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Permit
CITY OF TIGARD MECHANICAL PERMIT a COMMUNITY DEVELOPMENT Permit#: MEC2021-00221 Date Issued: 4/8/2021 T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 104AB 13500 Jurisdiction: Tigard Site address: 12403 SW 134TH AVE Project: Nguyen Subdivision: MORNING HILL NO.7 Lot: 163 Project Description: Bathroom vent:duct work from main house to addition Contractor: OWNER Owner: NGUYEN, KIEN TRUONG-NGUYEN, KIM NGUYEN,ANDREW 552 N WHITE RD SAN JOSE, CA 95127 PHONE: PHONE: FAX: FEES Specifics: Description Date Amount Duct Work 04/07/2021 $23.32 Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 04/07/2021 $23.32 Class of Work: ALT Type of Const: Utility Rooms) Occupancy Grp: 12%State Surcharge-Mechanical 04/07/2021 $10.80 Minimum Fee Adjustment-Mechanical 04/07/2021 $43.36 Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Holly ly Va,,De Wege Permittee Signature: 0 jet,App -,a ter t Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • 0...:.° EC EIVE ` �- L 9/a Mechanical Permit Application ',z,, City of Tigard 11111 13125 SW Hall Blvd.,Tigard,OR 97223 BAR 9 202+ y L OG x / i txe_:M u L�T1/ Phone: 503.718.2439 Fax 503.598.1960 'ITYOFTIGARi; N�� o,herl t:he.i!& 2G`l101109 f 1,,,1 is[i Inspection Line: 503.639.4175 Date Ready/By: heir B See Peke 3 for Internet: www.tigatd-or.goy 3 U I LD I N G DIVISION xaif0d/M«hob b`6/D�`2/OP I-.CC sarplemestrt Ietarmatioo TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees'are based on the value of the work ❑New construction %Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other. mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* and 2-family dwelling ❑Commercialmdustrial 0 Accessory building For special iq/onnatior sae rfec sx O Multi-family ❑Master builder 0 Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heatloe/codial: Air conditioning 46.75 Job site address: 1'2.,N4 v S L) 1 7)(.,tSI\ A-r Furnace 100,000 BTU(dacir/vem) . 46.75 City/State/ZIP: 7-`s� tit_ 9-4_ -2_,1, 7 Furnace 100,000+BTU(Ascts/vems) 54.9106 9911 , Heat pump 61. Stlite/bldgJaptno.: Project name: /v,I ztl�_©3 1J�q Ductwork 1 23.32 23'la-- Cross street/directions to job site: Hydronic hot water system 23.32 _ n(J Residential boiler(radiator or `?,t, 1rl'ix- t. hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wail,induct,suspended,etc. 46.75 Flue/vent for any of above , 23.32 Subdivision: Lot no.: Other: 2332 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 > .+ 27h LY.LZ,'t' ) ,T),(c7 upi 1f— r/ fireplace 23.32 r Log ligbter(gas) 23.32 1,Lc r� kV/ /r 4-).`e>_ _C4VC io Wood/pellet stove 33.39 \IN''cl 1 l_ ,- Wood fireplace/insert 23.32 i� , [ ( Chimney/liner/flue/vent 23.32 (0�)iV:'f p z6 `) �t- •( Other: 23.32 71,PROPERTY OWNER 0 TENANT i Environmental exhaust aid ventilation; Name: I/4( J J 1`''r /VErU 7`(.i Range hood/other kitchen equipment 33.39 Address: )-2 0°) 5,111/4J i 1,LI-, U$. Clothes dryer exhaust 33.39 7 Single-duct exhaust(bathrooms, City/State/ZIP: Ti n,09,`4. op._ e/7- 3 toilet compartments,utility rooms) ( 23.32 7 ,-W- Phone:( ) �' Fax( ) Anic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other 23.32 Business name: Fuel piping: $1435 for first four;54.03 for each additional Contact name:' 1 V 0 'M r)CU/ ) Furnace,etc. Gas co pAddress: 4Ink, C l— -n, WaWsuspended/ nitheater City/State/ZIP: To‘,,t`,,,,c) C.l)-l-b 4 Water heater Phone:( j)7) '1 iZ;\ - 3 )g i> , I Fax:( ) Fireplace Range E-mail: rdl41bl. _cDI,yk-va.ct-orCyahoo.Gom Barbecue CONTRACTOR Clothes dryer(gas) Business name: Other MECHANICAL PERMIT FEES* Address: O -' . Subtotal City/State/ZIP: � Minimum permit fee($90.00) +S) Plan review(25%of permit fee) Phone:( ) Fax( ) State surcharge(12%of permit fee) t 0..Z p CCB lie.: TOTAL PERMIT FEE )ip,V1 This permit application empires if a permit is net obtained within ISO .� Th.-County after it has been accepted as complete. Authorized signature: 1 t..(p' �,l . (_ ,UA\ J * Fee methodology set by Camty Building Industry Service Board Print name: K i F N ,i,4 "A,i I'NCi,.A..y;(tl Date: eel./S/ra/ 1:1BuildingTennits1MEC_PemitAApp_arm 13.d,c 440.4617T(11/O2ICOM/Wm)