Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00586
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/20/2011
Parcel: 1S 134CD07200
Jurisdiction: Tigard
Site address: 11730 SW TIGARD DR
Project: STEVENS Subdivision: BURLWOOD NO.3 Lot: 32
Project Description: Duct work and electronic air cleaner installation.
Contractor: MUEHE QUALITY HEATING INC Owner: STEVENS, DONNA MARIE
7301 SW KABLE LN #500 11760 SW TIGARD DR
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503 - 598 -0966 PHONE:
FAX: 503 - 598 -8498
FEES
Specifics: Description Date Amount
Duct Work 12/20/2011 $23.32
Type of Use: SF Other, ExhaustNentilation 12/20/2011 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/20/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/20/2011 $43.36
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 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.
/ A
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.
Dec 16 11 04:35p Muehe Quality Heating 503- 598 -8498 p.2
Mechanical Permit Application ' .. FOR OI is L l F ONLY -
City of Tigard C.) 0'
III Received Date/BY: 1� /fD .1IA Permit ,g:ad t --cJ 5 .(. i f 13125 SW Hall Blvd., Tigard, OR 9 ':
l ' Phone: 503.718.2439 Fax 503.59 a + 1 % 4 s) EEIEINMIIMIIIIIIIIII Other Pemtit
f l v h h n Inspection Line: 503.639.4175 ! C. �G� ♦S�� e Ready/By Juris: H See Page 2 for
Internet: www.tigard or.gov �" 11 G `� 4 $1 No tifieci 1 Method: • Supplemental information
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TYPE OF WORK 11r�a COMMERCIAL FEE* S CtIEDI1LE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alterationtic v ent performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: S
CATEGORY OF CONSTRI'Q I t RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
►i1 1- and 2- family dwelling ❑ Commercialiindustr at U Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder 1111 Other. Description I Qty. I Ea. Total
JOB SITE INFORMATION ANI 1 OC • TION Heating/ceoling:
Air conditioning
Job site address: 11730 SW Tigard Drive '(requires sire plan showing placement) • 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/Nests) 46.75
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt, no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: SW 121 and SW Surrm'r S est Drive Duct work 1 23.32 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32 __
Unit heaters (fuel -type, not electric).
in -wall, induct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32 i
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Remove existing filter cabinet and partial ductwork; iasbl ectronic air Gas fireplace 33.39
Flue vent for water heater or gas
cleaner and install new, larger ducting; make minor adjtstm nts fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Angela Bremer Environmental exhaust and ventilation:
Address: same as above Range hood/other kitchen
equipment 33.39
City /State/ZIP: Clothes dryer exhaust 33.39 ,
Single -duct exhaust (bathrooms,
Phone: (503)956 -1111 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ® b INTACT PERSON Att ic /crawlspace fans 23.32
Other: EAC I 23.32 23.32
Business name: Muche Quality Heating, Inc. Fuel piping:
Contact name: Kyle Birman $14.15 for first four, 54.43 for each additional
Address: 7301 SW Kable Lane, Suite 500 Furnace, etc.
Gas heat pump
City /State/ZIP: Portland, OR 97224 Wall/suspended/unit heater
Phone: (503) 5980966 Fax: : (503) 5'': -8498 Water heater
E -mail: MQHKYLE@INTEGRA.NET Fireplace
Range
CONTRACTOR Barbecue
Business name: Muehe Quality Heating, Inc. Clothes dryer (gas) ,
Other:
Address: same as above MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 46.64
Phone: ( ) Fax: ( ) Minimum permit fee (590.00) 43.36
Plan review (25% of permit fee)
CCB lie.: 50096 State surcharge (12% of permit fee) 10.80
4 TOTAL PERMIT FEE 101) 80
Authorized signature: 41100 This permit application expires if a permit is not obtained within 1810
S days after it has been accepted as complete.
Print name: Kyle Birman Date: 12/16 /11 ` Fee methodology set by Tri-County Building Industry Service Board
1:1Buildmg\Pamits\MEC PermitApp doe 09/09/10 440 -46I7T (1:102/COr eB)
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