Permit CITY OF TIGARD MECHANICAL PERMIT
11110• °,`-• COMMUNITY DEVELOPMENT Permit#: MEC2013-00651
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/30/2013
Parcel: 2S114BA08500
Jurisdiction: Tigard
Site address: 16400 SW WOODCREST AVE •
Project: Mala Subdivision: COPPER CREEK STAGE 2 Lot: 25
Project Description: Install heat pump
Contractor: OWNER Owner: MALA, DANIEL J & LAURIE MANGHELL
MALA, DANIEL J 16400 SW WOODCREST AVE
16400 SW WOODCREST AVE TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-869-5937 PHONE: 503-869-5937
FAX:
FEES
Specifics: Description Date Amount
Heat Pump 10/30/2013 $61.06
Type of Use: SF 12%State Surcharge-Mechanical 10/30/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/30/2013 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
• Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
. applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance wo suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility otification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or ect questions to OUNC b . ing 503.232.1987 or 1.800.332.2344. t/L
Is ed By: s'/0 Permittee Signature: I
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application'ftr 0\dcn FOR OFFICE USE ONLY
City of Tigard -_,63i "'' i 'E
Date/By: i
„ Received /O �f' / A -/ Permit No.: ! JQ-�6�f
° 13125 SW Hall Blvd.,Tigard,OR 9811.212936r
7223 a� Plan Review! �l I
III
' • Phone: 503.718.2439 Fax: 503.598.19 C T 3 ® 2013 Other Permit:
Date/By:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov (sl �GD Notified/Method: Supplemental Information
P!H! fll\l(Mi tii(n\l
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ❑CommerciaUindustrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. Total
JOB SITE'INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: /` you ,5' i.,' (^/U���( L v,,er, 4 Ve Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: I t „.f� 1 4 2 z V Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump / 61.06
Suite/bldg./apt.no.: Project name: Mk ,( 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 _
( Flue vent for water heater or gas
Ft e k 1 P , p 1,,i1,1.<_7/J--` fireplace 23.32
Y 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: P/n..../ i ( Jr. l4\ Range hood/other kitchen
equipment __ 33.39
Address: to 9'6 v ,. pl/ l%✓ Ct J ef,e C 19V€ Clothes dryer exhaust 33.39
City/State/ZIP: / I , Q z/ Z y Single-duct exhaust(bathrooms,
/ toilet compartments,utility rooms) 23.32
Phone:( ) p
if
-86 /,' _5G_ 7 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.
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: 0 Le N) E Other:
MECHANICAL PERMITFEESil
Address: Subtotal �ce
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax: Plan review(25%of permit fee) _ ---( ) State surcharge(12%of permit fee) t!r`3'-`0 _
CCB lic.: TOTAL PERMIT FEE J .
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: L--.R._
• Fee methodology set by Tri-County Building Industry Service Board
Print name: �(/t4Vt4 4'
l J C- A4 c Date: r U p / /3
(:\Building\Permits\MEC_PermitApp_040113.doc 44 6171'(I I/0(((2/COM/WWEB)
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.
1:\Building\Permits\MEC_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16400 SW WOODCREST AVE, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
2013-11-14 (null)
MEC2013-00651
PASS - No C of O
Violation Summary:
Inspector Contractor