Permit CITY OF TIGARD MECHANICAL PERMIT
111 s: CO MMUNITY DEVELOPMENT Pe rmit #: MEC2013 00442
T 'CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/01/2013
Parcel: 2S 112 BB00200
Jurisdiction: Tigard
Site address: 14010 SW HALL BLVD
Project: Hilden Subdivision:)NITA FIRS VILLAGE CONDO (PHASE Lot: 73
Project Description: Radon mitigation
Contractor: XAVIER ENVIRONMENTAL INC Owner: HILDEN, MARK
11300 SW CAHALIN RD 14010 SW HALL BLVD
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 503 - 991 -7250 PHONE: 503 - 625 -0482
FAX: 503 - 682 - 9506
FEES
Specifics: Description Date Amount
Other, ExhausWentilation 08/01/2013 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 08/01/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 08/01/2013 $66.68
Occupancy Grp:
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 = •ire I work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requi • you to follow - - les adopted by the Oregon
Utility Notifi ion Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR •52- 001 -0091. of - / •btain a c•py of the rules
or direc uestions to•OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: PermitteeSignatur j I jI
•
• 1
Call 503.639.4175 by 7:00 a.m. for the next available inspection da I
This permit card shall be kept in a conspicuous place on the job site until complet • fly project. `I
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A • • lic o • : EIV ( d=OR OFFICE USE ONLY
City of Tigard Date/By: b / Permit No.: H & a.) ,/
; . ° 13125 SW Hall Blvd., Tigard, OR 9722 1 2013 Plan Review
Ill Phone: 503.718.2439 Fax: 503.598. 196 Date/By: Other Permit:
TI G `R D Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
BUILDING 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
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: ( )I` J t j,f , I Air conditioning 46.75
1 � l Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: T1Cli ' Furnace 100,000+ BTU (ducts/vents) 54.91
i f Furnace
.�aAw..r_• Heat pump 61.06
Suite/bldg. /apt. no.: Project name: IP ` „ 1� '0 V Duct work 23.32
' Cross street/directions to job site: @ S(JJ C '( A I [l r t-1-1 D L , I Hydronic hot water system 23.32
`—V 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
• ' DESCRIPTION OF WORK Gas fireplace/insert 33.39
_ Flue vent for water heater or gas
,'k) ( ltd) fireplace 23.32
n
Waal Log lighter (gas) 23.32
r � �1 �� ��� Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
PROPERTY OWNER J ❑ TENANT Other: 23.32
�� ft L)\i
Environmental tand ventilation:
Name: Ranan hood/other hood/oth/oth er r kitchen
Address: / 1 / equipment 33.39
J l Clothes dryer exhaust 33.39
City /State /ZIP: q Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ` S y 62— — O Fax: ( ) Attic /crawlspace fans 23.32
J APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: . V' V, it G `1(V1 ? - , N • r Fuel piping:
$14.15 for first four; $4.03 for each additional
Contact name: a ' f _ 'L Fumace, etc.
Address: ( ,j a l ii� N I , Gas heat pump
1� Wall/suspended/unit heater
City/State /ZIP: )1I7h"1`egIL nti'r, Water heater
Phone: ( 40 c/ugga . '��� • Far Fireplace
^ ^ Range
��
E -mail: . en 'i � � 1 r
Barbecue
ONTRACTOR Clothes dryer (gas)
Business name:
Other:
MECHANICAL PERMIT FEES*
Address: r t C Q �,1 Ca/ Subtotal
City /State /ZIP: Minimum permit fee ($90.00) C r , an
Plan review (25% of permit fee)
Phone: ( ) Fax:
� ( State surcharge (12% harge (12 of permit fee) t�
CCB lic.: /540 8 I i TOTAL PERMIT FEE ( �
/5 1 This'permit application expires if a permit is not obtained within 180
5 f I r W days after it has been accepted as complete.
si Authorized sl _ ' Fee methodology set by Tri- County Building Industry Service Board
Print name: tiu'.1Ilri Date : � i 111 1�
1:\ Building\Permits\MEC_Permi tApp_0401 I3.doc 440 -4617r I /r 2/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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