Permit CITY OF TIGARD MECHANICAL PERMIT
2 ' • COMMUNITY DEVELOPMENT Permit #: MEC2012 00086
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2012
Parcel: 2S102DD00400
Jurisdiction: Tigard
Site address: 13750 SW HALL BLVD A
Project: Fanno Creek Village Duplex Subdivision: EDGEWOOD Lot: 3
Project Description: Install new firebox in existing masonry fireplace in duplex A.
Contractor: GROW CONSTRUCTION LLC Owner: SOLARES HOMES L L C
7900 SW HUNZIKER ST BY NORRIS BEGGS & SIMPSON
TIGARD, OR 97223 LOAN SVC DEPT
121 SW MORRISON #200
PORTLAND, OR 97204
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Wood Fireplace /Insert 02/14/2012 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 02/14/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/14/2012 $66.68
Occupancy Grp:
Stories:
Fuel
Fuel Types: Solid Fuel
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.4.
Issued By: Permittee Signature:
•
Cal 13.• 9.4175 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 roll OFFICE USE ONLY
City of Tigard � u � Received
Date/By: MN: Permit No.: 7 ' r a a d g
V 13125 SW Hall Blvd., Tigard, '7 J" -.111 * Plan Review "
.1
C . Phone: 503.718.2439 Fax: 50 '1. • •0 t ):^' ' Date/By: Other Permit:
T I G n R D Inspection Line: 503.639.4175 ' ' " k VV. Date Ready/By: ]iris: ® See Page 2 for
Internet: www.tigard �t1 , Notified/Method: Supplemental Information
TYPE OF 1 'is 0vi t ® COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
�� Mechanical permit fees* are based on the value of the work
ID New construction ,�Addition/altf6 eplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
K 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For specloi information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE F RMATIQ� AND hO1cAT ON Heating/cooling:
t 3 - �� t l A I( /, (v / Air conditioning
Job site address: _ _ _ _ , (requires site plan showing placement) 46.75
City/State /ZIP: 2- 3 r Furnace 100,000 BTU (ducts/vents) 46.75
l K3.A/Lo dL '9 2 Z Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 1_ Project name: J Q L4?, K f i /2 c c,1S -C Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
L
A t,f-- 4 FAr,J�a GR�R,Ates,_
Hydronic hot water system 23.32
SQt-- i 1kL1c '?Rt4c-i- (t-g-+n.k cg Ft C.A_ Residential boiler (radiator or
L v(� (A i p 1/I-AtS4 06. t 1 S tS i e �, N ll I4 A L& Unit heaters ic) 23.32
�7 Unit h (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
LoJtip 1t_ ( fl -a?-, ()O 1 r [ . , \r tf aJ G- IA pcSaN/L i Flue vent for water heater or gas
ft ii 0 t -Ja'�Z fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert / 23.32
ID PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, rooms) pantments, utili rooms 23.32
- APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
64... .,n.,..._. Other: 23.32
Business name: � £ _<») S_ - / C-rr / n LL c--_ Fuel piping:
Contact name: t C.. V , / t �t $14.15 for first four; $4.03 for each additional
Address: Fumace, etc.
71 S '^, 4 "2- t `� - � Gas heat pump
City /State /ZIP: �J cyz- 9 Z 'L 2-3 WalUsuspended/unit heater _
Phone: ( ) 4c7 — —.2 ` f d
Fax: : ( ) Water heater
1 Fireplace
E -mail: yt t � --- 1 All" — 4A A. 54 t.c-ki. .- <o✓'^ Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: Si- M (>?
Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal 96.('°
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee) ----"
CCB lic.: ( ( / 4/9 9-- State surcharge (12% of permit fee) (0 4(0
TOTAL PERMIT FEE /v, g
Authorized signature: This permit application expires if a permit is not obtai ed within 180
days after it has been accepted as complete.
Print name: C _ ' Date: .2. y " Fee methodology set by Tn -County Building Industry Service Board
1:\ BuildingWermits \MEC- PermitApp.doe 09/09/10 617T l 1 /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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