Permit CITY OF TIGARD MECHANICAL PERMIT
11111 E • • COMMUNITY DEVELOPMENT Permit #: MEC2013 -00015
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/09/2013
Parcel: 25111 CC06200
Jurisdiction: Tigard
Site address: 9920 SW CENTURY OAK DR
Project: Eischen Subdivision: SUMMERFIELD Lot: 92
Project Description: (1) gas fireplace replacement, (1) flue vent and (4) single -duct exhaust
Contractor: DANNYS HEATING AND COOLING IN Owner: STANLEY EISCHEN
46303 NE 36TH ST 9920 SW CENTURY OAK DR
VANCOUVER, WA 98682 TIGARD, OR 97224
PHONE: 503 - 914 -8058 PHONE: 503 - 440 -2095
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 01/09/2013 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 01/09/2013 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: Single Duct Exhaust (Bathrooms, Toilet, 01/09/2013 $93.28
Utility Rooms)
Stories: 12% State Surcharge - Mechanical 01/09/2013 $18.00
Fuel
Fuel Types:
Gas Pressure:
Total $167.99
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Ajpi l Yl 7
, t Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 F O FFICE USE O NLl
City of Tigard Received Per mit No.:
h' g RECEIVED Date/By: ( • �( me - c d013_17a)( 5
n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
° Date/By: Other Perini
Phone: 503.718.2439 Fax: 503.598.1960 ---:;20 p 120 )._ cc
TIGAF
Inspection Line: 503.639.4175 JAN 0 9 2013 Date Ready/By: g H See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
CITYOFTIGARD IN
TYPE OF WI LDING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addit ion /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building Forspedal information use d ecklti
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
lob site address: 9920 SW Century Oak Drive (requires site plan showing placement) - 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/ State/ZIP: Tigard, OR 97224 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: ' Project name: Summerfield Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Summeerfield Drive Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK 0 Water heater 23.32
Replace firplace insert/ replace 4 bathroom fans Gas fireplace/insert I 33.39 33.39
Flue vent nt f fo e/insert or water heater or gas
fireplace I 23.32 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Stanley Eischen Environmental exhaust and ventilation: _
Address: 9445 SW Brentwood drive Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Tigard OR 97224 Clothes dryer exhaust 33.39
Phone: (503)4402095 Single -duct exhaust (bathrooms,
( 2095 Fax: ( ) toilet compartments, utility rooms) 4 23.32 93.28
❑ APPLICANT ® CONTACT PERSON Attic/crawlspace fans 23.32
Other
Business name: TL Remodel & Construction Inc 23.32
Fuel piping:
Contact name: Timothy Labunsky $14.15 for first four; $4.03 for each additional
Address: PO Box 1996 Furnace, etc.
Gas heat pump
City/State/ZIP: Lake Oswego, OR 97035 Wall/suspended/unit heater
Phone: (503) 9842783 Fax:: ( ) Water heater
Fireplace
E -mail: tlremodel@yahoo.com Range
CONTRACTOR Barbecue
Business name: Dannys heating and cooling Inc Clothes dryer (gas)
Other:
Address: 46303 ne 36 th st MECHANICAL PERMIT FEES*
City/State/ZIP: Vancouver, WA 98682 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 9148058 Fax: ( )
Plan review (25% of permit fee)
CCB lic.: ; 99- 5y C , i f , ( ((( State surcharge (12% of permit fee)
et TOTAL PERMIT FEE (W. 4% •
Authorized sign This permit application expires if a permit is not obtaided within f80
r / days after it has been accepted as complete.
Print name: Date: • I • Fee methodology set by Tri -County Building Industry Service Board
I:1 Building \Permits\MEC- PennitAoo.doc 03/07 /12 440- 4617T /11 /02/COM/WEBI