Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC201300118
T IGARO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/27/2013
Parcel: 2S104DC01900
Jurisdiction: Tigard
Site address: 13485 SW BENCHVIEW TER
Project: Orsay Subdivision: BENCHVIEW ESTATES Lot: 19
Project Description: (2) NC replacements and (2) gas furnace replacements, (1) duct work All new PVC venting for both units
Contractor: NW SUNDANCE SERVICES INC Owner: ORSAY, PAUL
10117 SE SUNNYSIDE RD STE F1201 13485 SW BNECHVIEW TERR
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE: 503 - 750 -7442 PHONE: 503 - 276 -5663
FAX: 503 - 655 -3347
FEES
Specifics: Description Date Amount
Air Conditioning 02/27/2013 $93.50
Type of Use: SF Furnaces >= 100K BTU 02/27/2013 $109.82
Class of Work: ALT Type of Const: Duct Work 02/27/2013 $23.32
Occupancy Grp: 12% State Surcharge - Mechanical 02/27/2013 $27.20
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $253.84
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. , l
Issued By: /1 Permittee Signature: Oki /°L/ e 4" ) 2211AA, "" 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.
02/27/2013 13:48 5036553347 NWSUN PAGE 04/05
Mechanical Permit Applica V L� o� / IY:1K t)vPl( 1 t -.1"
IA(
City of Tigard �Et e.1 (3 sr" PermitNo:M C - 020/3- 00 0/2'
1 4 '-- . 13125
Phone: 5W Hall 503.718Blvd.,
2439 TigardFax: , OR 503.598.196 97223 0 E B 2i 1 q Other Permit:
r� 2013 D e/By W
-r 1 , : ; A i;1 : , 'Inspection Line: 503.639.4175 Date Ready/33y: 121 RI See Rage 2 Car
Internet: www- tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental latammtioa
RU!! .DING DNIS!ON -
TYPE OF tl1+ORK' COM E1 IA1. .FEE* SCHEDULE — CHECKLIST
Mechanical penanit fees* are based on the value of the work
❑ New construction gir Addition /alteratiion/replacement performed. Indicate the value (rounded to the neatest dollar) of all
❑ Demolition ❑ Other. mechanical materials, equipmentlabor, overhead, and profit.
Value: S
• CATEGORY. OP CONSTRUCTION .. . • HESIDENITALEQUDIVIENT /SYSTEMS •1dES•
1- and 24iixnily dwelling ❑ Commercial/industrial ❑ Accessory building For credal informs:film sse rhecilisr. ,
❑ Multi - family ❑ Master builder El Other: Description L Qty, Ea. [ Total
. . JOB SITE. INFOBMATioN Oa :LOCATION' '
Htatiuglcooliagt
Air condiduniog
lob site address: y 8S S� e. wool, .) _regime.
- (requires site plan showing placement) 46.75 q3
Furnace 10O.QOA BTII cducu/venni 46 -75
City/State/VP: T i e p / D t1' Furnace 100,000+ BTU (checte/veaa) ik 54.91 r
pump
5uite/bldgJapt. no.: Project name: HOB
(maitre the Plea showing plaoanatt) 61.06
Cross street/directions to job site: Duct work i d 23.32 5.5.32,
- Hydronic hot wa sys 23.32
Residential boiler (radiator or
hydronic) _ 23.32 -
unit hearers (fuel-type, not electric),
in -wall, in -duct, suspended, etc. .. 46.75
Subdivision: l Lot no.: Flue/vent for any of above 23.32
,_. - -- Otter: 2132
Tax map/parvel no.: Other fad appliances: •
p� /� c • DE9GYti1'f[O N OP WO1RiC. r� I Water 73.32
PI-a Li) `3Air PawA- 'S *JO (2) ) v#i ( ...:_�: F w a t er 33.39
c Flue for water heater or gas 23.32
ALL MEW ?VC- IIMJYiI4 1' 0TH iW it . . Log lighter (Bas) 23.32
_. - --
Wood/Relict stove 3339
Wood freplace /insert 2332
• • PROPERTY. OWNER .... 1 • . .0. TENANT . " other:
Chimney/liner/flue/van 2332 -
Other 23.32
Name: 7Au4. O(Ir14/
Environmental exhaust and ventilation:
Address: ('1 B / r y f - lew-NYIaus •rel equipment 33 -39
City/State/1FP: r i l lia.° / oiL! 4712,3 - _- Clothes
u e r xharea (bathrooms, 33.39
Phone: ( 3 , y ) 37(0 510 43 Fax: ( ) toilet compawtntentS, uHlrty rooms) 23.32
' 0 • : . ' • 0 CONTACT PERSON , . . • Aiticfc rawlspace fans ` 2332 -
Other: 23.32 _
Business name: 5 - 4M At s GeAr
{vg,, Fuel piping:
Contact name: $14.15 for that four; $4.03 for each additional_
Address:
Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
Ell:
Range
CON 1rRACTOR barbecue •
Business name: ow Svo�l N ca stoma a Clothes dryer (pis)
Address: Other ..,
1O lio S e sJamit I ee 'o It Fly 1 1t1$G�RPPICAI Y rrn� C't>1 S• .
City/State/ZIP: (4-4fAcirlatini I'tlo - --__- Subtotal 'Z•� -`A
Minimum permit fee (590.00)
Phone: () (free 1 Fan: (5o) La S- "33 Plan review (25% of pcannit fee)
CCB lie.: t 93 19 $ J f a - `- /I'S State surcharge (12% of permit fee) .
TOTAL PERMIT FEE 0 253.0y
This permit application expires it a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
I Print name: _rib...AIN& (/
Mil 1 . 0 , Date: 0 11 h.i h • Fee methodology set by Tri -Comity Building Industry Service Board
t: 1Bulding \Papols/MEC- PerraitApp-doc osn7na � {io..eur(I1/o)2,t0M/Wm) 0 153 • g(
02/27/2013 13: 48 5036553347 NWSUN PAGE 05/05
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 $20721 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.
T:8uildin Pedmits\MEC- PamitApp.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
13485 SW BENCHVIEW TER, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
04/01/2013 00:00
MEC2013-00118
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
13485 SW BENCHVIEW TER, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
03/25/2013 00:00
MEC2013-00118
FAIL
Please call for detailed explanation of furnace locations or meet on site.
Is house empty or homeowner occupied?
Violation Summary:
Inspector Contractor