Permit Pj MECHANICAL PERMIT
CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00139
GXitib 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/02/2010
Parcel: 2S102DB08300
Jurisdiction: Tigard
Site address: 9136 SW HILL ST
Subdivision: Lot: 0
Project: Jamal
Project Description:
Owner: FEES
JAMAL, MOUSSA AL Description Date Amount
9136 SW HILL ST
TIGARD, OR 97223 Air Conditioning 04/02/2010 $46.75
12% State Surcharge - Mechanical 04/02/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 04/02/2010 $43.25
Contractor:
ACTIVE AIR HEATING & COOLING
22415 NE SALMON DR
GRESHAM, OR 97030
PHONE: 503 - 201 -8453
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 Notifi on Cente . hose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct uestions to OUNC • c- • 50.246.6699 or 1.800.332.2344.
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Issuec By: I /1f
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 i 1
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i Received
City W Tigar Date/By: �_� Permit No.: ��iGl ?/ j' 9
13125 SW Hall Blvd., Tigard, OR 9722 v�
: ® Plan Review G �^
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: G, d�ld y ea 3
i . _ ',�, DateBy:
1 I E A1i Inspection Line: 503.639.417 Date Ready/By: Juris: ® See Page 2 for
•- - 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 0 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: $ 42C4449!"
- . RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
J 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description p Qty. Ea. I Total
• JOB SITE "INFORMATION 'AND LOCATION Heating/cooling
Job site address: C ; �c ..5 , r , i , t 1 ,_ � t Air conditioning
(requires site plan showing placement) l 46.75
City/State/ZIP: ' o Furnace 100,000 BTU (ducts/vents) 46.75 OP • �) ✓ 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
A4,1 A- • (_,- , Gas fireplace 33.39
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
I Chimney /liner /flue /vent 23.32
0 PROPERTY OWNER 1
. . ❑ TENANT . Other 23.32
Name: e ✓ e, / 2 r n a i. Environmental exhaust and ventilation
Address: 7 f3 . S F 1 4 ; •. 11 l S Range hood/ot kitchen
A, equipment 33.39
City /State /ZIP: / i� O2 Clothes dryer exhaust 33.39
S /� / Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
•
• -0 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 i, Barbecue
Business name: // tt � ) 1 / t Clothes dryer (gas)
r77 d' E- /i t''Pv i ✓• ;/' C_l > (] � � GtC; Other:
Address: `7 / c � ` . • MECHANICAL!PERMITFEES *' ,•
City /State /ZIP: /�-, � � e ,, 0/2 , e �c, _� c __„.„-- Subtotal o _
�/ / Minimum permit fee ($90.00) AO • � •
Phone: (`"';?) -3 Fax: ( )
�,D �G10 -�.S .) Plan review (25% of permit fee) lfir
CCB lic.: /7 / -- ,// // Z State surcharge (12% of permit fee) /0, gC
TOTAL PERMIT FEE 14 ' 0 .
gleil
This permit application expires if a permit is not obtain id within 180
Authorized signature: � days after it has been accepted as complete.
Print name: (f,., . ,. y r o .' Date: L j 2 -- c ` - ) cl * Fee methodology set by Tri- County Building Industry Service Board
1:t Building \Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (1 I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fees
$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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