Permit t CITY OF TIGARD MECHANICAL PERMIT
:r1 a. COMMUNITY DEVELOPMENT Permit#: MEC2022-00886
Date Issued: 10/11/2022
T t G A R.J_3 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S104CD02900
Jurisdiction: Tigard
Site address: 13578 SW HILLSHIRE DR
Project: Howell Subdivision: HILLSHIRE ESTATES Lot: 29
Project Description: Basement buildout(2)ductwork, (1)dryer exhaust, (2)single duct exhaust
Contractor: Owner: HOWELL,JOHN& ELENA SALVATORI FAM TRU
13578 SW HILLSHIRE DR
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 10/11/2022 $23.32
Type of Use: SF Clothes Dryer Exhaust 10/11/2022 $33.39
Class of Work: ADD Type of Const: Single Duct Exhaust(Bathrooms,Toilet, 10/11/2022 $23.32
Occupancy Grp: Utility Rooms)
Stories: 12%State Surcharge-Mechanical 10/11/2022 $10.80
Minimum Fee Adjustment-Mechanical 10/11/2022 $9.97
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. •u may obtain a copy of the rules
Issued By: /mot L L �. _ Permittee Signature: ,+ ��
! Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE LSE ONLY
City of Tigard ReceivDateived qAPermit No.: 4`
Cag... 0 „tor.4
III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 fora
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE• -.USE CHECKLIST T`,
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
p'1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
J.QB SITE INFORMATION.AND LOCATION Heating/cooling:
T �« ... ., Air conditioning 46.75
Job site address: 1 3$i 8 5,,,) Nv- t Y1.JI yQ D g Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 90 r it 1 d.,,,,4i OR ell-Z r, 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32 1..
Cross street/directions to job site: 5 \,J 11`3 < < 'Co Z D,R. 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
s ' "'-jai � '+"'ft. 1wM4� e ' ^�«® ® • r® ' w. . ��.3r. :e d" a 3 Gas fireplace/insert 33.39
Flue vent for water heater or gas
5,Ark,i-o o an--5 fireplace 23.32
Log lighter(gas) 23.32
1
I C)/`3 C-y- �an Wood/pellet stove 33.39
1lit a w o,k Wood fireplace/insert 23.32
• Chimney/liner/flue/vent 23.32
Other: 23.32
gjP PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Range hood/other kitchen
Name: auh t-�w 1( equipment 33.39
Address: ii '� ,�1
I 3 S �-QJ s�„/ t�I I,t S�,,t'1'C y1r1 fre Clothes dryer exhaust 33.39
`
Single-duct exhaust(bathrooms,
City/State/ZIP:
'-vi. °Jo-sd I 0 vi, 61.1-2..-Z-5 toilet compartments,utility rooms) 23.32 /.
Phone:( SD_J) 3 53- 111Z Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
�. Fuel piping:
Business name: = Q C t S C��
. .(Y1 G"'I✓! $14.15 for first four;$4.03 for each additional
y �
Contact name: Furnace,etc.
Gas heat pump
Address: Wall/suspendsx)/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) FireplaceRange
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: FEES*
j I-1 Gw4"i✓.I MECHANICAL PERMIT
Address: FO )Cl* I(qj Subtotal
Minimum permit fee($90.00)
City/State/ZIP: L.) 00
3 b V v h 6R ai g i, 7 , Plan review(25%of permit fee)
Phone:(O( 1) -4.i- 96 I ` Fax:( ) State surcharge(12%of permit fee)
CCB lit.: / TOTAL PERMIT FEE cX), '
I Z Z cv 3 Z r a This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: C * Fee methodology set by Tri-County Building Industry Service Board
ffeint name: (P1' To vi,, `J Date: q zi_ Z Z.
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)