Permit II " CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00527
:T1G,Apb 13125 SW Hall Blvd , Tigard OR 97223 503.639 4171
Date Issued: 10/07/2009
Parcel: 2S102DC00505
Jurisdiction: Tigard
Site address: 9175 SW EDGEWOOD ST
Subdivision: Lot: 0
Project: Sabbe
Project Description: Install wood stove.
Owner: FEES
SABBE, REMI & APRIL Description Date Amount
9175 SW EDGEWOOD ST
TIGARD, OR 97223 Wood /Pellet Stove 10/07/2009 $33.39
12% State Surcharge - Mechanical 10/07/2009 $10.80
PHONE 503 - 639 -4443 Minimum Fee Adjustment - Mechanical 10/07/2009 $56 61
Contractor:
TOUCAN PROPERTY INVESTMENT
PO BOX 4134
HILLSBORO, OR 97123
PHONE 503 - 407 -9393
FAX.
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types.
Gas Pressue:
Total $100 80
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 Notifi • n Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain a copy of the rules
or direct estions to OUNC by calling 503 246.6699 or 1 800 332 2344 r
Issue By: 1 / / �/ Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection 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 OFFICE USE ONLY
City of Tigard
Received
g Date /By JO 7 e) % all y Pennit No t o 9v09,_0D c 5" ,
INI 't 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
Phone 503.639 4171 Fax 503 598 1960 Date/By Other Permit•
Inspection Line 503.639 4175
TLGARD Date Ready /By. Jus ® See Page 2 for
Internet. www.tigard -or gov Notified /Method Supplemental Information
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❑ 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
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� Ile 1 SY S EMS U"Per ;
1;0- and 2- family dwelling ❑ Commercial /industrial 111 Accessory building ”'
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty I Ea Total
t� M x a asx�,,.5:a �' sca t^.:,?" :xrx.. �s+t�.;>•:: ^sn- �,v. � "^- ° •�„a- o " *'.,.��.4bY>
.. , ;y ,. tJO SITE IN ORIGIA',,_,, A LO,C TIONK,,, ' «; ; „p-„ _H Heating /cooling
a�l�. � >. �_�Q��.<������,� �, — .��_�, , -x. rt _ bus � "�:`u
Air conditioning
Job site address: 7/77 Se. .671,„o<- S� (requires site plan showing placement) 46 75
Cit /State /ZIP. 7 ,,,/� Furnace 100,000 BTU (ducts /vents) 46.75
} A! r r ��� Furnace 100,000+ BTU (ducts /vents) 54 91
Suite/bldg. /apt. no: Project name Heat pump 61 06
Cross street/directions to job site Duct work 23.32
Hydronic hot water system 23 32
Residential boiler (radiator or
hydronic) 23 32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 46.75
Flue /vent for any of above 23 32
Subdivision Lot no..
Other. 23 32
Tax map /parcel no.. Other fuel appliances
:h` fl;i ` a> r ,< IS l< ifj _. , �X-. , w � F," .”; �'M. ;-,F., s . , 4ii -. W 23.32
>� ,, ` t; � �;� � � .� � „,F, � �, �` t'�, � r z Water heater
p.Ir "`..5 ;,,T i 9 : ;; DESGs RIPTTONr` , OF> WO ” - -�'1 ; ;�.:.w)z
'^`?`..,°,$, <,�: "• P . u9 ,r;..:.i,�:'w.r�>ra..;.,.�s -. ti .,- ,r, , .:.`<aar : .. •,# � . >, t.�.`�u",:it?. -, a' ..z +.F.:,:�'o- N: �3�
�` Gas fireplace 33 39
—re? el/ .��We Flue vent for water heater or gas
fireplace 23 32
Log lighter (gas) 23.32
Wood /pellet stove / 33.39
Wood fireplace /insert 23 32
Chimney /liner /flue /vent
::,''''''' e''''''''''''''''"'"=1., ' . . = ° tip , „: F �� ryas .. , igrz,i.: 1,, .. ,v.= /flue /vent 23 32
®' „ PR E T,-Y OW NER ' . ` f.-. `1 �. „ < �-
a " OR
_ ,r -z .:�rv� -, ®�TE �: ` r4, ; -, '�°�
^� ., '. =� �r • �• �-: ' �~ '� <a Other: 23.32
Name: 4P ,;" 5 j 46‘, Environmental exhaust and ventilation
S e i JX Range hood /other kitchen
7�
Address: /- t equipment 33 39
City /State /ZIP: ]i/l'G'/ Clothes dryer exhaust 33 39
/ t Single -duct exhaust (bathrooms,
Phone: (0,,3 ) (9_ r3 Fax: ( ) toilet compartments, utility rooms) 23.32
ti ; i ; : §* r,,, air. ;y ,�Fzri � �Rr�;,4Z,V f%r.V ;„ ir � 4* t om .,;:* g'eW� *
; i" , kft,
`' s u ` t - APPLICANT t K4,` 4 ®,CONTACT PERSON �: 4y A tt i c/craw 1 sp ace fans 23 32
,,g
f- '_- at°`.r.^ >3a`E; st''s.- ' .,..,. -..: t.'s:.� < anda.,,.,i ..� s'd:" >Y,"s>"��.1."A•..t?:: .r ;: d.,.. ,r._ MZZwS ,a6.<,z*,- ..x.- ,�:
Other 23 32
Business name. Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Furnace, etc
Address.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax. : ( )
Water heater
Fireplace
E -mail: Range
..E Fvi'd.�"...^ '' '.Lf 'Fy,.l"':T *_ =i.,a - k- �iYt¢' .� y =+:.'F ' ", "-s+::
Kam' .;'? _ '71 ; x' ° o _O " "`; x ,,., V �M n ',, Barbecue
, ;;. ry , ; 0, f e t, �, e ,; CONTRAS Oi4 : : , k ' ' = a<
,'��dr� _�'���;t:�r'�Al;�.,.,,%��_:; �r� ::l , s a> �< . �.. :�,_.,- .- .,-�- tu s:Jvs ^ - -�' a�e,b���- ��`.�``� >; : =� >h..s;= 1t��';'w °•t
Business name` 7,;: cavi / � y �^_ e p r Clothes dryer (gas)
'�`-d� Other
Address: gat ��!/ : -4"° '"4 HI `"' -MECHe1NK>'AI YMIIT"F E *° - w r
�t / `ice., ��- _ _ '� �». ��� >,
Cit /State /Z1P. M` Ave— 9P
Fax�.3 � Subtotal 9 00
Minimum permit fee ($90 00) .
Phone: ( Ci
3 )9 7 � 5� ' ( ) Plan review (25% of permit fee) --
CCB lic . /5-9770 3/1g/to State surcharge (12% of permit fee) /U .
TOTAL PERMIT FEE /06. . 40
This permit application expires if a permit is not obtained within 180
Authorized signature. /.. : ' /` days after it has been accepted as complete.
Print name: �/ Yom !Sa/nPf Date: * Fee methodology set by Tn- County Building Industry Service Board
I \Budding\Permits \MEC- PermttApp doc 10 /01/09 440 -4617T (11 /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
$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.
1 \Building \Permits \MEC- PermtApp doc 10/01/09 2