Permit L
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00745
411?
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/8/2005
PARCEL: 1 S134BD -08500
SITE ADDRESS: 11542 SW WOODLAWN CT ZONING: R -4.5
SUBDIVISION: PENN LAWN ESTATES NO.2 LOT: 013 JURISDICTION: TIG
Project Description: Install woodburning hearth heater.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
OTH 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
VICTOR DAVIDSON Description Date Amount
11542 SW WOODLAWN CT [MECH] Permit Fee 11/8/200: $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 11/8/200E $5.80
Phone: Not provided Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Phone:
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.
i)
Issued By: Permittee Signature: l /1
Call 503 - 639 -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 Aga �. I OR OFFICE USE ONLY
City of Tigard -- ` Date/ ived
4 : 05 a ' Permit No.: n _
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit
503.639.4171 Fax: 503.598.1960 NOV 0 8 °" ' as' ' ' Date/By.
Inspection Line: 503.639.4175 1U c`� I Dale Ready/By. El See Page 2 for
Internet: www.ci.tigard.or.us , -- l Notified/Method A Supplemental Information
t�TCiTY OF I1(-iARD
Bt-i R IOIVI COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ addition /alteration/replaceement Mechanical permit fees* are based on the value of the work
/ 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*
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
M ulti- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: (�� Air conditioning or heat pump
!) S'1l ° k.V V� (requires site plan showing placement) 14.00
City/State/ZIP: / i r J A t 9 7 ZZ Furnace 100,000 BTU ( ducts/vents) 14.00
Furnace 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 14.00
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. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.. Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ / // / - I . Gas fireplace 10.00
-f- F ,S i (I N bear a rN h etki"C,( 1 0 k) (K15'
STl viol Flue vent for water heater or g as
fireplace 10.00
?eel° CiCa tACC Ole '2p . /ht5 /5 Log lighter (gas) 10.00
c,7ooc) toor I h eu\r!'� N ecA kC. Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROP RTY OWNS , } ❑ TENANT Chimney/liner/flue/vent 10.00
(// Other: 10.00
Name: ' �) 1�Adth s °l-1 Environmental exhaust and ventilation
Address: ii 5 (f Z 5( A D, ( ,,,4 �, Range hood/other kitchen
G( equipment 10.00
City /State /ZIP: ( , � d g, 7 7 z z 3 Clothes dryer exhaust 10.00
Phone. ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace funs 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) / F i x :: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name:
O(ial' r Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) F. ) Minimum permit fee ($72.50) 7a,
Plan review (25% of permit fee)
CCB lic.: / State surcharge (8% of permit fee) 5, f'f
TOTAL PERMIT FEE 1 f(_ 3o
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name:
Irk kr 1 — • L t t � Date: 0/L5' • Fee methodology set by Tn- County Building Industry Service Board
i \ Building \Pernits\MEC- PermitApp doe 12/03 440 -4617T (11 /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
$2,00 00 to $5,000.00 $72.50 for the first $2,001.00 and $2.30
for each additional $100 10 or fraction
thereof, to and includi $5,000.00.
$5,001.00 t. $10,000.00 $141.50 for the first $ •.,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to . d including
$10,000.00.
$10,001.00 to $50,01 00 $231.50 for the st $10,000.00 and
$1.35 for each . i ditional $100.00 or
fraction thereo , to and including
$50,000.00.
$50,001.00 to $100,000.00 '. • 71.50 for e first $50,000.00 and
$1. for :a ch additional $100.00 or
fraction ereof, to and including
$100,0',0.,,
$100,000.01 and up $1,39..50 for i - first $100,000.00 and
$1. i for each ad u ' . nal $100.00 or
fr. ction thereof.
Note: All new comm • cial buildings require 2 sets of pla i -
is\ Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 3
BUILDING DIVISION PERMIT #: MEC2005 -00745
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2005
Phone: (503) 639 -4171 Aw tiatt�l6
Inspection Requests (24 Hrs.): (503) 639 -4175 "__
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 140
SITE ADDRESS: ESS• 1142 SW WOOULAWN CT CLASS OF WORK:
SUBDIVISION: PENN LAWN 2 LOT #: 013 TYPE OF USE: •
ENN _AWN ESTATES NO..- 3
PROJECT NAME: DAVIDSON
DESCRIPTION: Install woodburning hearth heater.
OWNER: DAVIDSON, VICTOR PHONE #: Not provided
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 021060 -01 503-521-0410 Y - To YAW /m.0 . in
Corrections /Comments / Instructions:
5- O4Lti
- 2 ;O-0
Caai-
• •
IX PASS n PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAI ❑ CALL FOR INSPECTION ❑ ADDITIONAL ES ASSESSED
Inspecto . Date: I ' Phone #: (503) 718-