Permit CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit#: MEC2022-01029
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/3/2022
Parcel: 2S 104CD04600
Jurisdiction: Tigard
Site address: 13845 SW BENCHVIEW TER
Project: Harrell Subdivision: HILLSHIRE ESTATES Lot: 46
Project Description: Mechanical for ADU: (1)range hood and (1)bathroom exhaust fan.
Contractor: OWNER Owner: HARRELL, MONTE&CARYN A
13843 SW BENCHVIEW TER
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 11/03/2022 $23.32
Type of Use: SF Range Hood/Other Kitchen 11/03/2022 $33.39
Class of Work: ALT Type of Const: Single Duct Exhaust(Bathrooms,Toilet, 11/03/2022 $23.32
Occupancy Grp: Utility Rooms)
Stories: 12%State Surcharge-Mechanical 11/03/2022 $10.80
Minimum Fee Adjustment-Mechanical 11/03/2022 $9.97
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: `���W tt /I /_ Permittee Signature: 14(- 14
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIV riP:ey /I/313)- ii,7)--- Permit No.: MJ anra--v1(
. i q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review t7 ll l{�f
Phone: 503.718.2439 Fax: 503.598.1960 Nov3 2111. Other Permit:nl�,��p-Q00�6
Date/By:
I 1 t Al,.1 Inspection Line: 503.639.4175 Date Ready/By: Jul,: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARLYotified/Method: Supplemental Information
• Ill_niNir, nl'.n"t. I
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction VI Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition D Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder I 'Other: A_,Q(A Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
r� '// Air conditioning 46.75
Job site address: (3�'t 5 SVJ [3�j1641 UJC I e1- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:"7---15 ar d q .)1.2 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: J jg.{,-v 1/ /_ i.4 Duct work ( 23.32 73-VA
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
�1 n Flue vent for water heater or gas
/ 24-,e^", , _L p i fireplace 23.32
v Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
iy 7 PROP RTY OWNER ❑ TENANT Other: 23.32
(-� Environmental exhaust and ventilation:
Name: /yl/(VI. ay-reileita, Range hood/other kitchen ` ,;9Address: /•V V'V�`rJ G '^ equipment 33.39 3St 3 Q% 3id �I6_,..0 r Pr Clothes dryer exhaust 33.39
-"� �� �� 3 Single-duct exhaust(bathrooms,
City/State/ZIP:
y toilet compartments,utility moms) 1 2.3.32 ?-3.3,;;I,
Phone:(56 3) 3 .2.,6 3 Obyt Fax:( ) Attic/crawlspace fans 23.32
RI APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: Al J Fuel piping:
ri/:rJ/IJ}. $14.15 for first four;$4.03 for each additional
Contact name: � t rye`J Furnace,etc.
Gas heat pump
Address: ley i'� �S Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:(5?). ) ' ZQ 36 Fax::( ) Fireplace ,
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
1✓ 14 �� MECHANICAL PERMIT FEES* :,4;
Address: Subtotal 6-
City/State/ZIP: Minimum permit fee($90.00) ;—, f
Plan review(25%of permit fee) Z.' �
Phone:( ) Fax:( ) State surcharge(12%of permit fee) t "
CCB lic.: TOTAL PERMIT FEES„
This permit application expires if a permit is not obtained within 180
//� days after it has been accepted as complete.
Authorized signature: (1V * Fee methodology set by Tri-County Building Industry Service Board
Print name: pyi 11i rr /, Date: i I -72 - LD 7,2_
I:iBuilding\Permits\MEc_PetmitApp_040 113.doc 440-4617T(1l/02/COM/wEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
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.
Note: All new commercial buildings require 2 sets of plans.
1:\Building\Permits\MEC_PermitApp_040113.doc 2