Permit CITY OF TIGARD MECHANICAL PERMIT
1 1 1- n • COMMUNITY DEVELOPMENT Permit #: MEC2013 -00424
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/25/2013
Parcel: 2S102CA00915
Jurisdiction: Tigard
Site address: 13475 SW VILLAGE GLENN DR
Project: Burgess Subdivision: VILLAGE GLENN Lot: 15
Project Description: Replace furnace and gas piping.
Contractor: FIRST CALL INSTALLATION COMPANY Owner: BURGESS, YVONNE
13150 S CLACKAMAS RIVER DR 13475 SW VILLAGE GLENN DR
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 231 -3311 PHONE: 503 - 639 -0903
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 07/25/2013 $46.75
Type of Use: SF Fuel Piping 07/25/2013 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/25/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 07/25/2013 $29.10
Stories:
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: X Permittee Signature: ® / �� �e 49
c21
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.
JUL -25 -2013 09:45A FROM: TO:5035981960 P.1 AM I
Mechanical Permit Application ' FOR 01.1.1( I lltil ()N1.1
City of Tigard JUL 2 5 2013 Received Dato/8y: ,7 ZS 4 Permit No. EC_ / .3 -A011-A011,2 o' A
• Review
13125 SW Hall Blvd., Tigard, OR 97223 plan Rev
. ' 0 Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGAR i DateBy: Other Permit:
- 1 l c : ;\ It 1 ) Inspection Line: 503.639.4175 ta Ready/By: : luris: gi See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISI II ottfio&?4ethod: i� Supplemental Information
TYPE OF WORK 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 Mjormartnn use checklist.
❑ Multi- family ❑ Master huilder ❑ Other: Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: `� 1� ,I /� f�� �(/� �1 �Q/ Air conditioning
I� L� 0,\ Y I (lW�t�,�ll�t ,1 { (Jf ( teryuireasitoplanshowinRR�ement) 46•75
_City/State /ZIP: fl(n f Y'1 Q� V Furnace 100,000 BTU (duots/vents) 46.75
- '"" Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23 32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 2132
• Gas fireplace 33.39
Fluevent for water heater or gas
fireplace 23.32
0 I 1 i 1) l ()Caftan n Log lighter (gas) 23.32
e r ; I 4-6 - g _ILL._ Wood/pellet stove 33.39 1
-Wood fireplace/insert , 23.32
_ Chimney/liner/flue/vent 23.32
PROPERTY OWNER I • ❑TENANT Other. _
Name: \ NCnnt. VACC19 Environmental exhaust and ventilation
Range hood/other kitchen
Address: e) equipment 33.39
•
City/State/ZIP: Clothes dryer exhaust 33.39
)1 C)L Sinet exhaust (bathrooms,
Phone: compartments, ( ) toilet compartrt mennts, utility lity rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 ,
Other: 23.32
Business name: Tri County Temp Control Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
- Furnace, etc. 1 •
Address: 13150 S Clackamas River Drive Gas heat pump
City /Stnte/ZIP: Oregon City, OR 97045 Wall /suspended/unit heater _
Phone: (503) 557.2220 -Fax:: (503) 557.0919 _ Water heater
Fireplace .
E -mail: Range
CONTRACTOR Barbecue
Business name: First Call Installation Clothes dryer (gas)
Other: .
Address: 13150 S Clackamas River Drive MECHANICAL - PERMIT-FEES+
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum pcnnit fee ($90.00)
Phone: (503) 557.0230 Fax: (503) 557.0919 Plan review (25% of permit fee)
V CB lic.: 182714 State surcharge (12% of permit fee) O /
TOTAL PERMIT FEE
✓
Authorized signature: This permit application expires If a permit is not obtained within 180
gtt days after It has been accepted as complete.
Print name: Diane Mason Date: • Fee methodology set by Tri- County Building Industry Service Board
l :)auilding\Permlts\MEC- PermitApp dot 10/01/09 440.4617T (I I /07/COM/W118)