Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2013 00239
Date Issued: 05/06/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Parcel: 1S135DCO2401
Jurisdiction: Tigard
Site address: 11795 SW 91ST AVE
Project: Deicer Subdivision: NORTH TIGARDVILLE ADDITION Lot: 63
Project Description: Replace furnace, add chimney liner
Contractor: TRANTEL HEATING & COOLING Owner: DIEKER, ELIZABETH J
2616 SE 17TH AVE PO BOX 230422
PORTLAND, OR 97202 TIGARD, OR 97281
PHONE: 503 - 553 -9066 PHONE:
FAX.
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/06/2013 $46.75
Type of Use: SF Chimney /Liner /Flue/Vent 05/06/2013 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/06/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 05/06/2013 $19.93
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
issu• • -, or .rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Uti y Notification Ce er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or . irect questions to OU " by .(ling 503.232 1987 or 1 800 332 2344.
Issu: . By: Permittee Signature: •
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
City of Tigard Date ,...421112M , / Pent No /7 0/3 — 640,2 37
1111 111 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503 598.1960 DateBy. Other Permit
T I G A R D Inspection Line: 503.639 Date Ready/By Juris ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ddition/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 I SYSTEMS FEES*
'J- 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 46.75
Job site address: \ \ 1 1 5 s w C. ( sr jkJ t Furnace 100,000 BTU (ducts/vents) , 46.75 t-14 .1
City/State /ZIP: 'r■ t r Z a (I� Furnace 100,000+ BTU (ducts /vents) 54.91
1 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
I R I C., L.6 F ":1,-'1 i n ct c- (» Cln . nt k- t +3 s,v fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32 22n
Chimney/liner /flue /vent ( 23.32 .f •3/ /
❑ PROPERTY OWNER I ❑ TENANT Other:
Environmental exhaust and ventilation: 23.32
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
6 APPLICANT ❑ CONTACT PERSON Other. 23.32
Fuel piping:
Business name: v- tl � c Av $14.15 for first four; $4.03 for each additional
Contact name: S . n 2 ( Furnace, etc.
Address: ZIP (b S� ‘'�i,.LS- Gas heat pump
Wall /suspended/unit heater
City /State /ZIP: vz ----4) , a -a-- S '1 . Water heater
Phone: ( ) Fax: : ( ) Fireplace
Range
E -mail:
Barbecue
CONTRACTOR Clothes dryer (gas)
1 / 1 Other:
Business name: �Y' el A- �' [A Y..a....'l, t;^ 1 W , z` t q J i Tb MECHANICAL PERMIT FEES*
Address: 'L(, l 6 S, �' -AN . k O T Subtotal 9'f. °
City/State /ZIP: '� f � cj' ,_p 2 _ , Minimum permit fee ($90.00)
Plan review (25% of permit fee) �g
Phone: (95 3 _ S 3 ,. 5 0 to k, Fax: ( ) State surcharge (12% of permit fee) ,/) . 7J
CCB lic.: \ R E 9 k p TOTAL PERMIT FEE /00 . &C
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: _ 111L+ _ 1`_.6 * Fee methodology set by Tri- County Building Industry Service Board
_
Print name: S b11
� e ,� 1 ,/'� ,,,A._4_,‘ �) ate: S
1 \ Building \PermitsNEC_PermitApp_040113 doc 440 -46177 (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 $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.\ BuildingTerrmts \MEC_PermitApp 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
11795 SW 91ST AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
05/07/2013 00:00
MEC2013-00239
PASS - No C of O
Violation Summary:
Inspector Contractor