Permit CITY OF TIGARD MECHANICAL PERMIT
1111 g CO MMUNITY DEVELOPMENT Pe rmit #: MEC2012 00662
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012
Parcel: 2S 110 BA00400
Jurisdiction: Tigard
Site address: 14100 SW 117TH AVE
Project: Bravo Subdivision: CANTERBURY WOODS CONDO Lot: 76
Project Description: Install new furnace and vent.
Contractor: RELIANT PLUMBING & MECHANICAL Owner: BRAVO, CHRIS
11575 SW PACIFIC HWY SUITE 219 3780 BOONE RD
TIGARD, OR 97223 SALEM, OR 97317
PHONE: 503 - 246 -1201 PHONE: 971- 218 -7389
FAX: 503 - 246 -1205
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/17/2012 $46.75
Type of Use: SF FlueNent For Any of Above 12/17/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/17/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/17/2012 $19.93
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: A il , Perm ittee Signature: o ip /G / -77O '
Call 503.639.4175 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.
Dec. 13. 2012 2:21PM Relient Plumbing and Mechanical No. 6892 P. 1
Mechanical Permit A IYCatio EI VED I (It( ()I I R I I s I ()NI \
City of Tigard Re°°ivad
tY g Datar! /7 /uL ..'- r permit No.:/Y ►e2t/2. 7,0 -
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
■ Phone: 503.718.2439 Fax: 503.598.1960 DEC 1 3 2012 Date/By: Other Permit: '
TI( A u. tm
Inspection Line: 503.639 Dale Ready/By: lulls: 0 See Page 2 [or
Internet: w�yw,tlgard or.gov CITY OhTIGARD Nnllisd/Merhod: .f' Supplemental Information
RUH DING DIVISION
TYPE OF WORK COMMERCIAL FEES 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: $
CATEGORY OF CONSTRUCTION RESIDENTIAL. EQUIPMENT /SYMMS FEES!
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special infdrindridn use checklist.
❑ Multi - family Q Master builder • ❑ Other: Description I Qly, I Ea. I Total
JOB SITE INFORMATION AND LOCATION ITeatlnf/cootioR:.
Air conditioning
lob site address: 14100 aw 117 ave (requires alto plan showing placement) 46.75
1•Lmace 100,000 BTU (ducts/vents) 1 46.75 46.75
City /State/ZIP: tigard ore 97223 Furnace 100,000+ BTU (ducts/vents) 54,91
Suite/bldg./apt. no.; I Project name: Heat pump
(requires aite plan showing placement) 61.06
Cross streeVdirections to job site; Duet work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric), y. —
in -wall, in- duct, suspended, etc. _ 46.75
Subdivision: Lot no : Flue/vellt for any of above I 23.32 23.32
- Other: 23.32 _
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
istalled new furnace 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: Chris Bravo Environmental exhaust and ventilation:
Address: 3780 Boone rd Range hood /other kitchen
equipment 33.39
City /State/ZIP: Salem ore 97317 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (971)218 -7389 Fax; ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Atticicrawlspacc fans 23.32
Business name;
Other: 23.32
Fuel piping:
Contact me; 514.15 for first four; 54.03 for each additional w
na
Address: • Furnace, etc.
Gas heal pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Pax:: ( ) Water heater
E-mail: Fire. lace
Range
CONTRACTOR _ Barbecue
-
Business name; Reliant Plumbing&Mechanical Clothes dryer (gas)
Other:
Address: 11575 sw pacific Hwy S nice 219 MECHANICAL PERM IT FEES _
City /State /ZIP; Tigard Ore 97223 Subtotal
Minimum permit fee ($90.00) ( Q e 0
one: (503) 246 -1201 Fax: (503 -) 246 -1205
Plan review (25% of permit fee)
CCB tic. 169844 (I 1 I State surcharge (12% of permit fe e)
TOTAL PERMIT FEE / 00- 'O s./--- This permit ap expires If a permit is not obtained within 180
Authorized signature! days after it has been accepted as complete,
Print name: Jim Buss Date: 12 -13 -2012 ' Fee methodology set by Tri.County Building Industry Service Board
1: 17luitding \Permils\MEC•PermilApp.doe 03/07/12 440-46171'(I1/02 /COM/WGO)