Permit • CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00181
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/9/2008
PARCEL: 2S110BC - 10000
SITE ADDRESS: 12494 SW WINTERVIEW DR ZONING: R -7
SUBDIVISION: THORNWOOD PARTITION LOT: 001 JURISDICTION: TIG
PROJECT: BACKLUND
Project Description: Installing (1) bathroom fan.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF 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: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
ISSAC BACKLUND Description Date Amount
12494 SW WINTERVIEW DR
TIGARD, OR 97224 [MECH] Permit Fee 4/9/2008 $72.50
[TAX] 12% State Surch 4/9/2008 $8.70
Phone: 408 - 921 -1762
Total $81.20
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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 OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By. /� ��� Permittee Signature:
Call 50 .•4175 by 7:00 a.m. for inspections 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 \� Dat . L ( / /� 7 Permit No.: 77F � �
� —1 �(
')3125 SW Hall Blvd., Tigard, OR 97223 l
~ 12 Phone: 503.639 4171 Fax: 503 598.1 Plan Review Other Permit• /',�
Ins Line 503 639 4175 , \•� D ate/By �/ r I � (y �
T I G A It D f Date Ready/By Jugs; El See Page 2 for
Internet: www.tigard -or gov //" (, „vg) (, r � Notified/Method Supplemental Information
, dr 4 . r Og‘
TYPE OF WO ,Z +�_ \� ,GVII COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction D Addition/alterat
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family 0 Master builder
❑ Other: Description I Qty. I Ea I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
(� c c� Air conditioning or heat pump
Job site address:
12 I 5 V N i it Pr V I el— a_ (requires site plan showing placement) 14 00
City/State /ZIP: ri r � ,. cV � CR 1 2 Z 4/ Fumace 100,000 BTU (ducts/vents) 1400
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: & ki' 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
Subdivision: I 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
63 644 JLJO•”. /-L1C' 1:4 . 61‘ Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10 00
Wood fireplace/insert 10 00
[g PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10 00
Name: ' 7 s .0 (Re . Jc- /1) el Environmental exhaust and ventilation
Address: J Range hood/other kitchen
equipment 10 00
City/State/ZIP: Clothes dryer exhaust 10 00
Single -duct exhaust (bathrooms,
Phone: 0.4 ) Si. ' I - 116 Z Fax: ( ) toilet compartments, utility rooms) J 6.80 (p .
JJ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other 10.00
Business name: 0 n 2l _ 5,�� E
Fuel piping
Contact name: $5.40 for first four; $1.00 for each a dditional
Address: Fumace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: ��P�
Other
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($72 50) - 71.,
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee)
• TOTAL PERMIT FEE E / Authozed siature: •• "I /I This permit application expires a pet is not obtained thin 180
days after it has beau accepted as complete.
Print name: j 5 t t /3 c ` Date: LJ il / Q 4 • Fee methodology set by Tri-County Building Industry Service Board
1\Building\PermitsV�C- PermitApp.doc 01/19/07 440.4 /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 $100.00 or
fraction thereof.
Note: • All new commercial buildings require 2 sets of plans.
I:\ BuildingTermits \MEC- PermttAppdoc 01/19/07 ' 2
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008- 00181
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/912008
Phone: (503) 639- 4171 1DII t
Inspection Requests (24 Hrs.): (503) 639 -4175 �'� • °__..
INSPECTION WORKSHEET FOR DATE: 5114/2008 TIME: 7:04AM PAGE: 10
SITE ADDRESS: 12494 SW W1NTERVIEW DR CLASS OF WORK:
SUBDIVISION: THORNWOOD PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: BACKLUND
DESCRIPTION: Installing (1) bathroom fan.
OWNER: BACKLUND, ISSAC PHONE #: 408 - 921 -1762
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 069888 -01 408-921 -1762 Y
Corrections/Comments/Instructions:
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 4-- by----oe- Phone #: (503) 718 - '�.4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008.00181
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 4/9/200$
Phone: (503) 639-4171 14;41,M11
Inspection Requests (24 Hrs.): (503) 639 -4175 _ --__..
I
INSPECTION WORKSHEET FOR DATE: 7/29/2008 TIME: 7 :01AM PAGE: 5
SITE ADDRESS: 124 SW WINTER VIEW DR CLASS OF WORK:
SUBDIVISION: THORNWOOD PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: BACKLUND
DESCRIPTION: Installing (1) bathroom fan.
OWNER: BACKLUND, ISSAC PHONE #: 408 -921 -1762
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 073395 -01 503 - 598 -7177 Y
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 7— ZF l23 Phone #: (503) 718- Z4'a---7