Permit CITY *OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: MEC2013-00616 •
TIE G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/15/2013
Parcel: 2S103CA05100
Jurisdiction: Tigard
Site address: 11510 SW TERRACE TRAILS DR
Project: MARTIN Subdivision: TERRACE TRAILS Lot: 1
Project Description: Installing furnace and gas line in existing utility closet.
Contractor: G L HEINTZ HEATING&COOLING Owner: MARTIN,JESSE&WHITNEY
20871 SW 216TH PLACE 11510 SW TERRACE TRAILS DR
SHERWOOD, OR 97140 TIGARD,OR 97223
PHONE: 503-625-6798 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 10/15/2013 $46.75
Type of Use: SF FlueNent For Any of Above 10/15/2013 $23.32
Class of Work: ALT Type of Const: Fuel Piping 10/15/2013 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 10/15/2013 $10.80
Stories: Minimum Fee Adjustment-Mechanical 10/15/2013 $5.78
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: 011 _ / _� Permittee Signature:
— — i
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 ��� FOR OFFICE USE ONLY
Iiii City of Tigard ;�� AY - Date/By:ive �' ( Permit No.: —
• 13125 SW Hall Blvd.,Tigard,OR 27 2�` \% �� 'Il I A • •
C Phone: 503.718.2439 Fax: 503.59 \`' ? Plan Review
�J Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 \ \,------ \Va two Date Ready/By: tens HI See Page 2 for
Internet: www.tigard-or.gov )1C.).\ \) Notified/Method: Co Supplemental Information
TYPE OF WO E��, ,°,� "- COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
�1y' Mechanical permit fees*are based on the value of the work
❑New construction [1 Addition/alteratdtlt�Kacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 5,f<
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
ILI 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: //5/6 �r/oe.e. Ea-r 5 r
ri.,,
Furnace 100,000 BTU(ducts/vents) d. 46.75 lg. 7C
City/State/ZIP: T5ur Oa- 972?3 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
_ r Residential boiler(radiator or
:S(.r A< 7 / /erraCG Tr�.,/5 �/l/'r�c hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 4. 23.32 ;3.3?
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
L / /� �! // Flue vent for water heater or gas
l /l/ ///1‘ / j i' I s 0/-4, fireplace 23.32
/25•GL C/✓ kf � utn4G� Gn. xis /h / Log lighter(gas) _ 23.32
aye t'X t5 r,'is %i /t '/R Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
gl-PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: 3L3:554.. ( 14/41,17 �/G//i ., Range hood/other kitchen
Address: — equipment 33.39
��✓,' jet/ Jtrrra-t_' �/��S 9:4 2‘,--,- Clothes dryer exhaust 33.39
City/State/ZIP: -7;" u B� 97cz 3 Single-duct exhaust(bathrooms,
!� toilet compartments,utility rooms) 23.32
Phone:(,P2 ) Say_7579 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: Furnace,etc. I. /1113 1q./S
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: ''// 11 J/ // Other:
/7Pr.,6 /rlu�,1;5 Z-(oct•73 MECHANICAL PERMIT FEES*
Address: /5 72/S scd. /1'�//a�i el, Subtotal '3 C/. 2
City/State/ZIP: O Minimum permit fee($90.00)
y e-r d� 97��y �(a., t i_
Plan review(25%of permit fee) _
Phone:(spa) vas_ /7y% Fax:( ) State surcharge(12%of permit fee) _ tO4C _
CCB lie.: /da 5,3/ TOTAL PERMIT FEE _ ito,W _
This permit application expires if a permit is not obtained within IN
days after it has been accepted as complete.
Authorized signature' • Fee methodology set by Tri-County Building Industry Service Board
Print name: 47. f/et e) z Date: 0—/f-/3
I:\Building\Permits\MEC_PermitApp_0401 13 doc 440-4617T(I I/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