Permit 4
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00334
TIGAAD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/08/2009
Parcel: 2S 111 AD07200
Jurisdiction: Tigard
Site address: 8835 SW SCHECKLA DR
Subdivision: Lot: 0
Project: Aldridge
Project Description: A/C add on.
Owner: FEES
ALDRIDGE, CARINA Description Date Amount
8835 SW SCHECKLA DR Air Conditioning or Heat Pump 07/08/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 07/08/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 07/08/2009 $58.50
Contractor:
INTEGRITY HEATING
12564 SW MAIN ST
TIGARD, OR 97223
PHONE: 503 - 880 -8492
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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.
40001111111111117 "40111///11#
Issued By (J Y A n Permittee Signature:
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.
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Mechanical Permit Application �� � 4 7, �y�,g� 1 OR O FleElUS(• + N G i ' ; �, V,111� ° +� �,I' r, „� ;1
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` i l ' �' City of Tigard E I V �! eceived Permit No.: •
� , `J g DateIBy: II Q - �y��
Y1 13125 SW Hall Blvd., Tigard, OR 97223 JUL 0 8 2009 Plan Review
�' Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By:
"T r 1+ihG! Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
+dldi, x,i u+ Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISIO
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: $
1 - and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 8y j S- /�C �(R Air conditioning or heat pump
,S, (requires site plan showing placement) ` 14.00
City /State /ZIP: '/j 0(t 97 2 25' Fumace 100,000 BTU (ducts/vents) 14.00
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
.S.-/ S'cileck'CQ i �°I !y Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK , ' Water heater 10.00
Gas fireplace 10.00
A rc 4P0 p Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ❑ TENANT. ' Chimney /liner /flue /vent 10.00
Other: 10.00
Name: 5Aa�• ✓1 0f e Environmental exhaust and ventilation
Address: C Range hood/other kitchen
p�1f 5, Sc/kcjj/t equipment 10.00
City /State /ZIP: % t („A2v 'VC 1.7f '9' Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (S45) s-/ .1- i:pia Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: ./..Ye y, �T ( ''A Clothes dryer (gas)
�``� Other:
Address: /ZS'(cf SW 4/ S7 MECHANICAL PERMIT FEES*
City /State /ZIP: 77t/mA U/1._ 1 )225 Subtotal
Phone: (543) s-eu - � Z Fax: ( ) Minimum permit fee ($72.50) �a Sn
Plan review (25% of permit fee)
CCB lic.: /7/ //U • 8- O State surcharge (12% of permit fee) ' 7 Q
,.------- - TOTAL PERMIT FEE $ ‘ . 2 0
This permit application expires if a permit is not obtained within 180
Authorized signatu .• - - days after it has been accepted as complete.
Print name: - 5 - Aft.)--\ C' ,eli --t Date: 7 b-_ p f * Fee methodology set by Tri -County Building Industry Service Board
I'\ Building \Permits\MEC- PermitApp.doc 01/19/07 440- 4617T(1l /02 /COM/WEB)
‘f - --
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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