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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2010 -00045 i.T i G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/02/2010 Parcel: 1S136CA03600 Jurisdiction: Tigard Site address: 11290 SW 79TH AVE Subdivision: FRIENDLY ACRES Lot: 12 Project: Knight Project Description: Install heat pump and air handler leaving minimum 3' sideyard setbacks. Owner: FEES KNIGHT, ROBERT W Description Date Amount 11290 SW 79TH TIGARD, OR 97223 Air Conditioning 02/02/2010 $46.75 Furnaces < 100K BTU 02/02/2010 $46.75 PHONE: 12% State Surcharge - Mechanical 02/02/2010 $11.22 Contractor: TRANAIR HEATING & COOLING 16682 NE PACIFIC PORTLAND, OR 97238 PHONE: 503 - 516 -7907 FAX: Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressue: Total $104.72 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. Issued By: J Permittee Signature: IA L ' Call 503.639.4175 by 7:00 a.m. for an inspection tha), . usiness 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 Apulicat' I]E 1., ,,' r; ' i c>l� c >�� F c ' I i, ' , .: ';zl City of Tigard Date/By: ryt „ h 71 v 13125 SW Hall Blvd., Tigard, OR 97223 , Permit No.: 1' �� — r p O 2010 O Date/By: Plan Review Phone: 503.639.4171 Fax: 503.598.19 CD Date/By: Other Permit: C r I c A i - 6 Inspection Line: 503.639.4175 Date Ready /By: J 1 Page See Pa e 2 for Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: 1 Supplemental Information BIJII DING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - .USE CHECKLIST 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. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* V1.1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Air conditioning Job site address: if AZ 1 0 ko 1 Oc (requires site plan showing placement) 46.75 City /State /ZIP: Furnace 100,000 BTU (ducts /vents) 46.75 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 hronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: I Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances - • DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 r. ----) ' 1[t. / . .. r _ . ,ii, 1, ♦ _ t A _•, i, Cit. 4 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen equipment 33.39 City /State /ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ 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: T I Clothes dryer (gas) �R° Wa.a./ kik - Other: Address: ( ( % .9 Z k- c3�e— _ MECHANICAL PERMIT FEES* City /State /ZIP: 1 ess.t._ -tZ-� c Subtotal t Minimum permit fee ($90.00) Phone: (S03 5 _ 7 lei Fax: ( ) Plan review (25% of permit fee) CCB lic.: 1 c .- 4 2 State surcharge (12% of permit fee) / TOTAL PERMIT FEE . 1 a Authorized signature: / , I A _ - .. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: V . N....) Date: Z _ t _ in ' F ee methodology set by Tri- County Building Industry Service Board I:\Building\Permits \NEC- PermitApp.doc 10/01/09 440- 4617T(11/02/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. 1:\ Building \Permits \MEC- PermitApp.doc 10/01/09 2