Permit y CITY OF TIGARD MECHANICAL PERMIT
lih
t -. <'- COMMUNITY DEVELOPMENT Permit #: MEC2009-00438
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/20/2009
z Parcel: 1S125DB09700
Jurisdiction: Tigard
Site address: 7110 SW LOLA LN
Subdivision: Lot: 0
Project: Frewing
Project Description: Replace existing wood stove with new wood stove.
Owner: FEES
KAUFFMAN, GAYLE I & Description Date Amount
FREWING, JOHN L, 7110 SW LOLA LN
TIGARD, OR 97223 Wood /Pellet Stove 08/20/2009 $10.00
12% State Surcharge - Mechanical 08/20/2009 $8.70
PHONE. Minimum Fee Adjustment - Mechanical 08/20/2009 $62.50
Contractor:
SHAMBURG HEATING LLC
PO BOX 829
TUALATIN, OR 97062
PHONE: 503 - 692 -5563
FAX: 503- 691 -6855
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Solid Fuel
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
issua5e. -i suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Ut Notification Cente . Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
direct questions to OUN 0 ca in. 503.246.6699 or 1.800.332.2344.
sued By: )• / I � /' 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.
.
Mech`knical Permit Application . , ' . . . , FOR OFEltE.LSEONLY'
. .., : .
. ' City of Tigard Received (.1 90 I
, " 13125 SW Hall Blvd., Tigard, OR 97223
1111‘ Date/By. ap
Plan Review
CI Pencil No.: m 5 .
' • . • Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit:
Inspection Line: 503.639.4175
TIGARD Date Ready/By. Juris El See Page 2 for
Internet: www.tigard-or.gov ,
Notified/Method Supplemental Information
, '4InifgrtilL%>::rii.rtar' ife;:'oiiteafE0akVrgda'ijMP.fslrdii;t.gi&iWfV
Mechanical permit fees* are based on the value of the work
0 New construction 0 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
111 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
.
Value: $
e, AJEG:6 ,R. „FP,eO,y,C1 ,,,
iefwtAfAIP,PYx'Yf;9MMTAYV;PNbKW 4
0 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
El Multi-family 0 Master builder 0 Other: Description Qty. Ea Total
ir° TibWA. Y.J%‘'el 'Irr, gragrArffteAla Heating/cooling
Job site address: 11 c. 6 li L....63-4;) 1_._cbde
q t Air conditioning or heat pump
(requires site plan showing placement) . 14.00
City/State/ZIP:
Fumace 100,000 BTU (ducts/vents) 14.00
t -- kette—D Ve !6,z
Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project namet47)P7161/1E' V - F ls f 714 " 11 4 - 1- 1-7-1 -- 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: 1 Lot no.:
Other: 10.00
Tax map/parcel no.: . Other fuel appliances '
ee difiwai:Wfak,aiiisle*tMMAZMWOR.R-0 Water heater 10 00
','''s,t• ,, -
Gas fireplace 10.00
) RI'rn - c-s-j 9 P.-RI' t---qt44-70 Nric-vw Flue vent for water heater or gas
f fireplace 10.00
-- • s . k C-44=067r Log lighter (gas) 10.00
(j '7tEi, ' 6ta )
Wood/pellet stove 10.00
Wood fireplace/insert
1 10.00 /0 I
Chimney/liner/flue/vent 1 0. 00
''', tglowNwrigiiiiiNcwwrgtmav N
Name: j C44 N L iLs46,___ Environmental exhaust and ventilation
Range hood/other kitchen
Address: 1--- ) I Vt■ 4").-V 1..CM.-fis 1.49141/C equipment 10.00
City/State/ZIP: - . EP" (% Z Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: 603) e2_1\ . cy-- 17 Fax: ( ) toilet compartments, utility rooms) 6.80
':$4 mAtyi Attic/crawlspace fans 10.00
a. Vq
Other: 10.00
Business name:
Fuel piping
Contact name: 55.40 for first four; 51.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail: Range
;0,3t v ,,,, :: :5•! ; ! t," : 0NtIVAI:V.Z;r;t:Wr"e6RiMroie.m'APz:' ,, Foi ., 4itpria -, =' , wrsi 2" Barbecue
,,, -.;;2.T': - ±:04 - 4::,,A' , w0;.,•;.U4 , ,,g1 , •::ItT,, , ,,,•-- `'4 SA, ' . ,':
Business name: 5)-14 firoia-fr- tic-R P 1--1--6..... Clothes dryer (gas)
Other:
Address: "--k-51 c 6W icra 4V---I 12-€3:_p ,ig.:;t1,,V.Wil,WOMONIRRNINeiti;:;
city/State/ZIP: C ripl -- )ii.--141 - IN Ves--. Subtotal
-
..., l Minimum permit fee ($72.50) - ,, ,, 1;;;•30
Phone:SO ) 65Z_ 5-3 "P Fax: ( ) Plan review (25% of permit fee) .--0
CCB lie.: \5)_t 6 1 State surcharge (12% of permit fee) 'R 70
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete.
Print name: i0,14t1 Cp.‘7V 11,3 g---, Date: 253)1: * Fee methodology set by Tri-County Building Industry Service Board
I: \ Builchng \Permits \ MEC-P ermitApp. doe 01/19/07 440-4617T (11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Per�n>tt 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.
•
I \ Building \Pennits\MEC- PermitApp.doc 01/19/07 2