Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013 00450
T€GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2013
Parcel: 2S 112CC03800
Jurisdiction: Tigard
Site address: 8010 SW CHURCHILL CT
Project: Deck Subdivision: BOND PARK NO.3 Lot: 66
Project Description: Installation of A/C. Placement of NC or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: 24/7 HEATING&COOLING Owner: DECK, DENNIS D&VIRGINIA A
20022 SW 71ST AVE 8010 SW CHURCHILL CT
TUALATIN, OR 97062 TIGARD,OR 97224
PHONE: 503-804-6534 PHONE: 503-639-8144
FAX: 503-213-6067
FEES
Specifics: Description Date Amount
Air Conditioning 08/05/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/05/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 08/05/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow he rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicati FOR OFFICE USE ONLY
City of Tigard EIVED Received
Date/By: / -�WAm emit Nos y C4o2o „le U s-
° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960A u G 5 ^,n.1 Date/By: Other Permit:
Inspection Line: 503.639.4175 �' ` Date Read/B ® See Page 2 for
T l G A R D
Internet: www.ti g ard or. ov g Notified/Method: upplemental Information
CITY al;TIG h n n
'TYPE OF B IRING DIVISION 'COMMERCIAL FEE*"SCHEDULE - USE CHECKLIST '
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ Li-SO°
• . ' 'CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT 1 SYSTEMS FEES*..1
IS 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. Total
' 1 : JOB SITE(INFORMATION AND LOCATION Heating/cooling: .�
1-
$ Air conditioning \ 46.75 Lilt
Job site address: C)\0 SW CA\V Y C►r ''\\ � Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ,5 0,,,A e9-y- n �� 1 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
i DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
■ 64t d YN WY ClANC`Tll\OYON 1 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stovc 33.39
Wood fireplace/insert 23.32 1
Chimney/liner/flue/vent 23.32
� FROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: ,L `f_ ;S LLAL Range hood/other kitchen
� ` equipment 33.39
Address: et CA 0 3N4 t_v\LN C-m 1,1 Ci. Clothes dryer exhaust 33.39 .
City/State/ZIP: \ r ' Single-duct exhaust(bathrooms,
J toilet compartments,utility rooms) 23.32
Phone:( $ ) V3 1— $1 7I Fax:( ) Attic/crawlspace fans 23.32
• .. -,'1,.,,D,APPLICANT ,❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
•
Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
- Range
E-mail: Barbecue
' • 'CONTRACTOR Clothes dryer(gas)
Business name: "6,611 A� ,r� 7 6_00\A\,.. Other:
I J MECHANICAL PERMIT FEES*
Address: -430'_1— _- _) 1�' Av1° Subtotal I-$ 73
City/State/ZIP: A.v Al A ts,r, ov Ono( Minimum permit fee($90.00) 90,
� Plan review(25%of permit fee)
Phone:(5 ) c 0L '3 J} Fax:( ) State surcharge(12%of permit fee) 72, f-Q
CCB lic.: \o1$l\ Lt a���s' TOTAL PERMIT FEE /Qe ,Po
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ;g`\ _' • Fee methodology set by Tri-County Building Industry Service Board
Print name:Vat i+'' 0411 l Date: $- ,5- \- i 3, 7.,2--B
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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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