Permit V CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00068
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/18/2009
PARCEL: 2S110BD -03900
SITE ADDRESS: 11933 SW ELEMAR CT ZONING: R -4.5
SUBDIVISION: ASPEN RIDGE LOT: 004 JURISDICTION: TIG
PROJECT: SAYLOR
Project Description: Replace furnace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SAYLOR, GEORGE W AND ALICE E Description Date Amount
11933 SW ELEMAR CT
TIGARD, OR 97224 [MECH] Permit Fee 2/18/20. $72.50
[TAX] 12% State Surch 2/18/20. $8.70
Phone:
Total $81.20
Contractor:
MECHANICAL INC
PO BOX 19569 REQUIRED ITEMS AND REPORTS
PORTLAND, , O R 97280
OR
Contact #: PR! 503- 244 -1730
FAX 503- 245 -7613
Reg #: LIC 124283
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 By: 116 C 1 f I I $_ 1 Permittee Signature: C r ja A l I c v
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
- "1. F e b. 18. 2009_2 3: 1 9 PMapiicati • t ECE , ' No, 0114 P. 2
City of Tigard r Receive
d
N 13125 SW Hall Blvd., Tigard. OR 97223 Date/By: - • . Q „sta. No.: ��� Q
II
0 • Phone: 503,639.4171 F ax: 503,598.1960 FEB 1$ LUUJ Plan Review
• lc;,u;_t 503.639.4175
, Inspection Line:
Date /By: Other Permit:
Internet: Line: and -ar. v Date Ready/By:
g° CITY OF TIGARD Notified/Method: Supplemental
DING1)IVISIONI _
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST • ❑ New construction [Y 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
❑ Demolition ❑Other:
mechanical materials, equipment, labor, overhead, and profit,
�
CATEGORY OF CONSTRUCTION Value: $
121- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEW
[] Multi- family Q Master builder 0 Other: For special it7formarion use checklist,
JOB SITE INFORMATION AND LOCATION Hea He in /c Qty. ) a. Total
ting/cooling
Job site address: r 5 - p C r. Air conditioning or heat pump
City/State/ZIP: • re aims site lao i_i_ lacement 14,00
O 7 Furnace 100,000 BTU (ducts /vents) 14,00
Suite/bldg. /apt, no.: Project name: 5 .1 l a R Furnace 100,000+ gTU (ducts/vents) . 17.90
Gas hcatpump 14.00
Cross street/directions to job site: Duct work
10.00
moronic hot water system 14.00
Residential boiler (radiator or
— hydronic) 14.00
— Unit heaters (Biel -type, not electric),
— —
in -wall, in -duct, suspended, etc. 14.00
- Subdivision: _ Lot no : Flue /vent for any of above 6.80
Tax map /parcel no.: Other: 10.00
Other fuel ap 1p lances
DESCRIPTION OF WORK Water heater _ 10.00
---) " G
NIT— Gas fireplace 10.00 —
Flue vent for water heater or gas
fireplace
10.00
•— Log lighter (gas) 10.00
Wood/pellet stove 10.00 •
Wood fireplace/insert 10.00 J
❑ PROOPEERTY OWNER ❑ TIINANT Chimney /liner /flue/vent 10,00
Name: �.1�' ,7 i ct+ 5 , I j 1 f Other; _ 10.00
4l J Environmental exhaust and ventilation Address: ` Range hood/other kitchen
City/State /ZIP: — e ui met 10.00
Clothes dryer exhaust 10.00
Phone; t ) 2 70 q311 / Fax: ( ) Single-duct exhaust (bathrooms,
['APPLICANT toilet compartments utility rooms) 6.80
❑ CONTACT PERSON Attic /crawlspace fiats 10.00
Business name: seig y4 (^ .T `,., Other: 10.00
Contact name: r 1 r .�'` � C
'� ^�•
• Fuel 1 i
�.ML) j,,, ) ' t T E $5.40 for first Pour; S1_00 for each additional
Address: • • I . Ti 4 — Furnace, etc.
City /State/ZIP: D r rj Q Gas heat pump
City/State/ZIP:
C yy�� _ Wafususpcnded/unit heater
J VJ) / — ? � Fax:: 6 ) 7623 Water heater
E-mail: Fireplace
Range
• CONTRACTOR Barbecue _.
Business name: Clothes dryer (gas)
Address: Other:
MECHANICAL PERMIT FEES" ,
City/State/ZIP: - —
_ Subtotal '
Phone: ( ) l Fax. ( ) - Minimum permit fee ($72.50)
CC$ lie.: • Plan review (25% of permit fee)
a j ♦ —rm.. surcharge (12% of permit fee)
trill . TOTAL PERMIT FEE
Authorized signature: Tbla permit applleatioa expires ft s per is not ob tained within 180
Ir
t v
Print name: A 1 / days after it has been accepted as complete.
► Date: a ' Pce methodology set by Tri- County Building Industry Service Board
1' uHullding mnits C.PermitADp.doe 01/19/07
440.4617T (11/02/COM/WBB)
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: NI e02ooq,Cx'cun8 REQUIRED ON GREEN INSPECTION CARD.
1 ✓• Code •I Inspection Description .I; PASS.Date I:By - 4 /
:., :: Code;,. I;'Inspection.Descnptior •;'.; "�: PASS -Date B
BUP - •Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
j 205 Footing 120 Electrical rough -in
j 805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
j _ 220 Slab 140 Sign installation
310 Crawl drain
145 A/C or heating unit circuit
I 225 Post /beam structural 150 Hot tub /spa /pool
1 230 Underfloor insulation 195 Misc. inspection: •
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
I 245 Firewall
250 Roof nailing ELR _ Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
1 270 Reinforcing steel (rebar) .
275 Framing
■ 810 MFG - Structure set -up MEC - Mechanical Permit
! 280 Insulation •
605 Post /beam mechanical
j 285 brywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
1 295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
i 498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection: •
X_ _ 699 _ Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
910 Sprinkler rough -in PLM - Plumbing Permit .
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
1 . 330 Water service
335 Rain dram
340 Storm drain •
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tink
415 Grading 395 Misc. inspection:
205 Footing 399 _ Plumbing final
i ~ 210 Foundation walls
1 215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
_ 499 Final inspection _ 599 Final inspection
!: \ Building \Forms \InspCard- AOP- Blank.doc 02/02/07