Permit CITY OF TIGARD MECHANICAL PERMIT
IN •
COMMUNITY DEVELOPMENT
Permit#: MEC2022-00977
Date Issued: 10/19/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AB03600
Jurisdiction: Tigard
Site address: 14245 SW 114TH AVE
Project: Meyers Subdivision: COLE'S ACRES Lot: 16
Project Description: Installing piping for gas range and range hood.
Contractor: MARCELINO T NAVARRO JR Owner: MYERS, LISA L&JUSTIN J
PO BOX 7251 14245 SW 114TH AVE
ALOHA, OR 97003 TIGARD, OR 97224
PHONE: 503-318-2500 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 10/19/2022 $33.39
Type of Use: SF Fuel Piping 10/19/2022 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge-Mechanical 10/19/2022 $10,80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 10/19/2022 $42.46
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
r.
/ it
Issued By: ' -- - Permittee Signature: /' ���
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Cityof Tigard ECEIVED Received y:
IN • 131 SW Hall Blvd.,Tigard,OR 972 3 n Review r �/ ��
= Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I(_,A It I) Inspection Line: 503.639.4175 OCT 1 9 2021 Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard-or.gov ,� Notified/Metbod: Supplemental Information
�'crr OF r;( AHL)
TYPE OF # PING DIVISION COMMERCIAL FEE* SCHEDULE-USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction IN Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 2j 3---C3
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
IS 1-and 2-family dwelling E Commercial/industrial D Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
11
L' Air conditioning 46.75
Job site address: /_[ ., Zs- .S co / / 4° f/if Furnace 100,000 BTU(ducts/vents) , 46.75
City/State/ZIP: --1-, C 0,`.0O �. Furnace 100,000+BTU(ducts/vents) 54.91
1t Heat pump 61.06
Suite/bldg./apt.no.: Project name: Ductwork 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
-co
to Sp tie 'O C ( S °V'1 ' Ylp fireplace 23.32
(o F a1..SQ`J t / Fes' C T O(D Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen equipment t 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
}APPLICANT 0 CONTACT PERSON Other. 23.32
Fuel piping:
Business name: I `�e S14.15 for first four;$4.03 for each additional
Contact name: ✓i4 k4 C. Furnace,etc.
Gas heat pump
Address: P. O . tq 0 5C' -J./ S j Wall/suspended/unit heater
ity/State/ZIP: A 0 kc 0 ta
?d "� Water heater
Phone:(5"U3) 3 ' e ._ 0 d Fax::(
P c ) Fireplace
Range `
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone: Fax: State surcharge(12%of permit fee)
/
CCB lic.: )/6 5-0 5C /j 3/�L/ TOTAL PERMIT FEE
6 This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Authorized signature: / * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,fry/ Y1/ •/�a trC✓f tnr Date:/ —/Q`2Z
I:\Buildng\Permita\MEC_PermitApp 040113.doc /� 440-4617r(I 1/02/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.
I:\Building\Pemtits\MEC_PetmitApp_040113.doe 2