Permit ti
A - CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00189
�.5 DATE ISSUED: 5/8/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CB 11900
SITE ADDRESS: 15414 SW 81ST AVE ZONING: R -7
SUBDIVISION: ASHFORD OAKS NO. 2 LOT: 133 JURISDICTION: TIG
Project Description: Replace furnace.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 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: IT
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
ARTHUR MAUER Description Date Amount
15414 SW 81ST AVE
TIGARD, OR 97224 [MECH] Permit Fee 5/8/2006 $72.50
[TAX] 8% State Surcha 5/8/2006 $5.80
Total $78.30
Phone: 503 - 598 -9322
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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: . 2L12 . 22 .. —. Permittee Signature:
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.
r
" Mechanical Permit Ap
FOR OFFICE USE ONLY
City Received �1 Ci of Tigat'rd Date/By.. V 1:VP/ ,r
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
r '
Phone: 503.639.4171 Fax: 503.598.1960 IA"'111 g . •' Date/By:
Inspection Line: 503.639.4175 MAY 0 8 20 4. 11 Date Ready/By: El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: ES Supplemental Information
PI OF f kJ
' i e '
ID New construction [I Addition/alteration/replacement n/alteration/replacement ��'ORK c, !TRI N COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
t 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: $
12 1 - and 2 family dwelling ❑ CommerciaUindustrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
•
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: . — / / L / w 1 S V v Air conditioning or heat pump
J % / (requires site plan showing placement) 14.00
City /State /ZIP: 1 9 7 (/ Furnace 100,000 BTU ( ducts/vents) r 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision S . � -r ® Lot no.: Flue /vent for any of above 10.00 _
���""" `" Other: 10.00
Tax map /parcel no.: Other fuel appliances
DES CRIPTION OF WORK Water heater 10.00
:1 Gas fireplace 10.00
-� , tb G Yrt i\u Ncv (,- Flue vent for water heater or gas
fireplace 10.00
Loglighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10.00
ROPERTY OWNER ❑ TENANT
Other: 10.00
Name: , t ) , \ , \...)‘. �✓ Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (g) 5 9'' ' 3q.2Z Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
•
Contact name: 0 ^� ,__-- 't A/ $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 heater
Fireplace
E -mail: Range
. ' CONTRACTOR . Barbecue
Business name: �� ,
'.��
Clothes dryer (gas)
Q ( Other:
Address: MECHANICAL PERMIT FEES* '
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE -7 717
Authorized signature This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 13! (l (/ U /t u 0+ Date: r 5 • Fee methodology set by Tri-County Building Industry Service Board
i:\Building\Permits \NEC- PennitApp.doc 12/03 440.4617T (I1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: 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.
$1 0,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or •
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200S.00180
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/200(i
Phone: (503) 639 - 4171 " "�"��NPuipiy'�II
Inspection Requests (24 Hrs.): (503) 639 -4175 ' :_..
INSPECTION WORKSHEET FOR DATE: 5/17/2006 TIME: 7 :06AM PAGE:
SITE ADDRESS: 15414 SW 8'1ST AVE: / CLASS OF WORK:
SUBDIVISION: ASHFORD OAKS NO. 2 T #: 133 TYPE OF USE:
PROJECT NAME: MAUER
DESCRIPTION: Replace furnace.
OWNER: MAUER, ARTHUR PHONE #: 503.59€ -922
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/17,2006 Pour Time:
Code # e Inspection Description Confirm # Contact # Message
p p o e g
699 Mechanical final 030008.01 503.588 -3922 N
Corrections/Comments/Instructions:
de
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X . PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Date: / Phone #: (503) ��`"�f
Inspector: / ( ) 718-