Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
s ' COMMUNITY DEVELOPMENT Permit#: MEC2020-00567
T t G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ! Date Issued: 8/28/2020
(� Parcel: 2S101DB00608
/ + Jurisdiction: Tigard
Site address: 7670 SW CHERRY DR
Project: Caputo Subdivision: ROLLING HILLS Lot: 13
Project Description: Install furnace. 10/1/20:Added gas line to furnace.
Contractor: EVERGREEN GAS Owner: CAPUTO-BLAGGE, DIANNE E TRUST
16385 SW LANGER DR 7404 SW DELAWARE CIR
SHERWOOD, OR 97140 TUALATIN, OR 97062
PHONE: 503-407-9542 PHONE:
FAX: 503-344-6345
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 08/28/2020 $46.75
Type of Use: SF Fuel Piping 08/28/2020 $14.15
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/28/2020 $29.10
Occupancy Grp: 12%State Surcharge-Mechanical 08/28/2020 $10.80
Stories:
Fuel
Fuel Types: Natural Gas
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.
i
Issued By: y �. /�^ Permittee Signature: c;R "
"�6fiY��1 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.
47 r: t.- 1 vj - 1120 -
Mechanical Permit Application FOR OFFICE t'SE ONI.l
City of Tigard l 9 2020 Received _
III t3125 SW Hall Blvd.,Tigard OR 97223 Date/By: /`G` / At 9j,-- Ne' C j�C)-6/05-t/
a Phone: 503.7181439 Fax 503.598.1960 " 1(v �-'`7) Date/BrPlan Review Other Permit
1 �'Y t t- DateBy:
1"I t,A I;i� Inspection Line: 503.639.4175 0 c, I^. s Date Reed/B hair ® Set Page 2 for
Internet: www.tigard-or.gov �f LSE 1?t Notified/Method: '7S>_ Supplemental/"rCo °p�oxahl 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 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION .RESIDENTIAL EQUIPMENT/SW FMS FEES°
g"-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For'pedal injarraarbn use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Hesttng/eooltng:
7fo ^I� r } r FuAir conditioning ( ) 46.75
Job site address: \l U I,nl /-�/( Pomace 100,000 BTU(ducts/vow) 46.75
City/State/ZIP: TC((,v j O� ! 7�25`J Furnace 100,000+BTU(ducWmu) 54.91
HeaJ ^ net / Duct pumpwork 61.06
SuiteJbidgJept.no.: Project name:(fir 7� Duct work 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water beater 23.32
DESCRIPTION OF WORK Gas freplace Insert 33.39
,�-�1 /� n Flue vent for water heater or gas
ak 0_t7j -7 . ek shy YY7,-: ,4 t 620G�-z)O 7 fireplace 23.32
Log lighter(gas) 23.32
c as tj Kt --f-D Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER ❑ Tampa Other 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attidmwlspace fans 23.32
el APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name. rvc vc(4i G Ces S14.15 for tint four,S4.03 for each additional
Contact name: 'ej 1 I I 17)-[i/dl7M Furnace,etc. 1
Address: il - 5 5 W Lam,..,l ,r„ '71Y Gas heat pump
dedhmit`'�, U Wall/suspended/unit heater
City/State/ZIP: .�1,1p/�",obd . 7O C7///J Water heater
Phone:(503 ) 4/0 7- q5�i +� Fax::(S(kj )3q/ -(O3 4/3" Fireplace
Range
E-mail:
Barbecue
-. - - CONTRACTOR - - Clothes dryer(gas)
Other:
IN]name: � e rC d-t'.0 G7G(5 MECHANICAL PERMIT FEES*
Address: i(.0 3 '�V L a v 1- V r^' Subtotal
City/State/ZIP: S e"�(�Ti)J 0(A ( OP, % 7 ic/0 Minimum pemtit fee(590.00)
��7�y ) Plan review(25%of permit fee)
tit /77
Phone:(7b3) 0 7 _-/ Fax:(r3)7)3g4/1- tp j G75 State surcharge(12%of permit fee)
CCB lic.: /']R p 4/ TOTAL PERMIT FEE
Thu permit application cooker if a permit b riot obtained within 190
days after it has been accepted as complete.
Authorized signature: „/\..._ ---- * Fee methodology set by Tri-County Building Industry Service Board
Print name: 5j/f 13 el` Date: 9!qj/l y.p
I:+Building\Permn:NEC_Pam¢App_wol 13.4oc 440-461 (t ImVCOMIWEB)
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.
1:1BuildingWcrmils\MEC PennitApp_040113.doc 2
Branden Taggart
From: #Building Permit Technicians
Sent: Thursday, October 1, 2020 2:22 PM
To: 'Evergreen Gas Office'
Cc: Tina Escalera
Subject: RE:Add to permit MEC2020-00567 - 7670 SW Cherry Dr.
Attachments: Revised Permit.pdf; IVR_UserGuide_wOnlinelnfo_010119.pdf
Hi Molly,
I have revised your Mechanical permit, MEC2020-00567, and the permit is a attached above. No fees were due . You
may now schedule inspections at your convenience.
Thank you,
Branden Taggart
City of Tigard
, Senior Permit Technician
Community Development
'1!GAR 3_
13125 SW Hail Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or.gov
From:#Building Permit Technicians
Sent: Wednesday,September 30, 2020 4:03 PM
To: Evergreen Gas Office<office@evergreengas.net>
Subject: RE:Add to permit MEC2020-00567
Hi Molly,
I apologize for this delayed response. We have been responding to emails as soon as we can. We have a limited staff
and were closed for a week due to the hazardous smoke. In regards to your submittal. This has been forwarded to
the senior permit technician and will be processed in the order received.
Tina Escalera
Permit Tech Assistant
City of Tigard I Community Development
13125 SW Hall Blvd.Tigard, OR 97223
E-mail: TinaE@tigard-or.gov
From: Evergreen Gas Office<office@evergreengas.net>
Sent: Wednesday, September 9, 2020 1:57 PM
To: #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject:Add to permit MEC2020-00567
1
Caution!This message was sent from outside your organization.
Good Afternoon,
Attached please find an application for a fixture to be added to the existing mechanical residential
permit MEC2020-00567.
Let me know if you need anything else.
Thank You,
Molly
Evergreen Gas Inc.
16385 SW Langer Drive
Sherwood, OR 97140
P: 503-407-9542 I F: 503-344-6345
office@evergreengas.net
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