Permit . c1-2-2,0 -
Mechanical Permit Auuliembta" ED ' 112 OI'l l( 1. i se("l.`
Received Permit N
City of Tigard DaieBy: ,11I 0 4e' "1 2s 1 -d 0,is_
11 • 13125 SW Hall Blvd.,Tigard,OR 972n—p O 2 2020 plan n Review
ew Other Permit:
0 Phone: 503.718.2439 Fax: 503.598116Q Da
1 I t,,�R D Inspection Line: 503.639.4175 Date Ready/By: finis: ® See Page 2 for
Internet: www.tigard-ocgoy CITY OF TIGARD Notified/Method:?/z.L[l'2 �/ •fl Supplemental Information
BUILDING DIVISION -roil(-- C+C--t--1�E 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
mechanical materials,equipment,labor,overhead,and profit.
El Demolition 0 Other: Value:$$2,800.00
`t' ', if.,' " * P> at_ `+CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
D I-and 2-family dwelling ®Commerciallindustrial El Accessory building For special information use checklist
D Multi-family El Master builder ❑Other:
Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION Air conditioning 46.75
Job site address:13221 SW 68th Pkwy Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:401 Project name:Suite 401 Triangle III 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 heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
ducting and air distribution mods as drawn fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other 23.32
0 PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust , 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ® CONTACT PERSON Other 23.32
Fuel piping:
Business name:Latimer HVAC LLC $14.15 for first four;$4.03 for each additional
Contact name:Clint Latimer Furnace,etc.
Gas heat pump
Address:11230 SW Morgen Ct Wall/suspended/unit heater
City/State/ZIP:Tigard,OR 97223 Water heater
Phone:(971)294-0879 Fax::( ) Fireplace
Range
E-mail:clint@latimerhvac.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name:Latimer HVAC LLC _ MECHANICAL PERMIT FEES*
Address:11230 SW Morgen Ct Subtotal
Minimum permit fee(S90.00)
City/State/ZIP:Tigard,OR 97218 Plan review(25%of permit fee)
Phone:(360)513-4505 Fax:( ) State surcharge(12%of permit fee)
CCB lit.:220839
TOTAL PERMIT FEE 19Z e:3$
This permit application texpires eef a permit is not o within 180
days after it has been accepted as complete.
Authorized signature: C. * Fee methodology set by Tn-County Building Industry Service Board
Print name:Carlie Latimer Date:9/1/2020
I:\Building\Pennits1MEC_PermiNpp_04f 113.doc 440-4617T(I 1/02/COM/WEB)
•
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
S0.00 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\Permits\MEC_PermitApp_040113.doc 2