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Permit
CITY OF TIGAR® MECHANICAL PERMIT a COMMUNITY DEVELOPMENT Permit#: MEC2009-00553 0 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10120/2009 Parcel: 2S 103 BD02700 Jurisdiction: Tigard Site address: 11940 SW CARMEN ST Subdivision: Lot: 0 Project: Biehl Project Description: Install bath fan. Owner: FEES BIEHL, PHILIP Description Date Amount 11940 SW CARMEN ST Single Duct Exhaust (Bathrooms, Toilet, 10/20/2009 $23.32 TIGARD, OR 97223 Utility Rooms) PHONE: 12% State Surcharge - Mechanical 10/20/2009 $10.80 Minimum Fee Adjustment - Mechanical 1012012009 $66.68 Contractor: NORTHWEST CONSTRUCTION CRAFTSMEN INC 2920 SW 119TH AVE PHONE: 503-803-2118 FAX: Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressue: 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 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. i Issued By: n~-I (Z) a u Perm ittee Signature: Call 5013.639.417/5 byy17:00 a.m. for an inspection that business day. 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 - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Totalt �PrmitFee Yn� r4,r� $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.doc 10/01/09 2 FOR OFFICE USE ONLY Mechanical Permit ApplicationR F " Permit No.: City of Tigard DReceived ate/By • 6Q5S ° 13125 SW Hall Blvd.; Tigard, OR 97223 OCT ZpLOi = Plan Review Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 DateBy a Inspection Line. 503.639.4175 CITY OF T IGARD Date Ready/By luris: ® See Page 2 for Internet: www.tigard-or.gov p~I~01`1 DI ~lNotified/Method: Supplemental Information TYPE OF WORK U M COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction Addition/alteration/replacement Mechanical permit fees* are 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 El Commercial/industrial [3 Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling D Air conditioning Job site address: (requires site plan showing placement) 46.75 City/State/ZIP: , L 7 2 Z Furnace 100,000 BTU (ducts/vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: Project name: Heat um 61.06 Cross street/directions to job site: (,,,ej 5 Duct work 23.32 H dronic hot waters stem 23.32 Residential boiler (radiator or h dronic) 23.32 Unit heaters (fuel-type, not electric), in-wall, in-duct, suspended, etc. 46.75 Flue/vent for an of above 23.32 Subdivision: Lot no.: Other: 23.32 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 Gw Flue vent for water heater or gas fireplace 23.32 Lo lighter (gas) 23.32 Wood/ pellet stove 33.39 Wood fire lace/insert 23.32 Chimney/finer/flue/vent 23.32 ❑ PROPERTY OWNER ❑ TENANT Other: 23.32 Name: K" -e f L 1',d, a 5 Environmental exhaust and ventilation f tt Range hood/other kitchen Address: c(,5 416C>U equipment 33.39 City/State/ZIP: Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms, I Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON _ Attic/crawls ace fans 23.32 Other: 23.32 Business name: Fuel piping Contact name: $14.15 for first four; S4.03 for each additional Fumace, etc. Address: Gas heat um City/State/ZIP: Wall/sus ended/unit heater Phone: ( ) Fax: ; ( ) Water heater Fireplace E-mail: Range CONTRACTOR Barbecue Business Clothes dryer (gas) © tc1J e. 'uE tJ -1 Other: Address: 2~Z~ v AUL MECHANICAL PERMIT FEES* City/State/ZIP: (JA 760S Subtotal ,3a Minimum permit fee ($90.00) , d Phone: (s6~ ) 963 - 2-4 ff Fax:( ) Plan review (25% of permit fee) CCB lic.: 140-3 d. iy , State surcharge (12% of permit fee) TOTAL PERMIT FEE p . This permit application expires if a permit is not obtained within 180 Authorized signature: % S t may„ days after it has been accepted as complete. Print name: °s c0 ` ~y Ci"r_ Date: jV 2a p Fee methodology set by Tri-County Building Industry Service Board 1\Building\Permits\MEC-Permit.Appdoe 10/01/09 440-4617T(II/02/CO"'EB)