Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2014-00049
T I C;A R p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/12/2014
Parcel: 2S 111 BC01900
Jurisdiction: Tigard
Site address: 14535 SW 100TH AVE
Project: 3636 ESCHER Subdivision:aONDO SUPPLEMENTAL PLAT NO.3: Lot: 22838-2
Project Description: Installing(2)exhaust fans in master bathroom.
Contractor: RIGGS&MARTIN INC Owner: ESCHER, CASE E&ELIZABETH M
14200 SE MCLOUGHLIN BLVD STE C 14535 SW 100TH AVE
MILWAUKIE, OR 97267 TIGARD, OR 97224
PHONE: 503-650-6786 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 02/12/2014 $46.64
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 02/12/2014 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 02/12/2014 $43.36
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987• =•• 344.
Issued By: Permlttee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspe• i• date.
This permit card shall be kept in a conspicuous place on the job site untilic,mpletion of the project.
Approved plans are required on the job site at the time of eac inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received Permit No.:
14 Date/13y: p4//0.y �C<a��/Y-z k.t ,L/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 t*\\IED Other Permit:
DateBy:
1 i c A tt a Inspection Line: 503.639.4175 Date Ready/By: Juris. Ei See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
201
4 TAG
TYP OF WORK � 1 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction E Addition/alteratiott 0....(110041°T14 y m\ASA,. performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: v�f1`Q�`?,) mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
land 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: I 4453 g' 5-4-0 /0 u — 4/4— Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 9?Z Z/ Furnace 100,000+BTU(ducts/vents)
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
DESCRIPTION OF WORK Gas fireplace/insert - 33.39 .
` / [' Flue vent for water heater or gas
t +:1 .. -i 1�i,,-' Q G�5 !� 7 ' „L� i fireplace 23.32
t� Log lighter(gas) 23.32
V1,1-6) � `"`t"i Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ 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, u La toilet compartments,utility rooms) 23.32 _/ tD•1'7
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 _
APPLICANT L CONTACT PERSON Other: 23.32
Business name: �f Fuel piping:
`\i3 5 S �� )..... $14.15 for first four;$4.03 for each additional
Contact name: -.5-ca LtJ,2.a.../c.v Furnace,etc. _
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:(0,3 ) SO— gf.e8 Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
/144ri-ck/ .r-c . Other:
Business name: ksj 4- 1( MECHANICAL PERMIT FEES*
Address: /5tZos6 sL- ✓ Lr1l_/,l_ 020A , �1.t'-.42.C_ Subtotal 4(p.6et
p� Minimum permit fee $90.00
City/State/ZIP: /1/>'r`fc.>`cc,.L t� / 7 Z�, 7 pe ( ) derd cl. ,
Plan review(25%of permit fee) —
Phone:(03 ) 6 5Z) (a-794, Fax:( ) State surcharge(12%of permit fee) /11 11
CCB lic.: /07 0 z' J/`5/iy TOTAL PERMIT FEE /W..
f f ( This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatu , ,�/ - * Fee methodology set by Tri-County Building Industry Service Board
Print name: A. sco 6 -vu-tom _ Date: Z.2 l�l
I1Building\Permi,yJ' _PermitApp_040113.doe 440-461 (11/0/02/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