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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2014-00025 I/�d fg'/E Date Issued: 01/22/2014 T i G A R.0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111 CB00200 Jurisdiction: Tigard Site address: 14915 SW 103RD AVE Project: KEENEY Subdivision: DEL MONTE SUBDIVISION Lot: 1 Project Description: Gas line for range.2/27/14:Reprinted permit to include(1)range hood and(1)bathroom exhaust fan. Contractor: OWNER Owner: KEENEY, CHARLES& ROXANNE CHARLES KEENEY 14915 SW 103RD AVE 14915 SW 103RD AVE TIGARD,OR 97224 TIGARD, OR 97224 PHONE: 503-913-2959 PHONE: FAX: FEES Specifics: Description Date Amount Range Hood/Other Kitchen 01/22/2014 $33.39 Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 01/22/2014 $23.32 Class of Work: ALT Type of Const: Utility Rooms) Occupancy Grp: Fuel Piping 01/22/2014 $14.15 Stories: Minimum Fee Adjustment-Mechanical 01/22/2014 $19.14 12%State Surcharge-Mechanical 01/22/2014 $10.80 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: 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 Application 1 4/1.i(111 It I I ♦I t)�l , City of Tigard ' R 1©1i " Permit No ; t • 13125 SW Hall Blvd_,Tigard,OR 97223 Plan ittvtaw • Phone: 503.718.2439 Fax: 503.5911960 ,�s4tit Date/By. Other Penmt I'GATT) Im{ectioa Lux: 5()3.639.4175 p • . g�/gy h.,' id See Page 2 for Internet: www.tigard ar.gov �P ii►► -4 ��"; Sappleneatal taferwatiea i COMMERCIAL IRE* SCHEDULE -t CHECKLIST TYPE OF WORK �+�A+' •.‘ Mechanical permit fees'are based on the value of the work ❑New construction Addition/alteratiott/replacerpr performed.Indicate the value(minded to the nearest dollar)of all ❑Demolition !❑�Other`" , t/�� mechanical materials,a sijpmem,labor,overhead,and profit ��« Value S �1 CATEGORY OF CONSTRUCTION l RESIDENTIAL EQUIPMENT/SYSTEMS FEW ?Or I-and 2-family dwelling ❑Commercial/industrial ❑Accesso g Far special lformarlon tar c*ecJdtrt. ❑Multi-family ❑Master builder ❑Other: Description J Qty. J Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site addresx \ \s sc.,...) .J c_ Furnace 100,000 BTU(daasiventa) 46.75 Y City/State/711 Op_ ci""1.Z 1 Furnace 100,000+BTU(duns/vents) 54 91 Suite/bldg./apt.no.: Project name: 1 lieu P 23 32 e AI G'� Duct work 23.32 Cross street/dinxiions to job site: Hydronic hot water system 23.32 ___ Residential boiler(radiator or hydron) 23.32 Unit heaters(fuel-type,not electric). in-wall,induct,suspended,etc. 46.75 Flue/vent for any of above 23.32 _.. Other: _ 23.32 Subdivision: l Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESC f014 OF WORK Oles fireplace/insert 33 39 / Flue vent for water heater or gas 6(„5 /Arc r f"y _ fireplace 23.32 Log lighter(gas) 23.32 *Pt.id t fr et-A l-rA.t.Sf 1 "�7� �ct77Y•I -• Wood/pellet stove 33 39 �A ✓f a -Car u''f 0//)---7/1 K• Wood fireplace/Sinn 23.32 Chimney/liner/flue/vent 23.32 elid PROPERTY OWNER l 0 TENANT Off" 23.32 Environmental exhaust and ventilation: Name: ; 4n 4 Range otter kitchen / 33.39 33.3i — _monism Address: —1 �T Clothes dryer exhaust ► 33.39 City/State/ZIP: cP �`�- . I LX I L- Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 1 23.32 9j.3_3 Phone:50,30 G 13- Z•-t'\S°k Fax:( ) Auic/crawlspace fens 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: Fuel piping: r t 4,,,,) q S14.15 for(list four S4.03 for each additional Contact name: Furnace,etc. , Address: — Gas heat pump Wall/suspended/unit heater City/StatelLIP: Water heater Phone:( ) Fax: :( ) Fireplace Range 1 ,11f,/S-- E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name: ('her ON X0.1-f-� MECHANICAL PERMIT FEES' Address: Subtotal 7/3,id" Minimum permit fee(S90.00) i,i City/State/ZIP: _ Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) Xi MB tic.: TOTAL PERMIT FEE /A{J 4__) This penult app•ntleu rapine if a permit is act obtained wittier loo Oa if\1=S } �4�q.,. days after it has bete incepted as complete. Authorized signature: • Fee methodology set by In-County Building Industry Service Hoard Print name: .► ,sue Date: j /ly_1i_J 1.1aai1dinipo ndtdaccc P rmnArp-040113 doe 40. 1�Tr(11 n2/COMAYFB) CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2014-00025 Date Issued: 01/22/2014 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S1110600200 Jurisdiction: Tigard Site address: 14915 SW 103RD AVE Project: KEENEY Subdivision: DEL MONTE SUBDIVISION Lot: 1 Project Description: Gas line for range Contractor: OWNER Owner: KEENEY, CHARLES& ROXANNE CHARLES KEENEY 14915 SW 103RD AVE 14915 SW 103RD AVE TIGARD. OR 97224 TIGARD. OR 97224 PHONE 503-913-2959 PHONE FAX: FEES Specifics: Description Date Amount Fuel Piping 01/22/2014 $14.15 Type of Use: SF 12%State Surcharge Mechanical 01/22/2014 510.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/22/2014 $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 01 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 col of the rules or direct que 1 S-to.O\UUNC by calling 503.232 1987 or 1.800 332 2344. Issued B • A\ - `a„ Permittee Signature: - l 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 �� C1� of Tigard r�1� Datee/By: / /7 Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 V ���-�!K Z'�Ci/3�S` Plan Review • Phone: 503.718.2439 Fax: 503.598.1960 Ott Other Permit: DatelBy: T 1 G A R l Inspection Line: 503.639.4175 t�t',� ;,�Ready/By: June la See Page 2 for Internet: www.tigard-or.gov � P r C , ., , •,. ethod: ''7 Supplemental Information . w / .✓ TYPE OF WORK ` p�G41`S COMMERCIAL FEE' SCHEDULE - USE CHECKLIST ,_,/ C, Mechanical permit fees'are based on the value of the work ❑New construction JQ Addition/alteration/replacen1 $ performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition f❑Other: 40)- mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* trzfl-and 2-family dwelling ❑Commercial/industrial ❑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: S l � Air conditioning 46.75 Job site address: Q,�` e J Furnace 100,000 BTU(ducts/vents) 46.75 City/State/Z114--- ( J/'� ( � Furnace 100,000+BTU(ducts/vents) 54.91 1 - Heat pump 61.06 Suite/bldg./apt.no.: Project name: titCe A�,�� 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 S Flue vent for water heater or gas ;lit_ iG` rag - fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert , 23.32 Chimney/liner/flue/vent 23.32 PROPERTY OWNER El TENANT Other: 23.32 Environmental exhaust and ventilation: Name: vk i_A ` Ce^ Range hood/other kitchen equipment 33.39 Address: Clothes dryer exhaust 33.3.9_ City/State/ZIP: 9 ' - 1:7"S ('O & Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:5„D.. .) `1 VI— LCkc_ Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: e.ec jr-4 .z-S .rt 11J'P— $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 1 1'!l-- E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: tT,)M�Jt MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) qd.(� Plan review(25%of permit fee) Phone:( ) 1 Fax:( ) State surcharge(12%of permit fee) 0 CCB lie.: TOTAL PERMIT FEE AO, This permit application expires if a permit is not obtained within 180 • days after it has been accepted as complete. Authorized signature: r��� '1 ' Fee methodology set by Tri-County Building Industry Service Board Print name: gie ," Date: 1 (//E__I//:‹ l-1BuildingTennii s'MEC_PamitApp_040113.doc 440.46171'(11/02/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$1 0,000.00 $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. 1:1Building\Permits'MEC_PermitApp_040113.doc 2