Permit II .,._ ., CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2014-00120
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/13/2014
Parcel: 2S104AA90291
Jurisdiction: Tigard
Site address: 12646 SW KAREN ST 29
Project: Bellwood Terrace. Unit 29 Subdivision: BELLWOOD TERRACE CONDO Lot: 29
Project Description: Installation of new dryer vent
Contractor: RELIABLE HOME IMPROVEMENT INC Owner: BELLWOOD TERRACE LLC
PO BOX 230815 PO BOX 189
TIGARD. OR 97281 YAMHILL, OR 97148
PHONE 503-481-0240 PHONE
FAX
FEES
Specifics: Description Date Amount
Clothes Dryer Exhaust 03/1312014 $33 39
Type of Use: SFA 12%State Surcharge-Mechanical 03/13/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/13/2014 $56 61
Occupancy Grp:
Stories:
Fuel
Fuel Types
Gas Pressure-
Total S100 80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance. or if work is suspended for more the 180 days. ATTENTION Oregon law requires you Is follow the rules adopted by the Oregon
Utility t4dtiffication Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0w'0. •You may obtain a copy of the rules
or rest questions to OUNC by g 503.232 1987 or 1.800.332.2344.
I ued By: L.__ , d,d_414_,04.}
Permittee Signature: rrk.� !7! / �/.r/
i
Call 503.639.4175 by 7:00 a.m.for the next available inspectiori date.
This permit card shall be kept in a conspicuous place on the job site until corhpletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Anvil catiotir..111cr FOR OFFICE USE ONI,1
City of Tigard �� s Received �� r 2 I Permit No: ! ! j�G
MI I
13125 SW Hall Blvd.,Tigard OR 97223 •h, Received
01 �J �!C� (1
Phone: 503.718.2439 Fax: 503.598.1966'I 1 3 2014 Plan Review
Dale/By: Other Pennir.
T I G A R I) Inspection Line: 503.639.4175 Date Ready/By: tuns ® See Page 2 for
Internet: www.tigard-or.gov CITY Or 1IGARLJ Notified/Method: Supplemental Information
71;rr nIa I .,r„∎fsi"t
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction -r4ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑ Master builder ❑Other: Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Ileating/cooling:
Stud Apt conditioning 46.75
Job site address: /2.� �'Z 542 ,/jE440V S�%u Apt c ' Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: t lif1)—i) �)�'. pr 72-2 '5 Furnace 100,000+BTU(duets/vents) 54.91
[ Heat pump 61.06
Suite/bldg./apt.no.: Project name: a Duct work 23.32
Cross street/directions to job site: /9.6„.1.!_v �___ /Caf,��J 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: l Lot no.: Other: 23.32
Other fuel appliances: _
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
p..,,,,,,,,,.-,..-/ Flue vent for water heater or gas
/CJQ L�/1 /)g yc- ( [ -r t-- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/itsert 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,
toilet compartments,utility rooms) . 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans . 23.32
e APPLICANT ❑ CONTACT PERSON Other: 23.32 _
Fuel piping:
Business name: L i•4_(we- l jaw,e 7hr niatiGt _,---P”
S14.I5 for first four;$4.03 for each additional
Contact name: e,(2 4 AJ 7 Furnace,etc.
Gas pump
Address: p, v `f ..,230 3o g/5 Wall/suspended/unit pended/unit heater
City/State/ZIP: ao g.7 L 7) GY. -, 22 7 Th Water heater
Phone:(,5 3) 7 ,i_ a. . Li G Fax::( ) Fireplace
Range
E-mail. y yi-2 f t F/e,i,7/ c,E,,-.2-' • Barbecue
CONTRACTOR Clothes dryer(gas)
21+,-7 Other:
Business name: MECHANICAL PERMIT FEES*
Address: s/fiyl• AL — /111/14, 9m
Subtotal ,.
City/State/ZIP: Minimum permit fee($90.00) - —
Phone:(X3 ) l+/ / _p�y G Fax:( ) Plan review(25%of permit fee) .—
State surcharge(12%of permit fee) /c) kO
CCB lie.: Y8 (p 3 I TOTAL PERMIT FEE /Z'.9 )
This permit application expires if a permit is not obtained within 180
1` days after it has been accepted as complete.
Authorized signature: 3 ` • Fee methodology set by Tri-County Building Industry Service Board
Print name: 6 p A-7t r YvZ/4 71 Date: 3-/Y- ac./ y
I:1Buitdinerenni t&MEC_PmmitApp_O40l13.doc 440-46liT(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.
I:\Building\Permits\MEC_PermitApp_0401 I3.doc 2