Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2014-00104
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/06/2014
Parcel: 2S112BA01600
Jurisdiction: Tigard
Site address: 7990 SW FANNO CREEK DR
Project: Dalrymple Subdivision: WAVERLY MEADOWS Lot: 37
Project Description: Gas line to fireplace
Contractor: PORTLAND PLUMBING PLUS LLC Owner: LES DALRYMPLE
6819 SE 82ND AVE 7990 SW FANNO CREEK DR
PORTLAND, OR 97266 TIGARD,OR 97224
PHONE: 503-933-1183 PHONE: 503-504-2745
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 03/06/2014 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 03/06/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/06/2014 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct•-- • • OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issu:d By: ���L / Permittee Signature: 1
MVP-
Call 503.639.4175 by 7:00 a.m.for the next available inspec,t date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application r(li OFl I( I. I "...I. ()\1.1
Received
Cl of Tigard / Permit No.:
City g FIVEC) DateBy: Heti �)/ -Ck5 p
11111 II • 13125 SW Hall Blvd.,Tigard,OR h - Pl an Review
Phone: 503.718.2439 Fax: 503. .': •1 Date/By: Other Permit:
r i G A It i, Inspection Line: 503.639.4175 Date Ready/By: Juris Page 2 for
Internet: www.tigard-or.gov MAN Supplemental See Pa
r6�'?2p0p4 Notified/Method: Supplemental lnformatioo II 4 F 1 lGAH[) COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
TYPE ! , Ii b ,_r icip i Mechanical permit fees*are based on the value of the work
❑New construction �Additio a rep aceme performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. ,
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special Informoiion use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. [ Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: `t/9 5v it /j kik(/U G2 o r Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 7,---, 4 r V r ` �5 'rz Z LJ Furnace 100,000+BTU(ducts/vents) 54.91
./ ( Heat pump 61.06
Suite/bldg./apt.no.: Project name:L�3 i�A L�1/M / Duct work 23.32
Cross street/directions to job site: l 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
6- 1 L, J �r . /2l4 G fireplace 23.32
"T-E-51- I/ i/�_ Log lighter(gas) 23.32
/4) Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Si PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: y Range hood/other kitchen
-� �� )1 )//4/D equipment 33.39
Address: f 9,D f I� /.:;),,,./A 2 1... 27 r Clothes dryer exhaust 33.39
City/State/ZIP: Q Single-duct exhaust(bathrooms,
y T�� ' "�-� L �z Z Ll toilet compartments,utility rooms) , 23.32
Phone:(s/j3) 6-0 L f- Z-2 2) J) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 _
Fuel piping:
Business name: )
)'/)Y//�Tv //.z/Y&ill< }71 t $14.15 for first four;54.03 for each additional
Contact name: 3z !2 / A-LA Furnace,etc.
Address: /Q!'.7Cl�f'J '�✓v Gas heat pump
!O v �- �f- WalUsuspended/unit heater
City/State/ZIP r774 4, Q r— 5'Z..--d Z Water heater /
Phone:(5523 f 3 a
�,/l 3 'J Fax::( ) Fireplace _
/
Range
E-mail:...z.--A)rD v i,r' ,v 1.--7 I �-��ij w 2)LIs s 1;607' Barbecue
ue
CONTRACT
Clothes dryer(gas) -
Business name: r---)74,„,....z• /LC Other:
�G J LC/'(.1 p/l'Y� I��u'C MECHANICAL PERMIT FEES*
Address: f Subtotal
City/State/ZIP:l� ` t�7 b Minimum permit fee($90.00) ?Q�� -
r l ter✓
�� / _ J Plan review(25%of permit fee) r
Phone:(5`3) 1 "si Fax:( ) State surcharge(12%of permit fee) d,.Q'O
CCB lie.: / '1'i 3 941,/f TOTAL PERMIT FEE �, $0
/ !CJ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: G • Fee methodology set by Tri-County Building Industry Service Board
Print name:�f� Z r 5��r Date — J J�j
I:\Building\Per✓m✓''i``ta\MEC_PermitApp_0401 t3.doc / 440-4617T(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$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.
l:\Building\Permits\MEC_PermitApp_040113.doc 2