Permit CI TY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00427
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/16/2007
PARCEL: 2S 110DD -11000
SITE ADDRESS: 15510 SW 109TH AVE ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.13 LOT: 680 JURISDICTION: TIG
PROJECT: FESSLER
Project Description: Install a/c unit.
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: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MELVIN & MARGARET FESSLER Description Date Amount
15510 SW 109TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 7/16/2007 $72.50
[TAX] 8% State Surcha 7/16/2007 $5.80
Total $78.30
Phone: 503- 336 -0890
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.
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Issued B j ��� 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.
Mechanical Permit Application -` FOR O FFICE USE ONLY .
City of Tigard A to " ga s Date /B y � Permit No. r �l ,� L
114
e 1 3125 SW Hall Blvd., Tie a � ` c �t/i
. . '3'5'98. 3 _� Plan Review Other Permit: ` - ,.
$. Phone: 503.639.4171 Fax: S0 1T b � D /B r /
�T I li A R D Inspection Line: 503.639.4175 Date Ready /By. Fiffli la See Page 2 for
• . _. Internet: www.tigard - or.gov JUL 1 6 2001 Notified/Method: Supplemental Information
T4_dlilvi+ 11K I. 1"� �^ig, COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction i /a1�ia lgicia �v l s 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: $
p � / RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Ja '- 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: /6 SG() /. Air conditioning or heat pump L`
/D ( � � (requires site plan showing placement) / 14.00 i 7. 06
City /State /ZIP: �t A.._ew r 9 T,2 a ¢ 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: 44.64- ST Ic /) Duct work 10.00
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. 14.00
Subdivision: Lot no.:
Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/� Gas fireplace 10.00
4 (ir t // , e 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
.PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: `l�� , {/M g-T a^ _r l.-14 Environmental exhaust and ventilation
Address: /SS W) S'r.J /O 9 t 1 7 jE Range hood /other kitchen
equipment 10.00
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City /State /ZIP: 76 .w 'ZZ 1 Clothes dryer exhaust 10.00
/ Single -duct exhaust (bathrooms,
Phone: ( Sb3 ) 236 U F'''Y Fax: ( ) toilet compartments, utility rooms) 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 /Z1P: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
(' tU��� Clothes dryer (gas)
Business name:
Other: *-
1
Address: MECHANICAL.PERMIT FEES* _ .
City /State /ZIP: Subtotal /4/ oC)
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) 7-Z . 5
Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee) 5. m
TOTAL PERMIT FEE 78'. 3(
/ /./ This permit application expires if a permit is not obtained within 180
Authorized signature:
��� A0Q days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermuApp doc 01/19/07 440 -4617T (1 I /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.
$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- PennitApp.doc 01/19/07 2
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CITY OF TIGARD �'
CI
BUILDING DIVISION �����,w 1 P ERMIT #:
O MEC2007. 27
13125 SW Hall Blvd., Tigard, OR 97223 (du" DATE ISSUED: i 6/ 10
Phone: (503) 639 -4171 y o / P . ilhz# iii ��l
Inspection Requests (24 Hrs.): (503) 639 -4175 .....9.W - _ :_..
INSPECTION WORKSHEET FOR DATE: 8/29/2007 TIME: 7:00AM PAGE: 61
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SITE ADDRESS: 16510 SW 109TH AVE CLASS OF WORK:
SUBDIVISION: SUMMERI-IELD NO 13 LOT #: 680 TYPE OF USE:
PROJECT NAME: FFSSLER
DESCRIPTION: Install a unit.
OWNER: FF_SSLER, MELVIN & MARGARET PHONE #: 50:3. 336.10890
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 054769.02 603.33601391E 4" _ ,
Corrections/Comments/Instructions:
0/
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: Date: 2 _ 9 7 Phone #: (503) 718-