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Permit RECEIVE eb Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard FEB 3 2022 DatReceeBy (,9 22 .> PermitNo.:MEC2o22.-Citoo /• 13125 SW Hall Blvd.,Tigard,OR 97223 ived Plan Review �� Other Permit: ' Phone: 503.718.2439 Fax: 503.598.1960 t.JITY OF CIGARLi Date/By: < _ J u;,^,Iii1 Internet:n : 503.639.4175 3UILDING DIVISI DateReadyethod � rum„ 611 pie Supplemental age 2 for Internet: www.tigard-or.gov [[(>/ , 1. Su lemental Information TYPE OF WORK OMMERCIAL FEE* SCHEDULE—USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction I Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$5,750.00 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling I]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: Air conditioning 46.75 Job site address:10565 SW Nimbus Ave. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard/Oregon/97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suiteroldg./apt.no.:110 Project name:SBC-Big Leaf Networks 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: I 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 Install (1) Ductless Wall Mounted Split System 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 MI PROPERTY OWNER ❑ TENANT Environmental exhaast and ventilation: Name:KG Investment Range hood/other kitchen equipment 33.39 Address:10300 SW Nimbus Avenue Clothes dryer exhaust 33.39 City/State/ZIP:Portland/Oregon/97223 Single-duct exhaust(bathrooms, 9 toilet compartments,utility rooms) 23.32 Phone:(503)598-9980 Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name:Oregon-Alre Inc. $14.15 for first four;$4.03 for each additional Contact name:Ian McDonald Furnace,etc. Gasheatpump Address:7715 NE 33rd Drive I Suite A Wall/suspended/unit heater City/State/ZIP:Portland I Oregon/97211 Water heater Phone:(503)335-2222 Fax::( ) n/a Fireplace Range E-mail:permits@oregon-aire.com Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name:Oregon-Aire Inc. MECHANICAL PERMIT FEES* Address:7715 NE 33rd Drive I Suite A subtotal City/State/ZIP:Portland/Oregon/97211 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)335-2222 Fax:( ) n/a State surcharge(12%of permit fee) CCB lic.:64235 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: c 1ai //Kph id * Fee methodology set by Tri-County Building Industry Service Board Print name:Ian McDonald Date:2/2/22 I1Building\Permits1MEC_PerrnitApp_040I 13.doc 440-4617r(1 I/OLCOMRVEB)