Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00514
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 2S112CB09700
Jurisdiction: Tigard
Site address: 15286 SW KENTON DR
Subdivision: Lot: 0
Project: Webster
Project Description: Installation of tankless water heater and gas line. Plumbing under minor label.
Owner: FEES
WEBSTER, STEVEN G & MARJORIE Description Date Amount
15286 SW KENTON DR
TIGARD, OR 97224 Water Heater 10/21/2010 $23.32
Fuel Piping 10/21/2010 $14.15
PHONE: 12% State Surcharge - Mechanical 10/21/2010 $10.80
Minimum Fee Adjustment - Mechanical 10/21/2010 $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 I . All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issu , or if wor is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Util' Notification Center. T = e rule4 . e set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain . copy of the rules
or irect questions to OU. by ca • 50 .246.6699 or 1.800.332.2344.
Iss d By: I g ■ � � Permittee Signature:
.-•""
Call 503.639.4175 by 7:00 a.m. for an inspection that • • - iness 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.
I
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Mechanical Permit Application rc►li OFricl: USE UN1.1
City of Tigard Date/By: O Z / / Permit No.: ���D�a -do 5/
13125 SW Hall Blvd., Tigard, OR 97223 Received Plan Review ie
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By:
I.1 t; A it 1) Inspection Line: 503.639 Date Ready/By: Juris: 6§ See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK 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*
- .U1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
5 /� Air conditioning
Job site address:
l 7 ace t o J f•(� 7 -o i` , / �} /f_ (requires site plan showing placement) 46.75
City /State /ZIP: Cf '7223 Fumace 100,000 BTU (ducts/vents) 46.75
Fumace 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 / 23.32
Gas fireplace 33.39
!/N 5-74 &t- 774A/44-61",:c L /. 4--76 - /1 W ?%? Flue vent for water heater or gas
fireplace 23.32
S ✓ t�-r.Nt e, A- 7 / 6 ,4-s: / • f /r'A Log lighter (gas) 23.32
C 0-46 ---n. , / / I/� 1 ' 00- l� r #1 _ _. Wood/pellet stove 33.39
/ Wood fireplace/insert 23.32
IasPROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: s7� c_ i " , /��i--,.. { Environmental exhaust and ventilation
/ Range hood/other kitchen
Address:
/ � .2 to ,,c---.,/ ��/' .n/ 4-fr equipment 33.39
City /State /ZIP: q 72 2 3 Clothes dryer exhaust 33.39
City/State/ZIP:-.---1777 � ���' / Single -duct exhaust (bathrooms,
Phone: ea) 43 ( - ' 722 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; $4.03 for each_additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater j
Fireplace
E -mail: Range
CONTRACTOR Barbecue
�vv g3,---1. Clothes dryer (gas)
Business name:
c �l� �✓- F"'T�rif�� Other:
Address: A .5„... _3 3 � .•7 MECHANICAL PERMIT FEES*
City/State /ZIP: S ubto tal * o
�a mit..4-t/!i 72 9, 2 0
2 Fax: 7 � Minimum permit fee ($90.00)
Phone: (5:03j ' ? ! ''l �O, 5 Plan review (25% of permit fee) --8
CCB lic.: /73 b 7 , 5-' State surcharge (12% of permit fee) yy /0 .3C)
/ / TOTAL PERMIT FEE F/ .
Authorized signat = �/ / This permit application expires if a permit is not obtained within 180
����� days after it has been accepted as complete.
Print name: /q 0. f _ Date: 1 + 0 - 2 ( f 0 • Fee methodology set by Tri- County Building Industry Service Board
\ B
I:uilding \PermitAMEC- PermitApp.doe 10/01/09 440- 4617T(1l /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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