Permit CITY OF TIGARD MECHANICAL PERMIT
14 • COMMUNITY DEVELOPMENT MECHANICAL
MEC2021-00031
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/23/2021
T t "'� D Parcel: 2S101 BC00500
Jurisdiction: Tigard
Site address: 12300 SW KNOLL DR
Project: Fredrick Stolt Subdivision: KNOLL ACRES Lot: 10
Project Description: Install(2)exhaust fans and(1)heater for new and existing bathrooms
Contractor: OWNER Owner: STOLT, FREDERICK
12300 SW KNOLL DR
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 02/23/2021 $46.64
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: Fuel Piping 02/23/2021 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 02/23/2021 $10.80
Minimum Fee Adjustment-Mechanical 02/23/2021 $29.21
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: t i �►—— Permittee Signature: n C4 7 )1 r C C°r t1u=-Th
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 Application FOR OFFICE USE ONLY
City of Tigard Received
N"\•,) pomi,No 7 NkekitaA•WO 3 1, I
13125 SW liall Blvd.,Tigard,OR REcEIVED
N Dateitiy: I 1
P la n Review —
Oth Pei itat ,
it' Phone: 503.718.2439 Fax: 503.5t . Dated er3y:
Inspection Line: 503.639.4175
TIGARDDate Ready*: %\ lurk El See Page 2 for
Internet: www.tigard-orgov
JAN 4 2071 Notified/Method: Vot -Lk No Supplemental Information
„. —_—
__
T YPE OF Wart OF-K !) nnCOMMERCIAL FEES SCHEDULE - USE CHECKLIST
C3 IM
g A d d i I i o n/a I tiMpaNYISION Mechanical peit fees*are based on the value of the work
New construction
performed.Indicate the value(rounded to the nearest dollar)of all
Ej Demolition Ej Other: mechanical materials, tii mem,labor,overbead,and rofit.
Value:S
CATEGORY OF CONNFRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS I
tg 1.and 2-family dwelling 0 Commercial/industrial El Accessory building For special infrrniallun use eheeklio.
ID Multi-family El Master builder 0 Other: Description Qty. I Fa. Total
JOB SITE INFORMATIONIleating/cooling:
AND LOCATION
Air conditioning, 1 te„,„d 46.75
Job site address: i '....)r Furnace 100.000 tau ouctsktnto 0 46.75
City/State/ZIP, • , ,J a Cri,j)D. 3 Furnace I(MAO i BT1H(ducts.'vents) 54.91 re
. _ heat pump 61.06
Suite/bldg./apt.no.: Project name: .
Duet work P. .23.32
_..„...... _._
Cross street/directions to job sitf_11).rwt.,‘ Nan ..p,,,o) c.4 4..), At J1 li 23 Itydronie hot water system , 23.32 V
3 Residential boiler(radiator or
0/1 eixto i i Isk („? - ,i.3 , • is - hydronic) 0 23,32
Unit beaters Ouch-type,not electric),
in-wall,in-duct,suspended.etc. 4//- 46.75 cZ)
' Flue/vent for any of above (Z5 23.32 If
Other: 0, 23.32
Subdivision: Lot no.:
1 Other foci appliances:
Tax map/parcel no.: Water heater 0 23.32 p
_... _
DESCRIPTION OF WORK Gas fireplace/insert Co 33.39 I
_
, 4 , — Flue vent for water heater or gas
{ , A i
T il Lititi' tz)) • . r ,.,c ., t.repiac,, , o 23.32 0 Log lighter(gas) ‘23 23.32
- .-- . - - e er_e_elt"
• woodipeitet stove 33.39
Wood fireplacclinsert 23.32 Chimnevilinetilluei'vent 23.32
St PROPERTY OWNER I— D TENAJYT Other: 7
23.3- j 0
Name' Fled e,jc:it
' . $16 A- . _____ ... Environmental exhaust and ventilation:
Range hood/other kitchen
- Oe- f, equipment 0 33.39 0
Address: ,a"';00.- i,-) rj j)&II
Clothes dryer exhaust Of 33.39 0 .
i
City/State/ZIP: ---F ,d ok 7 CI' D) 3 Single-duct exhaust(bathrooms,
tft. toilet compartments,utility moms) D. ,... 2132 Lito.kilA
Phone:(503) . 0, .._., ,../ Fax:( ) /UM Attictcrawlspace fans 0 23.32 0 ,
—---
0 APPLICANT 0 CONTACT PERSON Other: " --(0 23.32 0
Fuel piping: ,_„,„„,„
Business name; AVIA!
514.15 fur Oro tour;54,03 for each additional
Contact name: (7)1, r1,fe v...- . Furnace,etc.
.........„,......._
Gas heat pump 8- S
Address: 47;)e A t _a_OLAIV Wall/suspended/unit heater 1 Pt 15- ittic
City/State/ZIP: Water heater a
.....______... . „._,Phone:( ) I Fax::( ) „ Fireplace 0
1 Range
E-mail: Barbecue
CONTRACTOR Clothes Myer(gas)
Other:Business name: (1,111 e r
MECHANICAL PERMIT FEES*
Address: 5oe A hex)e Subtotal
City/State/ZIP: .Minimum pennit fee(S90.00) 33 j 21
Plan review(25%of permit tee)
Phone:( ) Fax ( ) Suitcsurcharge(12%of permit feet 0 jfl
CCB lie.: TOTAL PERMIT FEE g
This permit application expires it a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: , . Fee methodology set by Tri-Crionty Building Industry Service Huard
Print name: rii ...en-c.k 6.1../J1 Date:
1:14titkiing;P5'rmiix'AFC_NemilApp_11451 11 doc 446.1511T I I 1,02,,COMANFO)