Permit CI TY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00419
;1112. DATE ISSUED: 8/23/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 133DC -16500
SITE ADDRESS: 13078 SW LAURMONT DR ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT: 020 JURISDICTION: TIG
Project Description: Gas line from meter, increase size with new line to kit. stove.
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:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
WALTERS, JAMES B + CHRISTINE L Description Date Amount
13078 SW LAURMONT DR
TIGARD, OR 97223 [MECH] Permit Fee 8/23/200E $72.50
[TAX] 8% State Surcha 8/23/200E $5.80
Total $78.30
Phone: 503 -529 -7085
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: �� / Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that b mess 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.
,t,. li
1VMechanical Permit Appl �' FOR OFFICE USE ONLY , -
Received
City of Tigard Date/By T Ob .i ' Permit No.:M CC pO6 - O D ''
° 13125 SW Hall Blvd., Tigard, OR 97223 A 2 .: 2006
4
Phone: 503.639.4171 Fax: 503.598.196 �' �oos Plan Review
Date/By Other Permit:
T I G A R D Inspection Line: 503.639.4175 - - G n � h ee Date Ready/By: tubs: ® See Page 2 for
Internet: www.tigard- or.gov �.lil. 't_/' ,L1 A Notified/Method: Supplemental Information
TYPE OF WORK , ,COMMERCIAL FEE* :SCHEDULE - USECHECKLIST
❑ New construction 21 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: $
. 'RESIDENTIAL EQUIPMENT / SYSTEMS' FEES*
.a 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. I Ea. I Total
. . JOB SITE INFORMATION AND 'LOCATION' ' . Heating /cooling
Air conditioning or heat pump
Job site address j 3O t (� • �!�/2Gl7orr� / 1//' (requires site plan showing placement) , 14.00 ,
City /State /ZIP: 601-7i O A q -7 2--- 3 Furnace 100,000 BTU (ducts/vents) _ 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: -- 5- e t-AL5GLs F - Sdv Duct work 14.00
c f`] ' )) )11 V h 1 f iv �r 7 Residential i hot wat
boiler a or sstem 14.00
J � � /�• � • I�7'- � �r� ‘� esidentir (raia
fit" " / t�� �• ftiz i 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: 10.00
Tax map /parcel no.: Other fuel appliances
.DESCRIPTION OF 'WORK Wat er heater 10.00 i
�^� � Gas fireplace 10.00
L-fl. x / /' /Op2 `/f7 T,Lsz., ? f f-C'g 0 Flue vent for water heater or gas
fireplace 10.00
CH 2-A F- / l i W UNA' fai Log lighter (gas) 10.00
/Z _se. 7 (/ Wood/pellet stove 10.00
• Wood fireplace /insert 10.00
. Chimney /liner /flue/vent 10.00
P.- ROPERTY OWNER , " ❑ T,ENANT .
Other: 10.00
Name: V ) In/ iq.(�- Environmental exhaust and ventilation
,r/ J Range hood/other kitchen
Address:
/ S Lf/ ° r �"�2�" ®� equipment 10.00
City /State /ZIP: t ja- , 1 2 . Clothes dryer exhaust 10.00
S .2 . -7U SS- Single -duct exhaust (bathrooms,
Phone: (� t3) 7oZ _ 0/ S[ Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT . - ❑ . CONTACT PERSON, ' ' Attic/crawlspace fans 10.00
Business name: Other: 10.00
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
Clothes dryer (gas)
Business name: A)WQ)-L. Other:
Address: - , MECHANICAL PERMIT FEES* •
City /State /ZIP: Subtotal q., Minimum permit fee ($72.50) ^ `R_
'Phone: ( ) Fax: ( ) Plan _review _(25 %.otpermit fee)_
• CCB lic.: State surcharge (8% of permit fee) W
TOTAL PERMIT FEE ,��.
Authorized SlgnatUre: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: J f /47 w 1i7 4 4 L S Date: - u�3 , T/V • Fee methodology set by Tri- County Building Industry Service Board
OCR
I:\ Building \Permits\MEC - PermitApp.doc 04 /06/06 440 -4617T (I I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
„Total.Valuation - � Permit Pee:
$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.
•
•
1:\Building\Permits\MEC- PermitApp.doc 12/30/05 2 •
CITY OF TIGARD .IP 111
BUILDING DIVISION
PERMIT #: IvIEC2006.00419
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2006
Phone: (503) 639-4171 : Ni
Inspection Re t quests (24 Hrs.): (503) 639-4175 ....-_,E# ....... Alg Aiva - Oo W.7
INSPECTION WORKSHEET FOR DATE: 8/24/2006 TIME: 6:69Alvi PAGE: 10
SITE ADDRESS: 13078 SW LAURMONT DR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #: 020 TYPE OF USE:
PROJECT NAME: WALT
DESCRIPTION: Gas line from meter, increase size with new line to kit. stove.
a■lom. anu m■m m ,
OWNER: WALTERS, JAMES B + CHRISTINE L, PHONE #: 503-5294085
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 036510-01 503-624-6085 Y
Corrections/Comments/Instructions:
-1 ' <:_. ... ( -1 - e - z - ,r— — -.-= .2e e5., — 7. - AL ' /:
•
', ' e•
11, ik
_ •
I PARTIAL APPROVAL I CANCEL n NO ACCESS
n FAIL H CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ./. Date: 2, 24- Phone #: (503) 718-
L ___ _. , . ..