Permit CITY OF TIGARD MECHANICAL PERMIT
e COMMUNITY DEVELOPMENT Permit fl: MEC2010 00436
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/01/2010
Parcel: 2S103CC04100
Jurisdiction: Tigard
Site address: 13888 SW 124TH AVE
Subdivision: EAGLE POINTE Lot: 16
Project: McCraven
Project Description: Install tankless water heater and gas line. Plumbing done under minor label.
Owner: FEES
MCRAVEN, DAVID K & RUTH A Description Date Amount
13888 SW 124TH AVE Water Heater 09/01/2010 $23.32
TIGARD, OR 97223 Fuel Piping 09/01/2010 $14.15
PHONE: 503 - 524 -7405 12% State Surcharge - Mechanical 09/01/2010 $10.80
Minimum Fee Adjustment - Mechanical 09/01/2010 $52.53
Contractor:
STAN THE HOT WATER MAN
PO BOX 33157
PORTLAND, OR 97292
PHONE: 503 - 760 -2992
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 N ''cation Center. ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rul- . T.
or dir ct questions to OUNC . • ' s 503.246.6699 or 1.800.332.2344.
Is ued By: / / Permittee Signature: ir6.9%
Call 503.639.4175 by 7:00 a.m. for an inspection that busi ••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 IoIZ o rici.: USE ONLY
City of Tigard Received permit No.:
11111 ° 131 SW Hall lvd., Tigard, OR 97223 Pl view ' D -/ /'�tG�o?Ol0 '700
Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
.1.1(; n u 1, Inspection Line: 503.639.4175 Date ReadyBy: Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction N' 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*
k'3- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: r . ^ Air conditioning
' 3<2133 �7i�J ,.G 7 t/ (requires site plan showing placement) 46.75
��
City/State /ZIP: 4 ' ✓✓✓ ___ 071_ ct 722 -3 Furnace 100,000 BTU ( ducts/vents) 46.75
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 ,
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 1 23.32
Gas fireplace 33.39
/ Al I
5 7444 T,q.N t, 4•OriS to J 4 A- ?Ex1Z ieT* r Flue vent for water heater or gas
4 & 1 6 t d( q / / pe Log lighter 23.32
Me L1//�/N N Q 6 ►�j� � Log ighter (gas) 23.32
�L uA�t 131,VG e01/>r/L o,N A- / i&Aat72 LA - 4 v__ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
.""PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: / j p ,i le eA Environmental exhaust and ventilation
Address: vC C Range hood/other kitchen
3$ 12� equipment 33.39
City/State /ZIP: Y �� C)r 77 2 3 Clothes dryer exhaust 33.39
r . 44...„2...6 / Single -duct exhaust (bathrooms,
Phone: (- 7 e/ )5 Fax :'( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping
Contact name: 514.15 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 Barbecue
Business name: S 4i �_� Clothes dryer (gas)
''*-tom G✓L
Other:
Address: pa n 3' MECHANICAL PERMIT FEES*
City /State /ZIP: �� ar & en - ? 72? 2 Subtotal
(�j� 2 9 Fax: ( -76/--057 Minimum permit fee ($90.00)
Phone:
7l/J � , 0 — / Z ��� Plan review (25% of permit fee) —4:2----
CCB lic.: / 3 755 State surcharge (12% of permit fee) l!J - frO
// TOTAL PERMIT FEE /O . L 2
Authorized SigrlatUr This permit application expires if a permit is not obtained within 180
i e lef-
%% d ays a i t has been accepted as complete.
Print name: , ` Date: O `/ — / V * Fee methodology set by Tri -County Building Industry Service Board
I:\BuitdinglPermitsWEC -P. ,itApp.doc 10 /01/09 440- 4617T(II /02/COM/WEB)
Mechanical. Permit Application - City of Tigard
Page 2 - 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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