Permit CITY OF TIGARD MECHANICAL PERMIT
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` 12 • •a' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00433
T1 G ARIA 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/19/2009
, .. Parcel: 1S134AD00900
Jurisdiction: Tigard
Site address: 11374 SW IRONWOOD LP
Subdivision: Lot: 0
Project: Davis
Project Description: Install new woodstove, connect to existing chimney.
Owner: FEES
DAVIS, PETER S AND MARY A Description Date Amount
11374 SW IRONWOOD LOOP Wood /Pellet Stove 08/19/2009 $10.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 08/19/2009 $8.70
PHONE. Minimum Fee Adjustment - Mechanical 08/19/2009 $62.50
Contractor:
CASCADE CHIMNEY CARE
P.O. BOX 775
ESTACADA, OR 97023
PHONE: 503 - 638 -3846
FAX: 503 - 982 -1603
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
N ...1
Issued By: / Q p t Permittee Signature: W 61
Call 503.639.4175 by 7:00 a.m. for an inspection that business da
Y P Y .
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.
Meth nacal Permit Application tj, r , . FOR OFFICE USE ONLY •
C O f T an d I % Received
` , g ' DateBy
Plan Review , , Permit No.: I `.
13125 SW Hall Blvd., Tigard, OR 97223
. Phone: 503.639.4171 Fax: 503.598.1960 AUG 1 9 2009 Date/By: Other Permit
TIGARD Line: 503.639 Date Ready/By: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified /Method: IIIM Supplemental Information
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rFEE SCHEDULE T LH °i ,,C)<CI I r a
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Mechanical permit fees* are based on the value o th wor
❑ New construction A Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
` , ........,. �CATEGOR
, s�3. � � OF C. ST � k ' -;� '� Value:
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' i- 1R - ESIDE T8NPA 1IeMENT TS S
KTR IArlEES* ;s.;.^
0 1- and 2- family dwelling 1:] Commercial /industrial ❑ Accessory building ` "� I � ` "� °� ` '
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
., a °rb <u �tc � ,;. � = : - %�, � <,..,, - » .^�;,;.:... s ^ ,�,� .: -:c, - u-.r >: .>~: " s'^"X -�'?.� , `�S:a "s
� � c rJ OB S INF OR T ION ° A ND LOCATIO , - ., -, Heating /cooling
Job site address: o�"�0/�1 Loop Air conditioning or heat pump
-- N � ' k D �} � OOd V (requires site plan showing placement) 14.00
City /State /ZIP: -TIIrd t U f . q - .a a3 Furnace 100,000 BTU (ducts /vents) 14.00
Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: . 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
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
, -, M.i V , ` r i +I.g L O OF WaR' % . i l -', ,, Water heater 10.00
s
;a , ;4M . �a : rg.a : � .t :-s. _. , ,k :� a4
.4.4.;,,. s -O r° w"at Gas fireplace 10.00
ho ok - Neu) U e )A5 l (NL , +0 Flue vent for water heater or gas
Oct {� p fireplace 10.00
'C JI 1 t nq N
+ l of 5 Log lighter (gas) 10.00
� Wood /pellet stove / 10.00
Wood fireplace /insert _ 10.00
.�,i �: ': "rs .�,,.W ,b �, r::x -- ,:": -;s. : „, ,, „,*,,
,,, Chimney/liner/flue/vent 10.00
..ROPERTY OVVNER���"` ,,.TENA1w,A.. y
� Other: 10.00
Name: 'v ' S Environmental exhaust and ventilation
Address: I131L tJ. _Von l)oo6i Loop Range hood /other kitchen
equipment 10.00
City /State /ZIP: /� Q � I Clothes dryer exhaust 10.00
;awes() ' Single -duct exhaust (bathrooms,
Phone: (503) 5(�p - 0 3,, Fax: ( ) toilet compartments, utility rooms) 6.80
...,n ..,:;..•.m.r.:.yx.., .. , ��, .; �k?� "'.c :�;�k:? ud".LJ �Y:3 .���x:i �. , o t.:'.
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14 �` .44. i < ; `. .,'° IC2]... z , : -..;:; :: .,,;3b'k< ., ' N ' 2 F:. 4 �tiA' Attic /crawls ace fans 10.00
r.���'...r� ;�.,:� f � ..;,- �.. �W�,.,�, .�.. .����-. ,��.� �:., . C O I �TA / C � T � � P � ER SON��,� p
Business name: 0 (AG kalif) l i (no p), CO ) F 1n 10.00
piping
Contact name: R0( Q rl t ` \e - $5.40 for first four; $1.00 for each additional
Address: T'"
` v J 1 D • ;? o J� 1 -1 E Fumace, etc.
P.D. . � '�
�� .C.Q.11 a , O R . q 10 a 3 Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
( 3) eo30 - -11 (i 5 3) c' Ba - I (003 Water heater
Phone: Fax:
Fireplace
E -mail: yy) m l 1,, l Q5' ( 3 V Sn CO M Range
' r '�t ga raft CO"o S�`: ` .
.' ia gyp Sq Barbecue
Business name: C a5Cac(Q. Chi al npy C � M. �' / Clothes dryer (gas)
Cam_ ww�� Other:, i s : Pa -at „ a u.` i " . s- »;. - i , s,* 'tiYA.- '' aW*e.-***-9 -iimm - ' - � - "a'+
Address: x � : -,., MECHANIC $AaL PJH`R ATEEES* x „ �.* ";
� c da OR . q is a� �� �� �
City/State/ZIP: Subtotal
2Q �? (� � Minimum permit fee ($72.50)
Phone: ( ) ( 3C ?-- 9LW Fax: (�� ) C, to a -1 (rc.-J
� � Plan review (25% of permit fee)
CCB lie.: t 1.5 \ 1 o .5 I l State surcharge (12% of permit fee)
/ TOTAL PERMIT FEE e 1 . eye
Gtr
/C' IA ' / / This permit application expires if a permit is not obtained within 180
Authorized signature: / days after it has been accepted as complete.
Print name: RO j r m, tier Date: 0- 1x--09 * Fee methodology set by Tri- County Building Industry Service Board
t\ Buildi \Permits \MEC -Per ' Appp. doc 01/19/07 440 -4617T (1 1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
TotalValu I
.„„teAm§VA PermitiTFee . 1 .; , ; ,s
•
$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 . J f
$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.
1. \Building \Permits \MEC- PermitApp.doc 01/19/07 2
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