Permit r CITY OF TIGARD MECHANICAL PERMIT
ri
' '!� 2 .'- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00277
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/16/2011
Parcel: 2S104AA90262
Jurisdiction: Tigard
Site address: 12654 SW KAREN ST 26
Project: Bellwood Terrace Subdivision: BELLWOOD TERRACE CONDO Lot: 26
Project Description: Install dryer vent.
Contractor: RELIABLE HOME IMPROVEMENT INC Owner: BELLWOOD TERRACE LLC
PO BOX 230815 PO BOX 189
TIGARD, OR 97281 YAMHILL, OR 97148
PHONE: 503 - 481 -0240 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 06/16/2011 $69.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/16/2011 $8.29
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $500.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $77.35
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 o I'. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you follow!the rules adopted by the Oregon
Utility No • : ter. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0'90. Y•u may obtain a copy of the rules
or dire questions to 0 C . calling 503.232.1987 or 1.800.332.2344.
Issued = � / j � 4i , / Permittee Signature: _ / , i G rj
Call 503.639.4175 by 7:00 a.m. for the next available inspe. ion date.
This permit card shall be kept in a conspicuous place on the job site un completion of the project.
Approved plans are required on the job site at the time o •ach inspection.
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Mechanical Permit Appl - k S ys FOR OFFICE USE ONLY
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City of Tigard
Date/By: �� `� ermit i� ♦ ..... 7 - 7 P No
11 13125 SW Hall Blvd., Tigard, OR 97223 JUN G 2011
III Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
, � I
T I GARD Ins Line: 503 CITY OF t I ,1;'tD
Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov
BUILDING DiviSiOi Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $d
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /SYSTEMS FEES *'
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
- []'Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: //e) . . c,„, K wV ` . //) ` At :41
W. (requires site plan showing placement) 46.75
City /State /ZIP: � ,, " � r � Furnace 100,000 BTU (ducts/vents) 46.75
1, y v f`nn l n t 3 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: uV Project name: AbuzeioD 741--‘4-12. Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
/0 / 7e 5 / f�J� /,A f - / Hydronic hot water system 23.32
/ (9 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 ,
f� ; ) r U ( Z.. y e�2 Gas fireplace 33.39
�� '� Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32 ,
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: t O ' ,d r./2 Environmental exhaust and ventilation:
Address: ;7
�,G)L / � � Range hood kitchen
t t equipment ment 33.39
City /State /ZIP: JJ'' (�.1.�,,,.. �� f Clothes dryer exhaust ) 33.39
�Y��� Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
AEhAPPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
it--4;,,,f/5,62 4 /_ _ . Other: 23.32
Business name: bO/y'L�
Fuel piping:
Contact name: 0 /i /(17 $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: P, o r 6 t✓ Q U S Gas heat pump
City /State /ZIP: a j G ,�-vv 7) 0.4 -7.2 8- ( Wall /suspended/unit heater
Phone: (50) l y Fif .- G,,)_ K Cj Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: 5 45 M,v -Q ■ Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES* 67
City /State /ZIP: Subtotal
Phone: ( ) / Fax: ( ) Minimum permit fee ($90.00) —
Plan review (25% of permit fee) - C , A
CCB lie.: 41810 5 7 State surcharge (12% of permit fee) O
TOTAL PERMIT FEE l
Authorized signature: l` e�0 This permit application expires if a permit is not obtaine w,{mn rau
days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri -County Building Industry Service Board
I.\ Building\Permits\MEC -Per • •p doe 09/09/10 440 -4617T (11 /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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