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Permit .. , CITY OF TIGARD MECHANICAL PERMIT �-' o : COMMUNITY DEVELOPMENT Permit #: MEC2013 -00148 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2013 Parcel: 2S 103DA00300 Jurisdiction: Tigard Site address: 13120 SW WATKINS AVE Project: Boles Subdivision: DERRY -DELL Lot: 3 Project Description: (1) gas furnace installation (switching from electric to gas) and (1) fuel piping Contractor: OWNER Owner: BOLES, PATRICIA ANN & JERRY LYNN 13120 SW WATKINS AVE TIGARD, OR 97223 PHONE: PHONE: 503 - 277 -8044 FAX: FEES • Specifics: Description D ate Amount Furnaces < 100K BTU 03/18/2013 $46.75 Type of Use: SF Fuel Piping 03/18/2013 $14.15 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/18/2013 $29.10 Occupancy Grp: 12% State Surcharge - Mechanical 03/18/2013 $10.80 Stories: (manual) Fuel Fuel Types: Gas Pressure: Total $100.80 • 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: / / / / /LA Permittee Signature: i ‘ + jpfr ..i.rdra..2 j Call 503.639.4175 by 7:00 a.m. for the next available inspection . : ' This permit card shall be kept in a conspicuous place on the job site until com Icon of the project. P Approved plans are required on the job site at the time of each inspection. Mechanical Permit A lication FOR OFFICE USE ONLY City of Tigard EIVED ReceiDate/By: ved 1 ✓ I r/ ¢ ( 3 Gt�O/ 3��� 5r Permit No.: /� [ J/ `J 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 MAR 18 Z013 Date/By: Other Permit: TI G A R D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: /1t Supplemental Information CITY OFTIGARD TYPE OF I JI,DING DIVISION 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. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: J 3 / z 0 k ) I I 46.75 City /State /ZIP: / W a fi� 'Furnace 100,000 BTU (ducts /vents) f 46.75 -Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: 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 Water heater 23.32 Gas fireplace/insert 33.39 g o,./.1 I h 4' w ( ha e_.--c_ Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 al PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: . rte 1 'a Q 1 %-t- Environmental exhaust and ventilation: Address: / Range hood/other kitchen 2,0 w �Ct t equipment 33.39 City/State /ZIP: 4 i e , ,d, 0 172 23 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, 1, Phone: ( ) .2_ 2 e- f if Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City/State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater E -mail: Fireplace Range CONTRACTOR Barbecue Business name: Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City/State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: State surcharge (12% of permit fee) TOTAL PERMIT FEE 1(5)).1) Authorized signature: This p ermit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board 1:\ Building \Permits\ME.0 - PermitApp.doc 03 /07/12 440 -46I7T (I I /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information • Commercial & Multi - Family Fee Schedule: Total Valuation: Permit Fee: • $0.00 to $500.00 Minimum fee $69.06 • $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $1 0,000.01 to $50,000.00 $347.71 for the first $1 0,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1.•\ Building \Pemiits\MEC- PermitApp.doc 03/07/12 2 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13120 SW WATKINS AVE, TIGARD, OR, 97223 Residential - Mechanical 610 Gas Line 04/09/2013 00:00 MEC2013-00148 PASS Standard pressure verified 10 lbs15 min Violation Summary: Inspector Contractor