Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit MEC2010 -00098
r ` Date Issued: 03/09/2010
7 [ G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103AD00803
Jurisdiction: Tigard
Site address: 11010 SW FONNER ST
Subdivision: Lot: 0
Project: DeSanno
Project Description: Install gas piping for new range.
Owner: FEES
DESANNO, DENNIS Description Date Amount
11010 SW FONNER Fuel Piping 03/09/2010 $14.15
TIGARD, OR 97223 12% State Surcharge - Mechanical 03/09/2010 $10.80
PHONE: 971 - 219 -7181 Minimum Fee Adjustment - Mechanical 03/09/2010 $75.85
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: Natural Gas
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 Noti - • - • -r. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to OU • • • If • . 503.246.6699 or 1.800.332.2344. �>
Issu =d By: ` /' !/ ``` Permittee Signa re: . ,
Call 503.639.4175 by 7:00 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 y . r u N •: FOR i OFF E USE �vo LY ' =_
., / Q 0651 City of Tigard Received Date /By: 3 / 9 le, ( Permit No.: � Q Z g
•° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ( ' LL���' C Ot
' ' C Phone: 503.639.4171 Fax: 503. 598.1960 Date/By: Other Permit:
-T I G A k`D. Inspection Line: 503.639.4175 Date Ready /By: )uris: HI See Page 2 for
:. . •.. Intemet: www.ti ard -or. ov
g g Notified/Metho Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE •- USE CHECKLIST
ID 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 ❑ Commercial /industrial ❑ Accessory building
For special information use checklist. —
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. I Ea. Total
' SITE INFORMATION AND LOCATION . Heating/cooling
R Air conditioning or heat pump
Job site address:
t ®t $ w -F,14� eft— (requires site plan showing placement) 14.00
City /State /ZIP: 1-w Ft/ / O 'T., i 7 Z t- 3 Furnace 100,000 BTU (ducts /vents) 14.00
J Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION 'OF WORK Water heater 10.00
1 Gas fireplace 10.00
5 2m / O r /��/ry t2 uat. Flu vent for water heater or gas
(fj s .5 C tJ / - J — — fireplace 10.00
0 Leg of (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
*PROPERTY OWNER - ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: ji,jk5 1) tS A m,,! 0 • Environmental exhaust and ventilation
Range hood /other kitchen
Address: `t 1 t$ S lJ� radO e.A--- equipment 10.00
City /State /ZIP: -- G I ,A JYQ Clothes dryer exhaust 10.00
• Single -duct exhaust (bathrooms,
Phone: '* v 4 ) 91 ! .- 71 el Fax: ( ) toilet compartments, utility rooms) 6.80
❑ :APPLICANT ❑ CONTACT PERSON ° Attic /crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: 55.40 for first four; $1.00 for each additional
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
1 Phone: ( ) - • - Fav :: ( ) Water heater
E Fireplace
E -mail: , , Range
CONTRACTOR Barbecue •
•
Clothes dryer (gas)
Business name: t eq -ntt -(( 5e/Z,_
Address: ` 3) 3 S - /du") . U 1 S , . MECHANICAL PERMIT FEES" ,
', City /State /ZIP: C a el. t vs Go t_. 4 "7/ ( 3 Subtotal o °C1 s Minimum permit fee ($72.50) 7
(
Phone: 3)2...t,, 7 7 Y Fax: ( ) Plan review (25 % of permit fee) -i
CCB lic.: ,'OZ 4 *73 State surcharge (8% of permit fee) (o. �d
TOTAL PERMIT FEE h , 'Q
Authorized signature: A This permit application expires if a permit is not obtained within 180 gau
da ys after it has been accepted as complete.
Print name:N�t ( 1,,- Q (/� Date: �// * Fe e methodology set by Tri- County Building Industry Service Board
1:\Building\Permits \NEC- PermitApp.doc 01 /19/07 4 4 617T (11 /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: . Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and •
$1.35 for each additional $100.00 or
fraction thereof, to and including
•
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
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