Permit CITY OF TIGARD
i3 7 MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00090
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/21/2008
PARCEL: 25111 CC -15800
SITE ADDRESS: 10015 SW HIGHLAND DR ZONING: R -
SUBDIVISION: SUMMERFIELD NO.4 LOT: 209 JURISDICTION: TIG
PROJECT: WALTER
Project Description: Replace gas furnace, mount tankless gas water heater, install gas fireplace, venting and piping for wa
heater, range, fireplace & furnace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 3
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 3
> 10000 cfm:
Owner: FEES
MIKE WALTER Description Date Amount
10015 SW HIGHLAND DR
TIGARD, OR 97224 [MECH] Permit Fee 2/21/200€ $72.50
[TAX] 12% State Surch 2/21/200€ $8.70
Total $81.20
Phone: 503- 684 -1224
Contractor:
PIONEER GAS FURNACE
2636 NE SANDY BLVD
PORTLAND, OR 97232 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 249 -5000
Reg #: LIC 173181
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued y: #'# /�2�I Permittee Signature: / 7
Call 503.639.4175 by 7:00 a.m. for inspections 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 Pe II : t
, i l; 1. r� n
'--' 1 _ I - ' L.' � Received
City of Tigard !;, t _, - r r)ate/ISy: a 2 6t1 Og Remit Nn.. J ��C�2'j� - CL'Y�'/
13125 SW Hall Blvd., Tgard, OR 9722.1 flan Review
Phone: 503.639.4171 Fax: 5t 0 ),11 61) 2QQ(1 n A rM , , Date /Ity. Other rennet:
Inspection Line: 503.639.41751 C T 'I I Date Ready /ley: lures: El See Page 2 for
r; Internet: www.ci.ligard.or.us OF . D n` Notified/Method: Supplemental Information
'T „ t , 1J`�t
7" b ' . glil E OF WORK COMMERCIAL FEE" SCHEDULE 03 i T'
❑ New construction Addition /alteration /replacement Mechanical permit fees' are based on the value of the work
-- performed. Indicate the value (rounded to the nearest dollar) of all
.0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
i; .- `T7W; t ?`^ ' CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYST t§
55 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Fier special information use checklist.
D Multi family ❑ Master builder ❑ Other: Description I Qty. I Ea. 1 Total
M, n r O ;i t,j. ;: d
��, � ,� � ,.. JOB'SITE` 1fNFORIi1ATlON AND LOCATION Heating/cooling
(k Air conditioning or heat pump
Job site address: / ex , / S _ , /l r 9 II/ a; ^, D bIZ (requires site plan showing placement) 14.00
• City /State/ZIP: T 14 b d 12 9 7z Zy ._ Furnace 100,000 BTU (ducts/vents) 1 14.00
Furnace 100,0001- BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name:
Gas heal pump 14.00
Cross street/directions to job site: Duct work 14.00
I lydronic hot water system 14.00
- Residential boiler (radiator or
hydronic) 14.00
• Unit healers (fuel-type, not electric),
in -wall, in -duct, suspended, ctc. 10.00
Subdivision: I .ol no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map/parcel no.: Other fuel appliances
�; .1, ?.', '" DESCRIPTION OF WORK Water heater I. 10.00
'" ~! T Gas fireplace 1 1 0.00
( 4-S' - 1-e, &- s / 2l mss' ¢ R t r N „o / - N Flue vent for water heater or gas
• , ( /�.,� fireplace 10.00
!� 1 '0' (Jet.' T I ' ew ^v �e �04r1. e O Cl � I ,og l ig h ter (gas) 10.00 •
. (,4)/iq Wood /pellet stove 10.00
, }' Wood fireplace/insert 10.00
,:" Chimney /liner /flue/ vent 10.00
t ' U PROPERTY OWNER l ❑TENANT Other: 10.00
Name: O I fc e. l-4)4.- 7 . �,. f f Environmental exhaust and ventilation
Address: I Range hood /other kitchen
/00 15 St Ii 1 G A /M NtD 1 0 iz equipment 10.00
City /State/ZIP: � 4iy zD a Q 9 7L - _ Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 4 E43 ) `g`/ g z z y Fax: ( ) toilet comparttnents, utility rooms) 6.80
ital, ;. El APPLICANT ❑ CONTACT PERSON Attic/crawlspacc fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $ 1.00 for each additional
•' Address: Furnace etc.
`''
Gas heat pump
City /State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: ( )
Water Healer l
Fireplace
E -mail: Range 1
3', 4 �!€ ,w,.:.. CONTRACTOR Barbecue
.Business name: /0/ N `O e� / 7 �' A ' e Clothes (irycr (gas)
(� y��{ J ( Other:
', Address: 1,3L NI( .5fa -K®1 I w o MECHANICAL PERMIT FEFS!:i:-
',` City/State/ZIP: A 1/ . 7 1 / a nd , C1 q 2. - Subtotal
5 0 . Q Minimum permit fee (572.50) / �Phone: Phe: ( 5 f 3 Fax (503 249 O Z6,0 Plan review (25% of permit fee)
CCB lie.: J 1 31g 1 Slate surcharge (8% of permit fee) e. 70
r I'O "I'A PERMIT FEE ` Q, w-
This permit application expires if a permit is not obtained w tthi 1110 J
• Authorized signature: " - : �I� _ _ _ _ days after it has been accepted as complete -
I Print name: - 1 1)31r" D --z__( • Fee methodology set hy'Fri- County Building Industry Service Board
• Mechanical Permit Application - City. of Tigard
Page 2 - Supplemental Infor'ination
Commercial Fee Schedule:
V�aloeation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $1 00.00 or. :
fraction thereof, to and including
•
$50,000.00.
$30,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$ I.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.0I and up $1,396.50 for the first $ 1 00,000.00 and
$1.10 for each additional $100.00 or
• fraction thereof.
Note: All new commercial buildings require 2 sets of plaits.
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