Permit CITY OF TIGARD BUILDING PERMIT
'. - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00081
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/02/2009
Parcel: 2S102CD02802
Jurisdiction: Tigard
Site address: 9865 SW OMARA ST
Subdivision: Lot: 0
Project: McDonald
Project Description: Install (1) heat pump, (1) furnace, and (1) tankless water heater.
Owner: FEES
MCDONALD, TERRY UDIANE L Description Date Amount
9865 SW OMARA Furnaces < 100K BTU 03/02/2009 $14.00
TIGARD, OR 97223 Gas Heat Pump 03/02/2009 $14.00
PHONE: 503- 639 -3573 Water Heater 03/02/2009 $10.00
Fuel Piping 03/02/2009 $5.40
Contractor: 12% State Surcharge - Mechanical 03/02/2009 $8.70
Minimum Fee Adjustment - Mechanical 03/02/2009 $29.10
PHONE:
FAX:
Specifics:
Type of Use: SF
Class of Work: ALT
Dwelling Units:
Stories: Height: ft
Bedrooms: Bathrooms:
Value: $0
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $81.20
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by callir 03. 48.6699 or 1.80 . .2344.
5
Issued By: VAsa yn kN Permittee Signature: /V \ CA
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.
4s
Mechanical Permit Applica _ t ip 1 CEIVED FOR OFFICE USE ONLY
City of Tigard _ Received Permit No.: �n
II I
• 13125 SW Hall Blvd., Tigard, OR 972231,,1l c� Date/By: 0 • 1' 1C.C2001 • 0vfu v I
II Phone: 503.639.4171 Fax: 503.598.196M 0 2 ZOOS Plan Review
DateBy: Other Permit:
TI G A P. D Inspection Line: 503.639 Date Ready/By: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: ,I Supplemental Information
RIM DING DIVISION
E 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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ct R be * (A) b Iv\ Rapt Air conditioning or heat pump
(requires site plan showing placement) 1 14.00
City /State /ZIP: "l kW\ , OR CI .7 2Z3 Furnace 100,000 BTU (ducts/vents) 1 14.00
Furnace 100,000+ BTU (ducts/vents) 1 7.90
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 1 10.00
p� Gas fireplace 10.00
1 V CVO. fk ( Pump t GAS t� 0 , Flue vent for water heater or gas
`�1 e / fireplace 10.00
r ` `NKl-t JS IJ,� l (l T Q Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: 74-11( (t1 L " ` t t•5 QALD Environmental exhaust and ventilation
�� �� � �(� /� Range hood /other kitchen
Address: , , ` u " j
equipment 10.00
City/State /ZIP: 1\ (\ \a 6 OR- Q17223 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (fio3) (0 R 337 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
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
I
Fireplace
E -mail: Range
CONTRACTOR Barbecue
_ ^ , J F l/ � Clothes dryer (gas)
Business name: (�, �./ Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 1 --V n i
Phone: ( ) Fax: ( ) Minimum permit fce ($72.50) `7O5•
Plan review (25% of permit fee) -®—
CCB lic.: State surcharge (12% of permit fee) '.70
TOTAL PERMIT FEE 87 • -PO
This permit application expires if a permit is not obtained within 180
Authorized si _ We: •
• • • _ t days after it has been accepted as complete.
Print name: Jui/WRIM Date: • Fee methodology set by Tri -County Building Industry Service Board
1:\Building\ Permits \MEC- PermitApp.doc 01 /19/07 440- 4617T(11 /02/COM/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.
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