Permit +, ' �•,
CITY TIGARD MECHANICAL PERMIT
fi DEVELOPMENT SERVICES PERMIT #: MEC2006-00256
°' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/6/2006
PARCEL: 2S110AB -00600
SITE ADDRESS: 14295 SW 112TH AVE ZONING: R -4.5
SUBDIVISION: COLE'S ACRES LOT: 007 JURISDICTION: TIG
Project Description: Install pellet stove & relocate wood stove.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
LELAND MORRIS Description Date Amount
14295 SW 112TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 6/6/2006 $72.50
[TAX] 8% State Surcha 6/6/2006 $5.80
Total $78.30
Phone: 503- 639 -8089
Contractor:
CASCADE CHIMNEY CARE
P.O. BOX 775
ESTACADA, OR 97023 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 630 -3846
FAX 503- 982 -1603
Reg #: LIC 115110
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.
1
Issued By: lii.f.Le__2 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.
� L
Mechanical Permit Applic . t m F OR OFFICE USE ONLY
u `J g . City of Tigard r Received
6 Daze /By. t 1 ��2 ( 1 /��_ `��
q 13125 SW Hall Blvd., Tigard, OR 97223 J U N 6 2006 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date /By Other Permit:
Inspection Line: 503.639.4175 Date Read El See Page 2 for
Internet: www.ti ard -or. ov
T I G A K D g g Cl j Y U �- i t'i.7f i f Dale R B d/Method: Supplemental Information
BI T3SYNC; IITITTRInis,
TYPE OF WORK COMMERCIAL , FEE* SCHEDULE - USE CHECKLIST'
I=I New construction ❑ 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: $
® 1 -and 2 dwelling - RESIDENTIAL =EQUIPMENT, /SYSTEMSFEESI'
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB _SITE INFORMATION AND LOCATION ' . " Heating /cooling
' r Air conditioning or heat pump
Job site address:
`� 2 C ���9 ) /2/4 4- (requires site plan showing placement) 14.00
City /State /ZIP: tc 4,‘ 0 , t 'L 4 7 7 7r 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: CQ4u, � 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
. ' - , DESCRIPTION OF WORK . Water heater 10.00
n Gas fireplace 10.00
T' , / e e IPd —S t r 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
Chimney /liner /flue/vent 10.00
PROPERTY OWNER I ❑ TENANT
Other: 10.00
Name: Le LE k Cic f ytetir - Environmental exhaust and ventilation
`� Range hood/other kitchen
Address: • q 2. qs . 4,0 / /VA. equipment 10.00
City/State /ZIP: t 0, ,) , (J 4._ cj `7 Z ? Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms, .
Phone: ( ' C 3 C ,_rc7A31 Fax: ( ) S4 -.,-,e 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 /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater .
Fireplace
E -mail:
Range
CON'PRACTO�I Barbecue
Business name: c 44-c., 04 t? ` C Clothes dryer (gas)
» ,mil m °ye "ram Other:
Address: c 63 / r 7 7 t M ECHANICAL PERMIT FEES*
City /State /ZIP: ' y t, ex. & , 0 * 1z Cf 7 Subtotal
Phone: ( ) Q . � Fax: ( ) Minimum permit fee ($72.50)
S V� tD �i Plan review (25% of permit fee)
CCB lie.: S surcharge (8% of permit fee
I /D a g( p )
TOTAL PERMIT FEE 'n.3Q
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: -t' 4 Date: 6,.,( ei C • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \ Permits \MEC- PermitApp.doc 04 /06/06 440.46I7T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard r, ,
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 12/30/05 2. •
CITY OF TIGARD ,.. ...
BUILDING DIVISIoN PERMIT #: IvIEC2006-00256
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 •
INSPECTION WORKSHEET FOR DATE: 6116/2006 TIME: 7:00AM PAGE: 80
SITE ADDRESS: 14295 SW 112TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 007 TYPE OF USE:
PROJECT NAME: MORRIS
DESCRIPTION: Install pellet stove 8, relocate wood stove.
OWNER: MORRIS, LELAND PHONE #: 503-639-8089
CONTRACTOR: CASCADE CHIMNEY CARE PHONE #: 50-630384
Inspection Request Scheduled For: Date: 6/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 031803-04 503-639-8089 Y
Corrections/Comments/Instructions:
. 1
1 --- 'PA - L --- El PARTIAL APPROVAL D CANCEL 1 NO ACCESS
fl FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: ,..., Date: ‘ —,/6—‘76, Phone #: (503) 718- — Z - 4--it--<"
. . .