Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00342
13125 SW Hall Blvd., Ti OR 97223 503.718.2439 Date Issued: 07/19/2011
TIGARD 13125 1S135 DCO3100
Jurisdiction: Tigard
Site address: 11545 SW GREENBURG RD
Project: Fitzgerald Subdivision: Lot:
Project Description: Replace gas furnace and NC with a single exterior unit. Unit must meet 3' minimum rear and side yard setbacks.
Contractor: HEAT MASTER CORP. Owner: FITZGERALD, MEGHAN M & JUSTIN M
14456 AMES ST 11545 SW GREENBURG RD
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 233 -2727 PHONE: 503 - 913 -7772
FAX: 503 - 723 -4381
FEES
Specifics: Description Date Amount
Air Conditioning 07/19/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 07/19/2011 $46.75
Class of Work: ALT Type of Const: Duct Work 07/19/2011 $23.32
Occupancy Grp: Fuel Piping 07/19/2011 $14.15
Stories: 12% State Surcharge - Mechanical 07/19/2011 $15.72
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $146.69 ,
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ///
•
Issued By: ,``/ � Permittee Signature: /
Call 503.639.4175 by 7:00 a.m, for the next available inspection date.
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 Applicatio ("1-RECEIVED FOR OFFICE USE ONLY
City of Tigard CEIVA..II) Received ..
- `J g Date/By: -7 /9 // -1 Permit /� // DLJ�
o
14
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 JUL 1 g 2011
TIGARD Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard CITY OF TIGARD Notified/Method: 11 CY Supplemental Information
BUILDING DIVISION COMMERCIAL FEE *' SCHEDULE - USECHECKLIST
' TYPE OF WORK ' .
Mechanical permit fees* are based on the value of the work
❑ New construction NI Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
.CATEGORY OF CONSTRUCTION .
• RESIDENTIAL EQUIPMENT / SYSTEMS "FEES *'..
r1 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi- family El Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION .AND LOCATION Heating/cooling:
Air conditioning 1 �/
Job site address: 11 q6 60 (7 f c-ers &) ` & l (requires site plan showing placement) { 46.75 7�0 .7j 5 '
Furnace 100,000 BTU (ducts/vents) _ / 46.75 5
City/State/ZIP: I , vA- RD /DR 7-2)a 3 Furnace 100,000+ BTU (ducts /vents) 54.91
Suitelbldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) _ 61.06
Cross street/directions to job site: cockw.0 0 5,,,,,_\ 75th Duct work / 23.32 ,2.3 3.'2
f� ` [� �(� \ / ` a , 2 e � Hydronic hot water system 23.32
, v� f11Vt� uV V ���N �Jl C'� 1t� J Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32 _
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
-� t i �y Pt5 /El �`� ; C P „ it k I r , + Gas fireplace
water heater or gas
• 33.39
1 (� / I [ -�.7C, _y,. 7�.1� M1 + Flue vent fo
60 GaIL �o \ %- O1X& 1t�. M„� O pv� fireplace 23.32
t7 S/.� VIJ�)� 1t� I• rC l{/ TN Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
a(. PROPERTY OWNER I ❑ TENANT
Chimney/liner /flue /vent 23.32
v , Other: 23.32
Name: Me A D 0 t�'�.3 t Environmental exhaust and ventilation:
Address: l s 5 iz 6 R , e , g ( R 7-26 � Range hood/other kitchen
33.39
City/State /ZIP: GA RD , i 9'7 3 Clothes dryer exhaust 33.39
Phone: (3) i i 3 - 177'7 Fax: ) list -I c)93 3
Single-duct compartments, rt exhaust (uathro
toilet compartments, utility rooms) 23.32
❑ APPLICANT , ' ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: _
Business name:
Fuel piping:
Contact name: $14.15 for first four; $4.03 for ch additional
Address: Furnace, etc. / /$
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: -
i_
0. 5 F f" T lrt'es Other:
• ( (AC P Clothes dryer (gas)
i j 1 7
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: 451Ze.60 iy Ct il 1DR Subtotal T
Minimum permit fee ($90.00)
Phone: ( ) 3 3 -an xi Fax: ) --7)3- 41 3f Plan review (25% of permit fee)
_ I 4 CB lie.: 9 // /01.- State surcharge (12% of permit fee)
0 TOTAL PERMIT FEE /q( , 69
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
RECEIVED
JUL 1 . 2011
CITY OF TIGARD
k___U BUILDING DIVISION
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation:. Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.