 -(4„; - ?c . "
t ' �- t 1L i ) '- ')-- Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) I 61.06 ( -Bic
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert 33.39
1 2 -c, p / 4 c c- t i r r7 4 c e_ 1 n .."Y " - Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: 0 'L S� 0. .' � INN co....1Th Environmental exhaust and ventilation:
Address: \ S �.� \...D �A, .l J. o o l` P L Range hood /other kitchen
5 equipment 33.39
City/State /ZIP: , cl r- L, oiler c ') 2 3 Clothes dryer exhaust 33.39
� Fax: Single -duct exhaust (bathrooms,
Phone: (
3 ) �- to - \ 3 i0� ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans _ 23.32
Business name: �7 Other: 23.32
�`rC� ✓ _F el, . j -c v� I i C t G7 0 t /� Fuel piping:
Contact name: _S n.� 1 r, .1 e....1 7 $14.15 for first four; $4.03 for each additional
Address: 2(P ( Lo S c f �-', /' \ Gas Furnace,
heat etc.
I� t Gas heat pump
City /State /ZIP: ‘., x-- 1 (3. ' "7 9-0 Wall /suspended/unit heater
Phone: (') St 3 - C -D (o co Fax: : ( ) Water heater
( Fireplace
E -mail: -SLe. e "Tr 6_n -1 eo. -, 9 ca.v■ CbZ'\ i rl_. , CD b`1 Range
CONTRACTOR Barbecue
/
� Clothes dryer (gas)
Business name: f rG. n + 14.c, rs 5 4 Co - o\ t o S
Other:
Address: 'L� \ t, C I -) .'M A' MECHANICAL PERMIT FEES"
City/State /ZIP: \, �� '- ( 'L_ c - 7 oL o - Subtotal 10') g
Phone: Minimum permit fee ($90.00)
( ) 5 S 3 a b l Fax: ( ) Plan review (25% of permit fee)
CCB lic.: / C s- q Y I Pi 1 1 L3 State surcharge (12% of permit fee)
TOTAL PERMIT FEE l,2f7.7
Authorized signature: 1 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: _c �,arte ��, 4- a I Date: - P__ I i Z/I - * Fee methodology set by Tri -County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 03/07/12 440 -4617T (l l /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\Building\Perrnits\MEC- PermitApp.doc 03/07/12 2
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Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15222 SW ALDERBROOK PL, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
02/28/2013 00:00
MEC2013-00095
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15222 SW ALDERBROOK PL, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
02/28/2013 00:00
MEC2013-00095
PASS - No C of O
Violation Summary:
Inspector Contractor