Permit CITY OF TIGARD MECHANICAL PERMIT
114
COMMUNITY DEVELOPMENT Permit#: MEC2020-00626
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/1/2020
T l iJ A R T) 9 Parcel: 2S103BC01700
Jurisdiction: Tigard
Site address: 12905 SW 121ST AVE
Project: Armas Subdivision: CANOGA PARK Lot: 1
Project Description: Install new furnace,ducting and range hood for fire repair.
Contractor: OWNER Owner: BASH RESIDENTIAL LLC
12600 SW 72ND AVE#140
PORTLAND, OR 97223
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 09/30/2020 $46.75
Type of Use: SF Duct Work 09/30/2020 $23.32
Class of Work: ALT Type of Const: Range Hood/Other Kitchen 09/30/2020 $33.39
Occupancy Grp: 12%State Surcharge-Mechanical 09/30/2020 $12.42
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $115.88
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questionsLLJJ 'to
OUNC by calling 503.232.1987 or 1.800.332.2344.
tt
Issued By: tT/ \\0` Permittee Signature: see
``
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatin&-NIECE 1 FOR OFFICE USE ONLY
' `��ED Received p ��/
City of Tigard Date/By: //. Jw �iJ(' Permit No. If1/(JVtP 2(0
;, .- ' 13125 SW Hall Blvd.,Tigard,OR 97223 SE? 0 S 2020
II Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Inspection Line: 503.639.4175OF Dete Ry.
nr1> CItY TIGARD Date Ready/By: 7us ® See Paget for
Internet: www.tigard-or.gov 1N�IS In�� Notified/Method:� jl j Zt� �,Q Supplemental Information
DI Ill_DIf�(� D
E`1 fitfL 1-1t 1.-
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
RI 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
�t 1 „/- i/d Air conditioning 46.75
Job site address: r Cf 0.5 s �d1. ` S 14 V V Furnace 100,000 BTU(ducts/vents) I 46.75
City/State/ZIP: ^r'; e,rd 0 R c( a a !3j�� Furnace 100,000+BTU(ducts/vents) 54.91
�J Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Duct work 1 23.32
Cross street/directions to job site: 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: 1 Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert/ 33.39
Flue vent for water heater or gas
/ 0 5 f c l I view IA c in_he c iL czvlCi Ciu.C%f t h7 q fireplace 23.32
F�1 F/�E 4 I i t Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: .f-1 i C Ci co-�C 5� ^ Range hood/other kitchen 1
Address: l�`a ?n 5 5 l.0 / Ol l"AV& equipmentCl 33.39
ty Tr S G Da e 7 a dryer exhaust 33.39
City/State/ZIP: l � Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(IT() got 70 p. Y� Fax:( ) Attic/crawlspace fans 23.32
`f
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
�
Range
E-mail: 114.a(I. G)r 1 r 1. \ (/
0 y� ra.'ei i'Y•{ ;-, / - C.O ry .. Barbecue
CONTRACTOR C.) Clothes dryer(gas)
Business name: meter
L /v N/� MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone: Plan review(25%of permit fee)
( ) Fax:( )
State surcharge(12%of permit fee)
CCB lic.: TOTAL PERMIT FEE 116 t Er8
This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Authorized signatur•• � * Fee methodology set by Tri-County Building Industry Service Board
4Print name: / L A,,_, Date: 9- z
1:1BuildiogPermit&MEC_PWermitApp_0401 13.doc 440-4617r(I1/02/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.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 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\Pennits\MEC_PennitApp_040113.doc 2