Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2013 -00202
- r t C ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/15/2013
Parcel: 2S103DD00424
Jurisdiction: Tigard
Site address: 10945 SW FAIRHAVEN WAY
Project: Kelly Subdivision: FAIRHAVEN COURT Lot: 9
Project Description: (1) wood stove and (1) chimney installation in detached garage
Contractor: BIRDS CHIMNEY SERVICE Owner: KELLY, JOHN D & DEVON
6604 SE CHARLES ST 10945 SW FAIRHAVEN WAY
MILWAUKIE, OR 97222 TIGARD, OR 97223
PHONE: 503 - 653 -4999 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Wood /Pellet Stove 04/15/2013 $33.39
Type of Use: SF Chimney /Liner /FlueNent 04 /15/2013 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/15/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 04/15/2013 $33.29
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. r
Issued By: Permittee Signature. / ' / /
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. LfU
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 Applicati FOR OFFICE USE ()NIA
City of Ti and DECEIVED Received i Permit No
`J gs Date/By: 4 {" / 6 3 1 og j.ty 3- 00jU ,.„1--
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960A P R 15 2 013 Date/By: Other Permit:
T I G A R D Inspe Line: 503.639.4175 Date Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: / Supplemental Information
BUILDING DIVI'ION �O
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*
p 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ 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 46.75
/
Job site address: dq ( /� C� T u_„ -, / A.....,.."7 Gti�/f Furnace 100,000 BTU ( ducts/vents) 46.75
City /State /ZIP: ` �� �� � !/ Furnace 100,000+ BTU (ducts/vents) 54.91
r' Heat pump 61.06
Suite/bldg. /apt. no.: Project name: Duct work 23.32
Cross street/directions to job site: 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
Flue /vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
�� f/ 4 // Lit/ nnl s p..�1 — /....-4 i y , fireplace 23.32
_ Log lighter (gas) 23.32
( .'� / �l� � -" ' Q Wood/pellet stove 1 33.39
Wood fireplace /insert 23.32
Chimney/liner /flue /vent 1 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City /State /ZIP: Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: ( ) Attic /crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: _ 23.32
Z,---f,.6- Fuel piping:
Business name: Zt ` I " •C $14.15 for first four; $4.03 for each additional
Contact name: /G �*" i� 4 „ _ 7 7,7 2 _ - Furnace, etc.
Address: �- Gas heat pump
� ti G ( J1 ' 4. -i 5 57 Wall /suspended/unit heater
City /State /ZIP: c / L* . a e s(9/ 9 7 2 z Z Water heater
Phone 3) 4 -^ Fax:: ( ) Fireplace
/ Range
E -mail:
Barbecue
CONTRACTOR Clothes dryer (gas)
Other:
Business name:
C /1"-e---- �S �� ,''� MECHANICAL PERMIT FEES"
Address: f
Subtotal
City/State /ZIP: Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee)
CCB tic.: r./ J c / 41.4.Ct 5101 < TOTAL PERMIT FEE / , J v. Ffb
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized si P . re: ' • Fee methodology set by Tri- County Building Industry Service Board
Print e: "P� Date:
1:1 Building \Penn' 1.MEC_PermitApp_040113.doe 440-4617T (11/02/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 $l00.00 r
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.
N
I:\ Building\ Permits \MEC_PermitApp_040113.doc 2
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
10945 SW FAIRHAVEN WAY, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
04/29/2013 15:16
MEC2013-00202
PASS - No C of O
Violation Summary:
Inspector Contractor