Permit a CITY OF TIGARD MECHANICAL PERMIT
: ° >` COMMUNITY DEVELOPMENT Permit#: MEC2010 -00424
T I GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/24/2010
Parcel: 2S 104AA90311
Jurisdiction: Tigard
Site address: 12646 SW KAREN ST 31
Subdivision: Lot: 0
Project: Bellwood Terrace
Project Description: Run dryer venting for units #31 & #32.
Owner: FEES
BELLWOOD TERRACE LLC Description Date Amount
PO BOX 189
YAMHILL, OR 97148 Mechanical Permit - COM 08/24/2010 $90.00
12% State Surcharge - Mechanical 08/24/2010 $10.80
PHONE: 503 - 662 -3010
Contractor:
RELIABLE HOME IMPROVEMENT INC
PO BOX 230815
TIGARD, OR 97281
PHONE: 503 - 481 -0240
FAX:
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $100.80
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: 1 Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
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 1:: • ays of
issua • -, or if work is su n ded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopt:. by the Oregon
• ity Notification Center. Th. e r -s are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obt•" a :py of the rules
or direct questions to OUNC • AI. 13.246.6699 or 1.800.332.2344.
Issued By: Ole / Permittee Signature:
CaII 503.639.4175 by 7:00 a.m. for an inspection that busine . s day.
This permit card shall be kept in a conspicuous place on the job site unti ompletion of the .
Approved plans are required on the job site at the time of =ach inspection.
Mechanical Permit Application l 0R 01..1 1(J. tatil'�)N i,'
C
City Permit o.: !
`J of Tigard Received Pi N
UPI g Date/By: t ,,- f7 /�etOlyQ"00 , TOt
V 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By: t
Tit; n RI) Inspection Line: 503.639.4175 Date Ready/By: `aria: Ell See Page 2 for
Internet: www.tigard -or.gov , Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST ,
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❑ New construction ddition /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.
I 4vitiTti- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
• JOB •SITE INFORMATION AND LOCATION Heating/cooling
Job site address: % (../( K % � ' t
- Air condi
l/ (requires site plan showing placement) 46.75
City /State /ZIP: 1 7 ?a .' 5 Fumace 100,000 BTU (ducts/vents) 46.75
��� G �,_ ( Fumace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: CVV � ` ' Heat pump 61.06
Cross street/directions to job site: p K-6-KJ /a6 7fi' Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
4 / I 3 3 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
Gas fireplace 33.39
G (.) Flue vent for water heater or gas
fireplace 23.32
`' ` ■ Log lighter (gas) 23.32
U Wood/pellet stove 33.39
Wood fireplace /insert 23.32
--PROPERTY OWNER 1 ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: 74 K4;2-c_3 _ Environmental exhaust and ventilation
''nn Range hood/other kitchen
Address:
• O t h, i 7L / Y b" equipment 33.39
City /State /ZIP: Y,r2/h /f /7/ o g- - Clothes dryer exhaust 33.39
' / Single -duct exhaust (bathrooms,
Phone: (1-0 6 ( a _ 30(0 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; 54.03 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
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Business name: J / Clothes dryer (gas)
`' v ! Other:
Address: P . v r 6,)1-- d-30-R1 • . MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal o n
y ��� J � Minimum permit fee ($90.00) s
Phone: 60 3) 17 — G Lid Fax. ( ) Plan review (25% of permit fee) ^'&
CCB lic.: 1 1 K (Q 3 '7 State surcharge (12% of permit fee) f ..E0
TOTAL PERMIT FEE r €0 ,
This permit application expires if a permit is not obtained within 180
Authorized sign: . e: / days after it has been accepted as complete.
Print name` // " f Date: -- ,2 Y 02. I / 0 * Fee methodology set by Tri- County Building Industry Service Board
� � z
I:\Buildin• .' Its \MEC- PermitApp. 'C i / 440-4617T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
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Pagel - 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.
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