Loading...
Permit Support Document ' GENE[ / Mechanical Permit Application rt)iz oi.i mCl: lnsl:O.1.1 City of Tigard MAR 2 701Z Received 43 .2022, 0,70 Permit.....: r" 1.Z-O©f i4J 4 13125 SW Hall Blvd.,Tigard,OR 97223 Date./By: :III II Phone: 503.718.2439 Fax: 503.598.1960,1 I Y OF I ItiPIH L Plan ReviewDate/By: Other Permit: T I C A R p inspection Lice: 503.639.4175 (t 1ILDING DIVISIO pate Ready/By: Aiir !a�r See Page 2 for Internet: www.tigard-or.gov Notified/Method: 1165 Supplemental Information TYPE.OP. WORK COMMERCIAL FEE'.;SCHEDULE='OSECHECKLIST Mechanical permit fees'are based on the value of the work 0 New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. _ Value 5 . CATEGORY OF CONSTRUCTION. - RESIDEl�T7AL'HQUIPMEtvT/$XsTEMSTEE$" . 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. Multi-family 0 Master builder 0 Other: DescriptionI Qty. Ea. Total JOB SITE INFORMATION AND`.LOGATION; ' ' ' fleeting/cooling: r Air conditioning_ 46.75 Job site address: 1,31145 SU..1 Uics fC 2.S r ?\ Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: r:yaCA. � CV122-3 Furnace 100,000+BTU(ducts/vents) 54.91 t� Heat pump 61.06 Suite/bldg./apt.no.: Project name: C^c,e / 3 12_z% 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 Subdivision: Lot no.: Other: 23.32 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 AA kc_ F f2)rnA.4 (cS 1_ fireplace 23.32 Lok( C'tv f,\�C J Wood/pelletg lhter(gaol 23.32 r,7 h /�� �` stove 33.39 ��"YV1 k.� 1 E C.,2 L ZZ- (,0 t\\ Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 PROPERTY OWNER 0 TENANT: Environmental exhaust and ventilation: Name: t dme S 4., y)2.\n ve, Vc Sj Range hood/other kitchen Address: t3`tC Sty l��1. e7CC Q\ Clothesodrpment 33.39 t dryer exhaust 33.39 City/State/ZIP`` 0,,_.('`ck... 0 Ck'l'L -- Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(545 '1') - 2-55C.4 Fax:( ) Anic/crawlspace fans 23.32 APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: `\ ,bS WQ33A.A. ^�^�+� $14.15 for first four;S4.03 for each additional Contact name: �nvvv�rr� t�,�` rt, Y t �' Furnace,etc. Address: t,.Tll..L1'"lr yL.7, se,.. /v,`tz\3`c,) At3 e_r Gas heat pump �1`� Wall/suspended/unit heater City/State/ZIP:'..--Pa,r..k.-\o....gNC. d C.V 126 Z-, Water heater Phone:6-65 23C.>1_/3-6k Fax::( 2) dp$- O,1CS5, Fireplace Range Email: Y\i\. .e.31/4`�c e(s ator, ,e¢,kLY,5.[,c>wk Barbecue CONTRACTOR Clothes dryer(gas) Other Business name: _ScAct_AE....,5 Via.z`" ,AS MECHANICAL PERMIT FEES* ' Address: Subtotal City/State/ZIP: b \,�.- Minimum permit fee(S90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: \ l �_ TOTAL PERMIT FEE /2r/5 This permit application expires Ira permit is not obtained within ISO days after It has been accepted as complete. Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board Print name: t ' t CSt . 'Th- t e r Dat .t_ 1.1Building\Pcrnws\MEC PamaApp_040113.doc 440-4617 (1IIDVCOM?WEB) Mechanical Permit Application - City of Tigard Page 2-Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valuations 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 S3.07 for each additional S100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to S 10,000.00 S207.21 for the first$5,000.00 and $2.81 for each additional S 100.00 or fraction thereof,to and including S 10,000.00. $10,000.01 to$50,000.00 S347.71 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 S100,000.00 S1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. S100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional S 100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:U3uilding\Pamits\MEC PermitAPp_040113.doc 2