Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2014-00175
T[GAR i3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/22/2014
Parcel: 2S103CA03200
Jurisdiction: Tigard
Site address: 11535 SW TERRACE TRAILS DR
Project: kitchen remodel Subdivision: TERRACE TRAILS Lot: 4
Project Description: Replacing range hood.
Contractor: HARVEST CONSTRUCTION LLC Owner: FORD, ROCKY T&MARILYN J
2515 W 10TH ST 11535 SW TERRACE TRAILS
WASHOUGAL,WA 98671 TIGARD,OR 97223
PHONE: 360-624-6151 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 04/22/2014 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 04/22/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/22/2014 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100 80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foll.w the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 1090. You m. a• .in a cop of the rules
or direct questions to OUNC by calling 503.232.198
Issued By: j� —Permittee Signature:
cif- :=s
Call 503.639.4175 by 7:00 a.m.for the next available in ••ction date
This permit card shall be kept in a conspicuous place on the job site until complet on of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application ``I�� [OR Of 1.1( I. I ,I. ON1
1 � Received
City of Tigard �K Received
" Permit No.:
IN
13125 SW Hall Blvd.,Tigard,OR 9� -
Plan Review
Phone: 503.718.2439 Fax: 503.598. q (Oh( Date/By: Other Permit: Ind _ a I 7
FIG�\ti 1) Inspection Line: 503.639.4175 Q �j I+ l• Date Ready/By: El See Page 2 for
Internet: www.tigard-or.gov N ���,cI� Notified/Method: pig Supplemental Information
TYPE OF WOI�ii �e,- O COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
,��� Mechanical permit fees'are based on the value of the work
❑New construction ❑Addition/alteratiacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES"
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
Air conditioning 46.75
Job site address: /l9 35 SG./ 7{roue 77 / I, ��, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -7--j de Furnace 100,000+BTU(ducts/vents) 54.91
/ 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
lecio)c,C-IKJ iL/ _ 1-lcx ( 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 I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 1 33.39 33 31
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
❑ AP LICANT ❑ CONTACT PERSON Other: 23.32
Business name: /�
^ ,_� 7,„, d /X Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: .2 .I�ti p '+ Furnace,etc.
Address: 2525- tO / Sr Gas heat pump
I ���� Wall/suspended/unit heater '
City/State/ZIP: (,/l),4 Water heater
! G Fireplace
ace Phone:5ZO) / 7 Fax:: ) F3/./_3/1_8‘7_____ Range
E-mail: ie VgRLI ^ i5�x w1YAR v 5r `o Barbe cue
CONTRACTOR Clothes dryer(gas)
Business name: 2 /I-I _ a,(�� Other:
�U . MECHANICAL PERMIT FEES`
Address: Subtotal 43.3er
City/State/ZIP: Minimum permit fee($90.00) -00
G I G l Fax:( ) Plan review(25%of permit fee)
Phone:( )
/4 l State surcharge(12%of permit fee) /0 .t7
CCB lic.: /& ?� � J 'r _ , TOTAL PERMIT FEE /(X)• n
/� This permit application expires if a permit is not obtained within 180
._ L � ,�, * days after it has been ycBuildi as complete.
Authorized Si:•• ,�� Fee methodology set by Tri-County Building Industry Service Board
Print name-i J/�j/-'i,`/477�� Date: / M
I.'Building\Permits\MEC_PermitApp_s'.113.doc 440-4617t(Il/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
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11535 SW TERRACE TRAILS DR, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00175
George Heimos
Violation Summary:
Inspector Contractor