Permit CITY OF TIGARD MECHANICAL PERMIT
12 * COMMUNITY DEVELOPMENT Permit#: MEC2013-00530
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2013
Parcel: 2S 114AB 12300
Jurisdiction: Tigard
Site address: 9365 SW MARTHA ST
Project: MCNULTY Subdivision: KNEELAND ESTATES NO.2 Lot: 124
Project Description: Gas piping for clothes dryer.
Contractor: STAN THE HOT WATER MAN Owner: MCNULTY REVOCABLE TRUST
PO BOX 33157 4100 COLTSFOOT LN
PORTLAND,OR 97292 LAKE OSWEGO,OR 97035
PHONE: 503-760-2992 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 09/19/2013 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 09/19/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/19/2013 $75.85
Occupancy Grp:
Stories:
•
Fuel
Fuel Types
Gas Pressure
Total $100.80
Required Items and Reports(Conditions)
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the • egon
e
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cor �i/�:
ils
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspe,date.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Mechanical Permit Application FOR OFFICE USE: ONLY
City of Tigard j Date/By.eed / �, Permit No.. `
13125 SW Hall Blvd.,Tigard,OR 9722. •�\��� Plan Review �" �'
C. Phone: 503.718.2439 Fax: 503.5':;11 Date/By Other Permit.
11 G n It D Inspection Line: 503.639.4175 - Date ReadyBy 611 See Page 2 for
Internet. www.tigard-or.gov EP 1 'IV Notified/Method. Supplemental Information
TYPE OF war,n EGA' 10N COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
('tD,V Mechanical permit fees*are based on the value of the work
❑New construction DrAddition/altrtO men[ performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: �V mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
I"1-and 2-family dwelling ❑CommerciaUindustrial 0 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:
^��� �� Air conditioning 46.75
Job site address: `1 4/4 .. a, ?
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 7'74 47,sA B-2 9 72 2( Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: /'I c_pu l-}Zr 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 33.39
� `` n Flue vent for water heater or gas
,4- s D 4.A� L,N� F;re. £ .'45 ® �/f fireplace 23.32
v Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert _ 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment _ 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
'APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: 5---7,4,,,„/ .--,. ' ' � .— /a/3�1,7 $14.15 for first four;$4.03 for each additional
Contact name: 9e�1,7 x,e,e.44,q�� Furnace,etc.
Address: O0 /30')C 33 (5 7 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: a ?La,N,A C '72"72 Water heater
j Fax: ( Fireplace
Phone:(�3 ) 76 O 24j 9 2 ,j�l 76/'0/✓r1`' -
Range
E-mail: 517A-€v g_S--74",7L16 keirT‘44,4-7_,."2„./(j,4IV, (747).4.i Barbecue
CONTRACTOR Clothes dryer(gas) i /y/S
Business name '�� s"-7,q� Za , , ,d4' �� Other:
���' �i�'— .� MECHANICAL PERMIT FEES*
Address: YD '3 31 rj 7 Subtotal j L/./s
City/State/ZIP: [fie ,7L��� �u q 7�9� Minimum permit fee($90.00) � LOi
r Plan review(25%of permit fee)
Phone:L5 3) 766 _2.992. Fax:(j'o� io 1—C?1,'7 State surcharge(12%of permit fee) , ro..ga
CCB lic.: /3075 J 11 TOTAL PERMIT FEE kill,$a
This permit application expires if a permit is not obtained within 180
•�+ / days after it has been accepted as complete.
Authorized signature. /,,`'j/ • Fee methodology set by Tn-County Building Industry Service Board
Print name: 4 /i`0...,4 Date:CV 51/5
I\Building\Permits\1 C_PemtitApp_040113 doc 4400-4617T(I1/02/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.
•
•
I:\Building\Permits\MEC_PermitApp_040113.doc 2
1