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Permit t. r� CITY OF TIGARD MECHANICAL PERMIT ` ! " COMMUNITY DEVELOPMENT Permit #: MEC2009-00255 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.639.4171 Date Issued: 06/02/2009 ;,„ Parcel: 2S114BA14000 Jurisdiction: Tigard Site address: 16250 SW COPPER CREEK DR Subdivision: Lot: 0 Project: Carpenter Project Description: Install tankless water heater Owner: FEES CARPENTER, CAROL J TRUSTEE Description Date Amount 16250 SW COPPER CREEK DR Water Heater 06/02/2009 $10 00 TIGARD, OR 97224 12% State Surcharge - Mechanical 06/02/2009 $8 70 PHONE Minimum Fee Adjustment - Mechanical 06/02/2009 $62.50 Contractor: NICHOLS PLUMBING PO BOX 68551, 4375 SE MARK KELLY COURT MILWAUKIE, OR 97268 PHONE 503 - 653 -2069 FAX• 503 - 513 -6402 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressue Total $81 20 Required Items and Reports (Conditions) This permit is_issuedd subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other app' • . Ib a law All work will be de e - in accordance with approved plans This permit will expire if work is not started within 180 days of .suance, or if work is susp -r fo me - - 180 days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center hese ru- - -re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules Issued By( �` /_ /. d � / , Permittee Signature: _ �� , J �� ". mss' — Call 503.639.4175 by 7:00 a.m. for an inspection that business 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. r Mechanical Permit Application ° } ° .FORAFFICE USE ONLY . ' City of Z'lgai'd (1 Date/By Received &flo % Permit No c � / •∎ 9 /oa� 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review e�J t ' Phone 503.639 4171 Fax 503 598 1960 Date/By Other Permit T I GARD Inspection Line. 503 639 4175 Date Ready /By ® See Page 2 for Internet www tigard -or gov Notified/Method Supplemental Information . , TYPE O F 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 - .,v ^ ' '� - . . , Value $ RESIDENTIAL EQUIPMENT /SYSTEMS SYSTEMS FEES *' ''.--------❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist ❑ Multi- family ❑ Master builder ❑ Other: Description Qty Ea Total -_.. --= ' " , '- JOB' SITE INFORMATION'AND LO_ CATI Heating/cooling Job site address: A i� Q,� �� Air conditioning or heat pump �" (requires site plan showing placement) 14 00 City /State /Z ': T � Furnace 100,000 BTU (ducts /vents) 14 00 Furnace 100,000+ BTU (ducts/vents) 17 90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 10 00 Hydronic hot water system 14 00 Residential boiler (radiator or hydronic) 14 00 Unit heaters (fuel -type, not electric), in - wall, in -duct, suspended, etc 14 00 Subdivision: Lot no.: Flue /vent for any of above 6 80 Other 10 00 Tax map /parcel no.: Other fuel appliances ' DESCRIPTION OF WORK, Water heater 10 00 Gas fireplace 10 00 Flue vent for water heater or gas fireplace 10 00 Log lighter (gas) 10 00 Wood /pellet stove 10 00 Wood fireplace /insert 10 00 Chimney /liner /flue /vent 10 00 PROPE$TI, OR ., ID TENANT,' ( Other ] 0 00 �' \\ Name: 0 G Q V Environmental exhaust and ventilation Address: Range hood /other kitchen equipment 10 00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6 80 . ° w':. ; ; 4 ❑ .APPLICANT ° ', ' ' ' El' ;CONTACT PERSON ' . -: � : " - Atti / p ace fans 10 00 Other 1600 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E - mail: Range Barbecue Clothes dryer (gas) Business name: V Other Address: . MECHANICAL PERMIT FEES* ` City /State /ZIP: `� Subtotal Phone �� ) f �o \4 Fax: V i " 9 \� -- I0� U 19" Minimum permit fee ($72 50) 7A' Sr) Plan review (25% of permit fee) -e CCB lie.: \ State surcharge (12% of permit fee) i' . 7O TOTAL PERMIT FEE V • This permit application expires if a permit is not obtained within 180 Authorized signatur: 11 �ii,,,� days after it has been accepted as complete. Print name: i scie mat, VA� Date: • * Fee methodology set by Tn- County Building Industry Service Board I \Buddmg\Permns\MEC- PermitApp doe 01/19/07 440 -46 7T (11/02/ OM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation:, "_ Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I \Budding \Permits \MEC- PermitApp doc 01/19/07 2