Permit a CITY OF TI ®r '' MECHANICAL PERMIT
11 Ft. ,�` COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00272
r DATE ISSUED: 5/14/2007
T $ r d 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S109DA - 07700
SITE ADDRESS: 15018 SW HAZELCREST TERR ZONING: R -
SUBDIVISION: SUMMIT RIDGE LOT: 054 JURISDICTION: TIG
PROJECT: LEE
Project Description: Install a/c unit.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
SANG LEE Description Date Amount
15018 SW HAZELCREST TERR
TIGARD, OR 97224 [MECH] Permit Fee 5/14/2007 $72.50
[TAX] 8% State Surcha 5/14/2007 $5.80
Total $78.30
Phone: 503- 620 -6482
Contractor:
BULL MOUNTAIN MECHANICAL
13580 SW RHETT CT.
TIGARD, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 702 -2945
FAX 503 -524 -6533
Reg #: LIC 157814
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By ,A 414 i i L s� , 1/ Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections thafThusiness 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 FOR OFFICE USE ONLY
City of Tigard t"`* P ermit No.:
tY Received
g = r : Date/By: r j o.� S l,{� f` I tCZt - �Z
Z�
il
13125 SW' Hall Blvd., Tigard, OR �3 , p >1 5 C.
C Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
T I G A RD Inspection Line: 503.639 MAY 1 4 2007
Date ReadyiBy: Juris 0 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 11 Supplemental Information
CaY ` i C s GAi (10
TYPE orilitOtiiik.e. DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ 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*
1211- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 156) /8 660 /7 a° e6 7.--f-r- Air conditioning or heat pump /
n (requires site plan showing placement) / 14.00
City /State /ZIP: J /9/94,�p d q7G 2 41 Fumace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: 77 Project name: . /9 •A.4 Furnace 100,000+ BTU (ducts vents) 1 7.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRH'11ON OF WORK Water heater 10.00
1 Gas fireplace 10.00
I N L /, // 4 ,/o- /1) f 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: S, fir LL Environmental exhaust and ventilation
(.C/ /�/9 /�? j -C S -/ JET-- equipment kitchen
Address: ice) /g s 10.00
City/State /ZIP: T/ /9/'2.L> Ca_ 4' 7 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( 6 20 64 . Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT El CONTACT PERSON Attic /crawlspace fans 10.00
Business name: 3 C.Q 1 / 0 c Ai2/A) / 7') X/0 -1 C-41"/ Other: 10.00
Fuel piping
Contact name: `-r`9 a /� JSrz S5.40 for first four; $1.00 for each additional
Address: j?). j 8D s " h c_ C/ c,Lt. ��- Furnace, etc.
Gas heat pump
City/State/ZIP: / /ZIP: ' /9/2.L) 72 2r Wall/suspended/unitheater
Phone: (7') 702 2 9 L/' Fax: 3) /) 2 -6� Water heater
�- 5 r L(, , /C ,' ) // , /� Range
E -mail: � D /� ,(` // 'J ( N ,, `. v lam' Range e
CONTRACTOR Barbecue
ry
Business name: Oki /7 /72& ,uz? »J ` e.6 - 4�� t C /-4,- Clothes dryer (gas)
�
a GL J 2 c Other:
Address: / , j S / pz 1 ,r MECHANICAL PERMIT FEES*
City /State /ZIP: 9/3/ -' i G' 7 22- ( Subtotal
Minimum permit fee ($72.50) �. 5 0
Phone: )) 72 2�L/1 Fax: ( ) cg y S Plan review (25% of permit fee)
CCB lic.: / C76 7 State surcharge (8% of permit fee) S• gO
TOTAL PERMIT FEE ? R . 3D
Authorized signature: i /44-(----1/4------''---- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ‘ /'3 /lJ /1J Date :/'j')j�
AI 2�/� • Fee methodology set by Tri- County Building Industry Service Board
11Building , Permits\MEC- Perm4App.doc 04/06/06 440 -4617T (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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