Permit I ,n
CITY OF TIGARD MECHANICAL PERMIT
11 1 COMMUNITY DEVELOPMENT Permit #: MEC2010 00605
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/19/2010
Parcel: 1S 126 DCO3800
Jurisdiction: Tigard
Site address: 9255 SW CORAL ST
Project: FISHER Subdivision: Lot: 0
Project Description: Gas fireplace with fuel piping.
Contractor: GASPRO INC Owner: FISHER, MICHAEL Q
7603 SE LOUNSBERRY LN 9255 SW CORAL
PORTLAND, OR 972056 TIGARD, OR 97223
PHONE: 503 - 775 -7020 PHONE:
FAX: 503 - 775 -7019
FEES
Specifics: Description Date Amount
Gas Fireplace 11/19/2010 $33.39
Type of Use: SF Fuel Piping 11/19/2010 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/19/2010 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/19/2010 $42.46
Stories:
Fuel
Fuel Types:
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -u b. Y u - obtain . -py of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2 •4.
Issued By: 'ermittee Signature:
Arlie
Call 50 .639.4175 by 7:00 a.m. for the next available insp: • ion 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 FOR OFFICE USF
USE ONLY
Received
City of Tigard Permit No.
`J g Date /By: 1 #j IL / — Co .
° 13 SW Hall Blvd., Tigard, OR 97223
C Plan Review
Phone: 503.639.4171 Fax: 503.598.19.,! Date/By: Other Permit:
I' I C. A R D Inspection Line: 503.639.4175 ''',,,,,,,.#.'' O�® Date Ready/By: See Page 2 for
Internet www.tigard- or.gov �� Notified/Method: Supplemental information
TYPE OF WORD,, C � COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
• Mechanical permit fees* are based on the value of the work
❑ New constructionddition /alterationit performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: 90' mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
nd 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
.K ...1*.sa Multi- family 0 Master builder 0 Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: T� S S S V (1 (,� (. Air conditioning
fires s to plan g placement) (requires site Ian showm lacement 46.75
City /State /ZIP: T / y42r) C) `t.._ 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
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
�
C Gas fireplace / 33.39
11 n c,2,, ` Flue vent for water heater or gas
//�'�
/ .A / fireplace 23.32
6 a S I' ,-8 Cl l. J9 ( e Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
ROPERTY OWNER ❑TENANT Other: 23.32
Address: / ,
r 11 r �G} ' K
`
Name: t � Environmental exhaust and ventilation
Range hood /other kitchen
4 equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
S� ) 7 9 _ �(�' [.� 9/ 6, D t
Single-duct exhaust (bathrooms,
Phone: ( Fax: ( ) toilet t compartments, ments, 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
Fireplace I
E -mail: Range
JONTRACTOR Barbecue
Business name: C 4 JC "v N� Clothes dryer (gas)
Other:
Address: 2 (2C 3 s� J, „ f k /� g � ,.. y ` / MECHANICAL PERMIT FEES*
City /State /ZIP: if& ` C /l ( 3 72 C C Subtotal 9 i d .00
Minimum permit fee ($90.00)
Phone: q[ / S 02 0 Fax: ( ) ' Plan review (25% of permit fee)
CCB lic.: /6, 2 , 3 State surcharge (12% of permit fee) j 0 ,
7 TOTAL PERMIT FEE WO,
This permit application expires if a permit is not obtained within 180
Authorized signature: / _ \Permits\MEC PermitA n days after it has been accepted as complete.
Print name: 4 / L ,{J � r / / �� S Date: / /// / �j * Fee methodology set by Tri- County Building Industry Service Board
I:\Buildin .doc 10/01/09 440 -4617T 11 / WEB
B PP t )
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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