Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00677
t6,Ag_� 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/23/2009
,..,,... Parcel: 2S103CA02200
Jurisdiction: Tigard
Site address: 11860 SW JAMES CT
Subdivision: Lot: 0
Project: Doss
Project Description: Installation of gas fireplace insert and gas piping.
Owner: FEES
DOSS, DAVID & NANCY Description Date Amount
11860 SW JAMES CT Gas Fireplace 12/23/2009 $33.39
TIGARD, OR 97223 Fuel Piping 12/23/2009 $14.15
PHONE: 503 - 579 -8901 12% State Surcharge - Mechanical 12/23/2009 $10.80
Minimum Fee Adjustment - Mechanical 12/23/2009 $42.46
Contractor:
FLANDERS JR
33535 NW VADIS RD
CORNELIUS, OR 97005
PHONE: 503 - 647 -9320
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 N. a ion Cen - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or d' -ct questions to OU • =llin. 03.246.6699 or 1.800.332.2344.
-sued By: /� Permittee Signature: ! /
Call 503.639.4175 by 7:00 a.m. for an inspection that business cl .
This permit card shall be kept in a conspicuous place on the job site until comp etion of the project.
Approved plans are required on the job site at the time of each inspection.
4 1 - W iit oof nix arc of fr x^!i.
Mechanical Permit Application t rO r�ic H s � 1 1—Cr&
City of Tigard Date/By: ,4 09 0 9 7 Permit No.: / [Gem7 polo 7
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
2 Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
,1- I t A R D Inspection Line: 503.639.4175 Date Ready/By: furls: ® See Page 2 for
( 716 . ---
/ !(Q
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
•
Mechanical permit fees* are based on the value of the work
❑ New construction ddition/alteration / replacement 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*
For special information use checklist.
- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
M ulti- family 0 Master builder 0 Other: Description I Qty. Ea. I Total
J013 SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 8 / o 5 ' [ Lv� e S ` ) Air conditioning
(requires site plan showing placement) 46.75
City /State /ZIP: CS a t - o� 7 - 7 2 Z 7
Furnace 100,000 BTU (ducts /vents) 46.75
l > Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
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
Tax map /parcel no.: Other fuel appliances
• DESCRIPTION OF WORK "� Water heater 23.32
r I /� I Gas fireplace 33.39
. \c C c., p v to,/. / t- LA-- r, (.c._ Flue vent for water heater or gas
/ fireplace 23.32
Jt r e' l Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
PROPERTY OWNER I ❑ TENANT Other: 23.32
Name: Nc, _ 5 Environmental exhaust and ventilation
Address: 1 Q 3 ) U Q�f i �1 o , t •.∎ C c? — Range hood /other kitchen
equipment 33.39
City /State /ZIP: . -' \S a-,9 V 3 T 7'Z Z 3 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone:) s '70( g9 , :s Fax: ( ) toilet compartments, utility rooms) 23.32
. ❑ APPLICANT - .0 , CONTACT PERSON Attic /crawlspace fans 23.32
• Other: 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax :: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR . Barbecue
Business name: ( 4 II/t..iC�f' �f „„ t p � S • Clothes dryer (gas)
3 '3 Other
Address: �'✓ 1/ ( r - MECHANICAL PERMIT FEES*
City /State /"LIP: C 0 A A e (c,/ j 0 Re. 5 71( 3 Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) Q Q •
eV
Plan review (25% of permit fee) - 6'
CCB lic.: l 0 2_'1 7 S State surcharge (12% of permit fee) /v • $'Q
t TOTAL PERMIT FEE /r. - 8)
This permit application expires if a permit is not obtained within 180
Authorized signature: d ays after it has been accepted as complete.
I
Print name: 7 2, 41 .- e I- i Date: ( 2 — ` . 3 02/C l7 1 s Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permits\ME - itApp.doc 10/01/09 440 -4617T (1I OM/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.
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