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Permit CITY OF TIGARD MECHANICAL PERMIT i II COMMUNITY DEVELOPMENT Permit#: MEC2022-00326 T I<;Aft D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/25/2022 I Parcel: 2S 106AC04500 1 Jurisdiction: Tigard Site address: 12979 SW MEADBROOK LN Project: Banjade Subdivision: RIVER TERRACE EAST 3 Lot: 17 Project Description: Installing NC unit. Contractor: ACTIVE REFRIGERATION Owner: BANJADE, DILA RAM 13150 SW FOOTHILL DR JOSHI, MAHIMA PORTLAND, OR 97225 17205 NW WOODREED CT PORTLAND, OR 97229 PHONE: 503-333-7577 PHONE: FAX: FEES Specifics: Description Date Amount Air Conditioning 04/25/2022 $46.75 Type of Use: SF 12%State Surcharge-Mechanical 04/25/2022 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/25/2022 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules Issued By: A_, ---r. Permittee Signature: • Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE Om.' 1111 City of Tigard HECEIVED DateBey ` / ,? .. -iv -- , • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review t: Phone: 503.718.2439 Fax: 503.598.1960 C Other Permit: APR 2 5 2022 Date/By: T l G:1 R.D Inspection Line: 503.639.4175 Date Ready/By: F5 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARb Notified/Method: BM Supplemental Information TYPE OF W11LDING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction NI Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* M1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. 0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning .pg I 46.75 c6. ` Job site address: la. L V rS Mea cf 42rook LA Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: )eager to n I ®a_ / g qi,D-7, Furnace 100,000+BTU(ducts/vents) 54.91 / Heat pump 61.06 Suite/bldg./apt.no.: Project name: ,+'' " -�l. kt J aof� 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 ✓ an r fireplace 23.32 Log lighter(gas) 2332 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: a: 1,21 © ^� Range hoodlother kitchen f 1 equipment 33.39 Address: 12 9�9 SW l QCf rook L,� �` Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 11-# APPLICANT ❑ CONTACT PERSON Other 23.32 i LL l Fuel piping: Business name: A C"C t v Q le e ru t—ir 1 )� , $14.15 for first four;$4.03 for each additional Contact name: ()'fl lb -a/�5a P�V Furnace,etc. Address: (? 1 SC) 1 q () 0,{1,‘..ti �r- Gas heas pump Wall/suspended/unit heater City/State/ZIP: pnf-t(,n►nL'C 1 n (A-722r Water heater `4"S ' - (l J Fireplace Phone:(�O�j) nj`�j Fax::( ) Range E-mail: a C.Ery , _ IA v O-C r(--- Q� (4 a a , . c)(V'. c, Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: A_ e,�� c pe rJ- Q MECHANICAL PERMIT FEES* ('7 Address: S Sr.LJ 0i k. (% 1) r G+ Subtotal (/�1-s City/State/ZIP: '��.- ‘Ok ® (t,��/22.- Minimum permit fee permit fee) f T Plan review(25%of permit feet Phone:(5j'a) eZi,"?) � I-"J Fax:( ) State surcharge(12%of permit fee) ?CCB lic.: IS' Z©� T TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 r days after it has been accepted as complete. Authorized signature: ,/'.---Y * Fee methodology set by Tri-County Building Industry Service Board Print name: " Date: ©f/2'512,2 I:\Building\Permits•\MEC_PennitApp_040113.do: 440.4617T(1I/02/COM/WEB)