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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2022-00824 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/8/2022 Parcel: 2S111AB00301 Jurisdiction: Tigard Site address: 9055 SW MOUNTAIN VIEW LN Project: WOODWARD Subdivision: None Lot: None Project Description: Wood fireplace insert and venting. Contractor: R& D INSTALLATIONS Owner: WOODWARD, ERIC E & CHARLOTTE M 5246 SE 62ND 9055 SW MOUNTAIN VIEW LN PORTLAND, OR 97206 TIGARD, OR 97224 PHONE: 503-774-7142 PHONE: FAX: 503-774-7142 • FEES Specifics: Description Date Amount Wood Fireplace/Insert 09/08/2022 $23.32 Type of Use: SF Chimney/Liner/FlueNent 09/08/2022 $23.32 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 09/08/2022 $10.80 Occupancy Grp: Minimum Fee Adjustment-Mechanical 09/08/2022 543.36 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 f 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules Issued By: iikee..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 ONLY City Of Tigard Received I�ECEIV Date/By: ,�,r Po nuI No x�,xFC 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B Algol_ �,,/.i Plan Review 6�P� Phone: 503.718.2439 p Q goryq DateiBy. Other Permit: TIGARD Inspection Line: 503.639.4175 SEf O L LC Date Ready/By: iulis: fi7 See Page 2 fur Internet: www.tigard-or.gov Notifiied/Method Supplemental Information Gay OF TIGARD TYPE OF W� GDIVISION1 3 r „. �, ° ' , �`� .,a sG` }A�@'14f,-�YyGHEDULE-USE CHECKLIST El New construction /Lidition/alteration/rep(acement Mechanical permit fees°are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)ol'all 0 Demolition I 0 Other: mechanical materials,equipment,lahor,overhead,and profit. - F aYta S 'Y OF CONSTRUCTION Value N' RESIDENTIAL EQUIPMENT!SYSTEMS FEES'a- nd 2-family dwelling ❑ Commercial/industrial 0 Accessory building For special information use checklist. Multi-family ❑ Master builder 0 Other: Description Qty Ea. Total JOB SITE INFORMATION.AND LOCATION` Heating/cooling: Job site address: © 6�L� v rc4� / ,t_ Air conditioning 46.75 `ter` Furnace 100.000 BTU(duets/vents) 46.75 City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt no.: Project name: Heat pump 61.06 Duct work 23 32 Cross street/directions to job site: Hydronic hot water system 2332 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 ,_32 Flue/vent for any of above 23 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 �� ( .1 Flue vent for water heater or gas '���i�' Ili r�� fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33 39 ---- Wood fireplace/insert F 23.32 ).3,.�.. Chimney/liner/flue/vent / 23.32 n,3). ❑ PROPERTY OWNER t ❑ TENANT Other: 23.32 Name: ,jt. + z / Environmental exhaust and ventilation: r =. ,_ Nit_ f a+r t y'ifc. Range hood/other kitchen Address: I equipment 33.39 City/State/ZIP: Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms, Phone toilet compartments,utility rooms) 23.32 ( ) Fax ( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: Fuel piping: Contact name: $14.15 for first four;$4.03 for each additional Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax: :( ) Fireplace E-mail: Range ., Barbecue ,, •ONTRAC'fOlt, ,. Clothes dryer(gas) Business name: Cj *II'S� Cpt,. (0 ��^,-���C.,' Other. ._d Y r MECHANICAL PERMIT FEES" Address: `•S$ nC' City/State/ZIP: ITJlr'1�1 O . 9 6 Bantam) vIpLf Minimum permit fee($9Q00) a Phone: )�� ! 7 Fax:567) '���� flan review(25%of permit Pee) 93 State surcharge(12%of permit fee) / ,V'— CCB lic.: TOTAL PERMIT FEE {`L{-.) Yam/ This permit application expires if a permit is not obtai ed within ISO Authorized Signature 1' days after it has been accepted as complete. ti n /� * Fee methodology set by TB-County Building Industry Service Board Print name:'14_.er� (C L nC:10 ."-.q Date: �.- /Zo� I:1BuildinglPennilsllMEC_PermilApp_082520.doe �-�'V 440-4617T(Il/OUCOM/WEB) 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. I:\Building\Permits\MEC_PermitApp_082520,doc 2