Permit CITY OF TIGARD MECHANICAL PERMIT
111 C COMMUNITY DEVELOPMENT Permit #: MEC2013 -00369
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/08/2013
Parcel: 1S125DD07700
Jurisdiction: Tigard
Site address: 9675 SW VENTURA CT
Project: Manning Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 85
Project Description: Replace gas firplace, venting and gas line.
Contractor: EVERGREEN GAS INC. Owner: MANNING, ROBERT WAYNE &
PO BOX 388 TAYLOR, JUDY GAIL
WEST LINN, OR 97068 9675 SW VENTURA CT
TIGARD, OR 97223
PHONE: 503 -407 -9542 PHONE:
FAX: 503 - 344 -6345
FEES
Specifics: Description Date Amount
Gas Fireplace 07/08/2013 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 07/08/2013 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: Fuel Piping 07/08/2013 $14.15
Stories: 12% State Surcharge - Mechanical 07/08/2013 $10.80
Minimum Fee Adjustment - Mechanical 07/08/2013 $19.14
Fuel
Fuel Types: Natural Gas
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 • a ion e - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or d' -ct questions to OUNC b• allin• 503.232.1987 or 1.800.332.2344.
ssued By: O/P/1 / , Permittee Signature: k
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.
Mechanical Permit Application l OI OFFICE US ;,ONLY
City of Tigard Received Cab Permit No.: N
q 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: 7 5 / 3 / t gC/�D/ 3 -Oo 3 6 A
Plan Review Other Permit:
��11 Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov 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 dition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Ek4Occtiher: mechanical materials, equipment, labor, overhead, and profit.
. Value: $
CATEGORY OF CONSTRUCTION RESIDENTIALEQUIPMENT / SYSTEMS FEES* .
and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building For specialinjormaiionusechecklist.
❑ Multi - family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
• Job site address: („ 73,../ 5, ry I (Jr
conditioning 46.75
. J Furnace 100,000 BTU ( ducts/vents) 46.75
City /State /ZIP: ! F C�L 97? 7 _C Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 61.06
Suite/bldg. /apt. no.: Project name:
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33
'-C � / Flue vent for water heater or gas
er l4 __ t� A - . S t-Q(1 4 4-- fireplace 1 23.32 9-3' 3i'
U e444✓Ly '1 - I - ( /' - - 5 f _-. V - Wood/pellet Log /pel e (gas) 23.32
,v/ let stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
ROPERTY OWNER ❑TENANT
Other:
r Environmental exhaust and ventilation:
Name: b b WA_ v I �a , Range hood/other kitchen 23.32
r. equipment 33.39
Address: 675 C I - \J / v f u 74- C-1-- Clothes dryer exhaust 33.39
City /State /ZIP: — ` i �
/ C c- 977:z Single -duct exhaust (bathrooms,
3 toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: ( ) Attic /crawlspace fans 23.32
- ❑ APPLICANT ' < CONTACT PERSON Other: _ 23.32
Business name: Fuel piping:
$14.15 for first four; $4.03 for each additional
Contact name: Fumace, etc.
Address: Gas heat pump
Wall /suspended/unit heater
City/State /ZIP: Water heater i
Phone: ( ) Fax: : ( ) Fireplace
/ /�"�
' Range _
E -mail:
Barbecue
CONTRACTOR . Clothes dryer (gas)
Business name: EI✓CA-e ire / L
Other:
J �7l` S MECHANICAL P�RMIT FEES*
Address: 2 3„.. 3 ' 3 Subtotal
City/State /ZIP: ' n , S I-- 1_,\9 v t i9 7D/g5 Minimum permit fee ($90.00) 9D • o
( ) U v " G Fax: ( ) c Plan review (25% of permit fee)
Phone:
S�3 / O7 _c l Z State surcharge (12% of permit fee) /U •
CCB lic.: ` V A 7 1 TOTAL PERMIT FEE /OD o
• g
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signat e : " Fee methodology set by Tri -County Building Industry Service Board
Print name: l 11( 'J I Z �� e `�v(� Date: 7 /0 3
1:t Building\ Permits \MEC_PermitApp_0401I3.doc 440 /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 $10000 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 1 • ' ! • •
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 Y.
fraction thereof.
Note: All new commercial buildings require 2 sets, of plans.
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