Permit y ., CITY OF TIGARD MECHANICAL PERMIT
'`1 2 COMMUNITY DEVELOPMENT Permit#: MEC2015-00704
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2015
Parcel: 1 S134AD08700
Jurisdiction: Tigard
Site address: 10579 SW WINDSOR CT
Project: WATSON Subdivision: WINDSOR PLACE Lot: 24
Project Description: NC and furnace installation.
Contractor: MASTER HEAT CORP Owner: WATSON,TERRY C&MARIBEL
3226 SE JOHNSON CREEK BLVD 10579 SW WINDSOR CT
PORTLAND, OR 97222 TIGARD,OR 97223
PHONE: 503-678-2517 PHONE.
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 10/19/2015 $46.75
Type of Use: SF Furnaces< 100K BTU 10/19/2015 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/19/2015 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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 oth•
applicable law. All work will be done in accordance with approved plans. This permit will expire if ork is not started within 180 day o
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the O'-goii
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00•1. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.23 • 32.2344.
Issued By: Permittee Signature: ' / e(/
Call 503.639.4175 by 7:00 a.m.for the next available ins,• ion da e.
This permit card shall be kept in a conspicuous place on the job site until c• . •tion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
lig Received
City of Tigard I'ennit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ` MPS— ��� /� I� [, ( � - �Qt�
S Phone: 503.718.2439 Fax: 503. '• Plan Review
' Date.By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
f
Internet: www.tigard-or.gov Notified/Method: '.} _ Supplemental Information•
TYP F
.S11,1\WDK . COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
aI'
�tt- 1,. Mechanical permit fees*are based on the value of the work
❑ New construction ddition/al —010 aCC9t v performed.Indicate the value(rounded to the nearest dollar)of all
if; �� mechanical materials.equipment,labor,overhead,and profit.
❑ Demolition ❑Other: !yl ,�; �, P
4
jj�ii.�l,y�.` Value:S
CATEGORY OF GV�STRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 Z(.(p,lc--
Job site address: /D 59 G,L 7 L!1/,D 5 p 2 G.-T"
Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP: r j 6,+T2 D r 7__ q 9-2 2: Furnace 100,000+BTU(ducts/vents) 54.91
, -�N �^ Heat pump 61.06
l
Suite/bldg./apt.no.: Project name: �roV/L) 2
Duct work 3.3,.
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
�IJ C 0����y � 1 �-k` C� fireplace 23.32
/r Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
— Other: 23.32
❑ PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
�-"
Name: f " '( a r.,,--) Range hood/other kitchen
l a 93-1' to W ice" C.7' Clothes dryer 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: ri 4-'-P D e972_ .1-9-22_3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(6'1,3 9-30 ei 1/F-. Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater _
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
p4� cfeati�rr� ci it1lej4 &%-.Q-2) Other:
Business name: MECHANICAL PERMIT FEES*
Address: Subtotal SD
n�N�e� ��� �jLv 9�3
City/State/ZIP: ?pa:C/44v D l< 1922— Minimum permit fee($90.00) -----"
Plan review(25%of permit fee)
Phone:(tJ 0' &1,0 -7 Fax:( ) State surcharge(12%of permit fee) /i .a-2"
CCBlic.: .2 fZ) 22 g &` /(j� TOTAL PERMIT FEE !oy*7a.
�4 ,, /G/ /}�n /�`,�c This permit application expires if a permit is not obtained within 180
K YC days after it has been accepted as complete.
Authorized signature: + * Fee methodology set by Tri-County Building Industry Service Board
Print name: p.41/ 1,t)_ Date: /Cl— .�/
1:Building.g.Permits MEC_PermitApp_0401 I 3.doc 440-4617T(It 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\Permits\MEC PennitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10579 SW WINDSOR CT, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00704
David Young
Correction complete, inspected 10/26/15.
Violation Summary:
Inspector Contractor