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Permit CITY OF TIGARD MECHANICAL PERMIT _ COMMUNITY DEVELOPMENT Permit#: MEC2009-00584 . e 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 DateIssued: 11/03/2009 Parcel: 1S133CD12200 Jurisdiction: Tigard Site address: 11925 SW WILTON AVE Subdivision: Lot: 0 Project: Atanasov Project Description: Change out to gas furnace add A/C Must maintain a 3' rear and side yard setback Owner: FEES ATANASOV, ATANAS S & ELENA S Description Date Amount 11925 SW WILTON AVE Air Conditioning 11/03/2009 $46.75 TIGARD, OR 97223 12% State Surcharge - Mechanical 11/03/2009 $10.80 PHONE: 503-823-7345 Minimum Fee Adjustment - Mechanical 11/03/2009 $43.25 Contractor: DURAMAX HEATING & COOLING INC 25027 SE HWY 224 BORING, OR 97009 PHONE: 503-558-1260 FAX: 503-637-5394 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressue: 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 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: ely, x//06 ! f Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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 City of Tigard RECEIVED Received Permit No tY Date/By: (1,(ri~((~ tV 56,t_{- 13125 SW Hall Blvd., Tigard, OR 97223 C Plan Review Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 ~.-0V 01-2009 ~ DateBy: Inspection Line: 503.639.4175 Date Ready/By: Juris: See Internet: www.tigard-or.gov Notified/Method: S Page for Supplemental CITY OF TIGARD Supplemental Information TYPE OF W COMMERCIAL FEE* SCHEDULE USE.CHECKLIST ❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work t~}L-1; performed. Indicate the value (rounded to the nearest dollar) of all El Demolition Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: S 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 Job site address: ! l W t Air conditioning (requires site plan showing placement) 46.75 City/State/ZIP: (5\1'1- • Furnace 100,000 BTU (ducts/vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: Project name: Heat um 61.06 Cross street/directions to job site: Duct work 23.32 H dronic hot waters stem 23.32 Residential boiler (radiator or h dronic 23.32 Unit heaters (fuel-type, not electric), in-wall, in-duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue/vent foranof above 23.32 Other: 23.32 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 S Gas fireplace 33.39 G~ C Flue vent for water heater or gas ('~17 IC_ fireplace 23.32 Lo lighter ( as 23.32 Wood/ pellet stove 33.39 Wood fire lace/insert 23.32 Chimne /liner/tlue/vent 23.32 ROPERTY OWNER ❑ TENANT Other: 23.32 Name: i LIB AVC-VIGS 400 . Environmental exhaust and ventilation Range hood/other kitchen qJr Address: ' t S W , l ` equipment 33.39 City/State/ZIP:' (J r- • Clothes d er exhaust 33.39 Single-duct exhaust (bathrooms, Phone: (srp ) 'Z 3 3 y Fax. ( ) toilet compartments, utility rooms 23.32 ❑ APPLICANT Ef-CONTACT PERSON Attic/crawls ace fans 23.32 Other: 23.32 Business name: Fuel piping Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat um City/State/ZIP: Walt/sus ended/unit heater Phone: ( ) Fax:: ( ) Water heater 1 Fireplace E-mail: Range CONTRACTOR Barbecue Business name: Clothes dryer as Kam Other: 4-- Address:'MECHANICAL PERMIT FEES* City/State/ZIP: 6(2.. ~ 7 Subtotal Minimum permit fee ($90.00) Phone: (S"V!-l t~ Z Fax: SC!;,3-J -I Plan review (25% of permit fee) -7 72'1 r' 17 State surcharge (12% of permit fee) CCB tic.: ' _ TOTAL PERMIT FEE Authorized SIatUi . This permit application expires if a permit is not obtained within 180 bn 14 \ days after it has been accepted as complete. FPrint name: 1116.1 Date: iL 0 * Fee methodology set by Tri-County Building Industry Service Board C\Buitding\Permits~ C-PermitApp.doc 10/01/09 440-4617T (I 1/02/COMMEB) ,11 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation `Perriit F „ee • $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. I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 2 ry QQ2c . • 0OS6,9 1 1 i GS t.0 � r1 - 0 -, Au. off' " J Se tock 'C) o rs P� e va c t ^e i �x} G0rci.e '00 z 0