Permit C ITY bF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00282
TIGARD DATE ISSUED: 6/5/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103BB - 03300
SITE ADDRESS: 12500 SW KAREN ST3 ZONING: R - 4.5
SUBDIVISION: KAREN COURT CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: BROOKSIDE
Project Description: Installation of new bathroom fan.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS: 1
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODDRYERS:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
DANIEL GRANT LLC Description Date Amount
12407 SW 133TH
TIGARD, OR 97223 [MECH] Permit Fee 6/5/2008 $72.50
[TAX] 12% State Surchai 6/5/2008 $8.70
Phone: 503- 481 -0240
Total $81.20
Contractor:
RELIABLE HOME IMPROVEMENT
PO BOX 230815
PORTLAND, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #:
Reg #: LIC 48634
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
/
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspectionsthaj.business •a /
This permit card shall be kept in a conspicuous place on the job site until comp ., ' • n of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
T iga rd Date/By: d
City of . ,S Q f • b• Permit No.: / EC '
° 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review �a Ad ���r
C ; Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By:
T I G A RD Inspection Line: 503.639.4175 Date Ready/By: ims ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
dwelling ❑Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2-family g ❑ Commercial /industrial
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. Total
JOB SITE, INFORMATION AND LOCATION . Heating/cooling
Job site address: / 2s Q SGT /�� yo Aiq conditioning o ngt pump
(requires site plan showing placement) 14.00
City /State /ZIP: rd ' .oi 7a .t" Fumace 100,000 BTU (ducts /vents) 14.00
(/ 4 . I)
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.:3 Project name: 63 tOO I( . 9 Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
r /� n Hydronic hot water system 14.00
42 'C �/� - / - c Residential boiler (radiator or
I hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.:
Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
• DESCRIPTION OF WORK Water heater 10 00
Gas fireplace 10.00
7 jJS Sir- / �' f Flue vent for water heater or gas
v / 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 ❑TENANT Other: 10.00
Name: 2/VIEL G/zq . Environmental exhaust and ventilation
Address: /01 — Range hood /other kitchen
�� / G 7 S4/ / 33 -- equipment 10.00
City /State /ZIP: t, d Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms, G
Phone: (3''3) G/ ( pa c/O Fax: (5,3) 5d / - g yg-1, toilet compartments, utility rooms) ' 6.80 / s , p o,
'❑ APPLICANT ❑.. CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
,`
Business name: t a-. th e /o •X4/) Fuel piping
Contact name: t _ e� r $5.40 for first four; $1.00 for each additional
Address: �r O t SC a Gas h 3G f(5- ea p
Gas heat pump
City /State /ZIP: oe7G6 -, 0 97c. S" / Wall/suspended/unit heater
Phone: (S3) %IV — Ga Y0 Fax: : (SG 3) .oj/ ., g a, et. Fireplace erhater
E -mail: • Range
CONTRACTOR - Barbecue
Business name: 'PG L ; /1 / /7 (, e ��/ � , Clothes dryer (gas)
r1 7/ /y""` Other:
Address: 12, U j3, Gi 23 & F( 'MECHANICAL PERMIT FEES*
City /State /ZIP: ' 0 0 i7G...9,-t-0 aL cr7d l< / Subtotal
Minimum permit fee ($72.50) w2 , • 5'n
Phone: (5 c (_ G d c G F ax: ( ) Plan review (25% of permit fee)
CCB lic.: 41 t 3 ? State surcharge (12 %ofpermit fee) d o 70
TOTAL PERMIT FEE ,4 , ,gb
Authorized signature: This permit application expires if a permit is not obtained within 180
J t-(� L days after it has been accepted as complete.
Print name: ( vie klr/ yy •/' -! Date: 0 — 3- - 6 * Fee methodology set by Tri- County Building Industry Service Board
1:\Building \Permits \MEC- PermitApp.doc 01/19/07 440 -46 17T (I I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard . .
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.
1:\ Buil ding \Perm its \M EC-Penn itApp.doc 01/19/07 2
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200B.00282
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/&2008
Phone: (503) 639 -4171 �uv "Ny�u�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6110/2008 TIME: 7:01AM PAGE: lei
SITE ADDRESS: 12600 SW KAREN ST CLASS OF WORK:
SUBDIVISION: KAREN COURT CONDOMINIUMS LOT #: TYPE OF USE:
PROJECT NAME: BROOK SIDE
DESCRIPTION: Insiallation of new bathroom fan.
OWNER: DANIEL GRANT LLC, PHONE #: 503- 481 -0240
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 6/10/1008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
695 Misc. inspection 071157 -01 503 - 481 -0240 Y
Corrections /Comments /Instructions:
•
•
SS H PARTIAL APPROVAL n CANCEL U NO ACCESS
FAIL I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: - Date: Phone #: (503) 718 -S(;�