Permit III CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Pe
COMMUNITY MEC2023-00285
T f C;A.R 17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/24/2023
Parcel: 2S107AA23200
Jurisdiction: Tigard
Site address: 16774 SW ROCKHAMPTON LN
Project: Polygon at Roshak Ridge, Lot 232 NC unit Subdivision: ROSHAK RIDGE Lot: 232
Project Description: A/C unit after C of 0 was issued.
Contractor: PRO HEATING AND COOLING INC. Owner: TAYLOR MORRISON NORTHWEST LLC
2095 NW ALOCLEK DR, SUITE 1103 703 BROADWAY ST STE 510
HILLSBORO, OR 97124 VANCOUVER, WA 98660
PHONE: 503-443-5692 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 04/24/2023 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 04/24/2023 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/24/2023 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is spot started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the/ruffles adopted by the Oregon
odt a Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may ain copy of the rules
Issued By: ��/// Permittee Signature:
/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONL\
City of Tigard Received ,
Date/By: dh Permit Nu.:0 �. ci _co e. t
III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review t*rGG. �G4
s Phone: 503.71R2439 Other Permit:
Inspection Line: 503.639.4175 Date/By:Ready/By:I t 1 I:O Date Saris: Ia See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE*SCHEDULE—USE CHECKLIST
New construction ❑Addition/alteration/replacement Mechanical permit fees*arc based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling 0 Cotmnereial/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:
'Job site address: i L.4 � Air conditioning \ 46.75� ��^� �� Furnace 100,000 BTU(ducts/vents) 46.75 �-
�
City/State/ZIP: -TAG k+�n 1F^ oft_ c-?�j �� Furnace 100,000+BTU(ducts/vents) 54.91
t
Suite Bldg./apt.no.: Project name: t utw►2tat. Heat pump 61.06 -
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
n
Subdivision: Lot no.: ...3 t�, Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
l h BIA. �12 CON Q S\0"t/'cT Flue ventfor water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 2332
3 PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: ` tIl.b0_,, t„( 1.1, A Range hood/other kitchen
Address: 390 ,,,yeel. hr i)r: to equipment 33.39
A Clothes dryer exhaust 33.39
City/State/ZIP:
V i couje,L. , D,.)' S g(.(p e, Single-duet exhaust(bathrooms,
Phone:( ) Fax:( )
toilet compartments,utility rooms) 23.32
t,,� Attic/crawlspace fans 23.32
IpQ APPLICANT CONTACT PERSON Other: 23.32
Business name: lT .5 k3edu Fuel piping:
�"^ $14.15 for first four;$4.03 for each additional
Contact name:
t�5 �� 't S Furnace,etc.
Address: C A M.L.5 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:
)) )� C)4H� Water heater
Phone:(` J Fax::( )
Fireplace
E-mail: Ce• r o'r,,A-S 1 C'1'ol e>'f aTn
vy. r1 co-., . eon Range
CONTRA R Barbecue
Clothes dryer(gas)
Business name: WO
Mti�•rtM 11 t l/" , _`u`f Other:
Address: V t 2S �L ikk.00 vt �� ST• 'rj
Subtotal
MECHANICAL PERMIT'FEES*
City/State/ZIP: (� �J ir,,�
` t71 ) f r l VI Minimum permit fee($90.00)
Phone:(4' ) W�. I�8 ci Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.: .7.05;` TOTAL PERMIT FEE
' This permit application expires if a permit is not obtained within 180
,.. days after It has been accepted as complete.
Authorized signature: .
i' . Fee methodology set by Tri-County Building Industry Service Board
0 Print name: 404S a 6.,(tJ 5 Date: L'i'✓L L3
\B I: uildmgiPem 1 ntsMEC_PermitApp_0E2520.doc 440-4617T(II/07JCOMIWEB)
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:
S0.00 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.
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