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Permit 71 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2022-00601 Date Issued: 7/12/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DA08200 Jurisdiction: Tigard Site address: 10693 SW LADY MARION DR Project: Bancroft Subdivision: ERICKSON HEIGHTS Lot: 43 Project Description: New gas line for pool heater. Contractor: JAVAZ HEATING&AIR CONDITIONING LLC Owner: BANCROFT, ALEXANDER A&SHANNON 12009 REES ST NE 10693 SW LADY MARION DR DONALD, OR 97020 PORTLAND, OR 97224 PHONE: 503-310-9416 PHONE: FAX: FEES Specifics: Description Date Amount Fuel Piping 07/12/2022 $14.15 Type of Use: SF 12%State Surcharge-Mechanical 07/12/2022 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 07/12/2022 $75.85 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 o taj a copy of the rules Issued By: 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 City of Tigard Received Date/By: �s�.Permit No.: II 13125 SW Hall Blvd.,Tigard,OR 97223 ry y �l��/s�,� ,6br - 2�" woo _ Phone: 503.718.2439 ���1C'"�w V Plan Review vG V L.. Date/By: Other Permit TIGARD Inspection Line: 503.639.4175 Date Read /B Juns Internet: www.tigard-or.gov y } See Page 2 for 2 2022 Notified/Method: Supplemental Information JUL fj L jai/ ;t s 2,it )at a;-, , .uir,T m, f ,,''`T E'OF°W nivi,rt COMMERCIAL'FEE SCHEDULE-USE CHECKLIST ❑New construction )4 Addition/altajiagiament Mechanical permit fees*are based on the lalue ofthe\Aork performed. Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment.labor.overhead.and profit. ' r l t r ri -, ..,i CATEGORY'OF CONSTRUCTION Value $ Z.1-and 2-family dwelling ElCommercial/industrial 0 Accessory building RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑Multi-family 0 Master builder 0 Other: For special information use checklist. Description Qh LI ii Loral , .f, �(`, ,7 ,f. .-JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: i 06 g 3 5 rJ l ctoi Ma Y l oY 0 Y Air conditioning 46.75 �t�c,, d+l 17?Z / l`J Furnace 100,000 BTU(duets/vents) 46.75 City/State/ZIP: cil Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 Cross street/directions to job site: Duct work 23 32 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: F Lot no.: Other: 23.32 Tax map/parcel no.: Other fuel appliances: emirs Ata r Water heater 23 32 4, ,...r 0i'r; ,-mos` �y,, SCR I+O �O yWOR .: Gas fireplace/insert 33,39 4,.p�_l Flue vent for water heater or gas 1 �QI CA qa5 tY)X ©l ON �1� i fireplace 23.32 U Log lighter(gas) 23.32 Wood/pellet stove 33 39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23 32 r.;, s :PROPERTY OWNER ',t0.TENANT'. Other: 23.32 Name: F\I C *�01 _ � Environmentaln e exhaustitches and ventilation: wI/y Y1C��4 Range hood/other kitchen Address: 1 s 6GI3 5W Ladt6 Moi 1 to in '(1 f, equipment 33.39 V Clothes dryer exhaust 33 19 City/State/ZIP: TI^Q -01) dSI °) 1221/ Single-duct exhaust(bathrooms, Phone: �J toilet compartments,utility rooms) 23.32 ( ) Fax:( ) eta �! Attic/crawlspace fans 23.32 ,,x ilt d, �x,T : , .- _ , /., D C $TAc ' �' ;F2SON., ' ,, Other: �-(-�• ,(� 23.32 Business name: ovoi �$ol'_Ivy ox , . At l� Cpvidl�t Ov1ty,„j Fuel piping: Contact name: -y^ `' J l $14.15 for first four;$4.03 for each additional Tot O�j V 0,7 C}ti t"� Furnace,etc. I ` [ JH�IJ Address: 12dng , S 4 N G Gas heat pump City/State/ZIP: £)ono,.l of OR. of 7O�,/� Wall/suspended/unit heater Phone: I �\ �J Water heater (563) Fax: :( ) 3� ���l�. Fireplace Email IJ�"vOx'L I1g017Iv ` AY1dcooiir�@311^G1)•CO \ Range Barbecue 4; 1�ti,r: "g° s ' v _;I,"_'CU`N R.7""`R . Clothes dryer(gas) Business name: a'o ova `�1 1fy w A/c_ �1 C, C. Other: Address: 21k'7�1 2t.S S�J A f 1. ,C'li1'"RECAi, . 11'ILT *+. adw .��,4 /`t Subtotal is'( is City/State/ZIP: 0ogk fk CR CI' o2 0 Minimum permit fee($90.00) 4 ).,..0 Phone:(c031 ?AO -Iii f Fax:( ) Plan review(25%of permit fee) —State surcharge(12e/of permit fee) { Z CCB lie.: \3�0l ��y 1d3 TOTAL PERMIT FEE � Lc O�� i V / This permit application expires if a permit is not obtained within I80 Authorized Signature: days after it has been accepted as complete. \ � * Fee methodology set by Tri-C'onniv Ruilding tnductry Set ice Roard Print name: Date: JUiiiIt Cod'? I:\Building\Perils\MEC_Pemu App_082520 oc 44(1-4617 tI I/02/COM/W EB) I Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. • (2) sets of equipment cut sheets. • (2) copies of site plan for ground and roof top equipment location and screening per Tigard development code. Commercial & Multi-Family Fee Schedule: Total Valuation: 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 $3.07 for each additional $100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 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$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional $100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional $100.00 or fraction thereof. • \Building\Permits\MEC_PermitApp_082520.doc 2