Permit CITY TIGARD MECHANICAL PERMIT
rA' DEVELOPMENT SERVICES PERMIT #: MEC2005 -00113
r � 1 1 � 13125 SW Hall Blv Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/16/2005
PARCEL: 2S112BC -03200
SITE ADDRESS: 14685 SW 83RD AVE ZONING: R -4.5
SUBDIVISION: HAMBACH PARK LOT: 016 JURISDICTION: TIG
Project Description: Bathroom exhaust, add 1 register.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS: 1
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
RALPH STAEGER Description Date Amount
14685 SW 83RD AVE [MECH] Permit Fee 3/16/200E $72.50
TIGARD, OR 97224 [TAX] 8% State SurcharE 3/16/200: $5.80
Phone: 503 - 598 - 0362 Total $78.30
Contractor:
COMPLETE COMFORT SYSTEMS INC
12300 SW 69TH AVE. REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Phone: 503 - 598 - 4798
Reg #: LIC 152736
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 i n 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 • 2- 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct ques s to • UNC by cal ng 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: 7f24,,da.tee Permittee Signature: 4 1
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business • ay.
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.
,
Me ha nic L 1 - j i i i � �; I •1 � ; t10ll FOR OFFICE USE ONLY
, W t__ I s
CIt 'i 'l l I, 1 Receive Permit n
1312 ll SW Hall Blvd., Tigard, OR 97223 DateByD f 6 / 1 I/� �(�j ....661, �3 Plan Revie
Phone: 503.639.4171 Fax: 503.598.M5 /4t Date/By:
� y.
Other Permit:
Inspection Line: 503.639.4175 ■ y, rI I Date Ready/By: See Page 2 for
Internet: www.ci.tig rWirYsOF TIGARD ` r """' Notified/Method: � Supplemental Information
'3UILDING DMViSION
TYPE OF WORK _ COMMERCIAL FEE* SCHEDULE USE CHECKLIST
❑ New construction 4 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.
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CATEGORY OF CONSTRUCTION Value: $
�,, RESIDENTIAL' EQUIPMENT / SYSTEMS,'FEES*
:IJ 1- 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: 1 Li. ( ?s 5 w Q 3 2 u Air conditioning or heat V (requires p
uires site plan showin g placement) 14.00
City/State/ZIP:7"I a y 4 b 2 S-) z 23 Fumace 100,000 BTU (ducts/vents) 14.00
5 I Fumace 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
,) l s /- W , Hydronic hot water system 14.00
S� ��(A 4 J gen-114 Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above / 10.00
• Other: "e47 MVSft Y 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
qel ei 14 vS� A� ) i Gas fireplace g 10.00
d � Flue vent for water heater or as
fireplace 10.00
P SI `c SI 4/ Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: / G OS S a 3 PZ el Range hood /other kitchen
equipment 10.00
City/State/ZIP: s.,. V 0 9 7 2 Li Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) I 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace 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 heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: C S L inGG/�o�, )c Clothes dryer (gas)
Other:
Address: /2..3 O O S `7 f
r S MECHANICAL PERMIT FEES* .. `'
City/ State/ZIP: 7 i cD Q� 5" 7 7Z 3 Subtotal
Phone: O3 ) S ! v ` d Fax: (A) 6,3 9 ....O y 9 a Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: ' 5 Z -73 G State surcharge (8% of permit fee) if. J TOTAL PERMIT FEE 3jv
l _ This permit application expires if a permit is not obtained within 180
Authorized signature: , e days after it has been accepted as complete.
Print name: _ t o s y J j /1_ Date: 01 I i i f J S' * Fee methodology set by Tn - Coo� , � unty Building Industry Service Board
V
i:\ BuildingTermits \MEC- PermitApp.doc 12/03 " 440-4617T(11/02/COM/WEB) �`U
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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.
$10,001.00 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
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CITY OF- TIGARD
BUILDING DIVISION PERMIT #: IVEEC200a 00113
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2005
Phone: (503) 639 -4171 4 ����'�4I' ii
Inspection Requests (24 Hrs.): (503) 639 -4175 :��
INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: 71
SITE ADDRESS: 14686 SW 83RD AVE CLASS OF WORK:
SUBDIVISION: HAMBACH PARK LOT #: 016 TYPE OF USE:
PROJECT NAME: STAEGER
DESCRIPTION: Bathroom exhaust, add 1 register.
OWNER: STAEGER, RALPH PHONE #: 503 - 598 -0362
CONTRACTOR: COMPLETE COMFORT SYSTEMS INC PHONE #: 503 - 598 -4798
Inspection Request Scheduled For: Date: 7/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010604 -01 503 - 589 -4798 N
Corrections/Comments/Instructions:
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7 P� ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A Date: - 7—/-0 Phone #: (503) 718-