Permit CITY OF TIGARD MECHANICAL PERMIT
111 IS • CO MMUNITY DEVELOPMENT Pe rmit #: MEC2010 00578
T [ GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/12/2010
Parcel: 2S102CCO2600
Jurisdiction: Tigard
Site address: 13885 SW 102ND AVE
Project: Gill Subdivision: FRELEON HEIGHTS NO.2 Lot: 12
Project Description: Installation of tankless water heater and venting. Gas line is existing.
Contractor: OWNER Owner: GILL, EDWARD & CORYELL, JANET L
13885 SW 102ND AVE
TIGARD, OR 97223
PHONE: PHONE: 503 - 968 -9039
FAX:
FEES
Specifics: Description Date Amount
Water Heater 11/12/2010 $23.32
Type of Use: SF Chimney /Liner /FlueNent 11/12/2010 $33.39
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/12/2010 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/12/2010 $33.29
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
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 • ' .'e ion - Thos: es are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. = u may obtain a copy of the
or di - ct questions to OUNC • • - Iling 503.232.1987 or 1.800.332.2344.
Iss ed By: 0 `� %..411-1114 Permittee Signature:
1
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 II /14 01 l : I ( . I : I i l : t 1,N I.Y
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City of Tigard Received / Permit No.: �' g ECE pit y: ► ��wo ��
.
13125 SW Hall Blvd., Tigard, OR 972 R
Phone: 503.639.4171 Fax: 503.598.19 DateBy: Other Permit:
i . i ,. , i , 1 Inspection Line: 503.639.4175 NOV 12 2010 Date Ready/By: tuns: ® See Page 2 for
Internet: www.tigard- ot.gov Notified/Method: Supplemental Information
TYPE OF W 46 8 s TY OF TIGARD
LDING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ 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*
g l . - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. J Total
JOB SITE INFORMATION AND yCATION Headnp/cooling _
Air conditioning
Job site address: i? leg, S 514). r Da (requires site plan showing placement) 46.75
City / State/ZIP: -77p T 04 97g 9s 3 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: Heat pump 61.06
Cross street/directions to job site: . /0 $�e,A),1!) 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: I Lot no.:
Other: _ 23.32
Tax map/parcel no.: Other fud appliances
DESCRIPTION OF WORK Water heater / 23.32
-.. AA Gas fireplace 33.39
u ov E ELI r W 6T1� R Flue vent for water heater or gas
/ ` � 5 �� � S /• fireplace 23.32
�/ (�' Log lighter (gas) 23.32
1 -7 Q � Wood/pellet stove 33.39
""� Wood fireplace/insert , 23.32
ROPERTY OWNER I ❑ TENANT Oter Chimney/liner/flue/vent / 23.32
Other: 23.32
Name: !■ p/► p y> / Environmental exhaust and ventilation
Address: - ! ,! AVE— Range hood/other kitchen
i� leg /O�• equipment 33.39
City / State/ZIP: t Clothes dryer exhaust 33.39
� $ —9'0 5 '
Single-duct co compartments, (bathrooms,
rooms) s,
Phone:
Fax: ( ) toilet compartments, utility ro 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 addttlonal
Furnace, etc.
Address: Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Water heater
Phone: ( ) I Fax: : ( ) Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Clothes dryer (Ras)
r� ) Other. 1 Ef Address: c`"� MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal 90
Minimum permit fee ($90.00)
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee)
CCB Iic.: / f / State surcharge (12% of permit fee) 1Q.
/ � / / � // TOTAL PERMIT FEE l0� . 1(U
/ / / This application eapira if a permit is not obtained within 180
Authorized signature: / ..I' i r days after it has been accepted as compkte.
• Print name: j Date: • Fee methodology set by Tri -County Building Industry Service Board
t:Suildin&PumaiV C- PermitApp.doc 10/01/09 440.4617T(1I/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
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$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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