Permit CITY OF TIGARD MECHANICAL PERMIT
IN • COMMUNITY DEVELOPMENT Permit#: MEC2014-00217
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/08/2014
T Z A R i) 9 Parcel: 2S104DB05400
Jurisdiction: Tigard
Site address: 13201 SW MAPLECREST CT
Project: Landrith Subdivision: MAPLECREST Lot: 1
Project Description: Installation of NC. Placement of unit must meet manufacturer's requirements.
Contractor: LEGACY HEATING AND COOLING Owner: LANDRITH,TONY&TRACI
325 N 7TH AVE 13201 SW MAPLECREST CT
CORNELIUS, OR 97113 TIGARD, OR 97223
PHONE: 503-367-4752 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 05/08/2014 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 05/08/2014 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 05/08/2014 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100 80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Z./0"11h , Permittee Signature:
I
Call 503.639.4175 by 7:00 a.m.for the next available inspection dat=
This permit card shall be kept in a conspicuous place on the job site until completi•n of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicatioRi ECEIVEP FOR OFFI('1: I SF Oy1.1
City of Tigard Date/By: */ Permit NonE(rc20/V-4104,2/9
13125 SW Hall Blvd.,Tigard,OR 97223 8 2014 plan Review
Phone: 503.718.2439 Fax: 503.598.1960 MAY Date/By: Other Permit:
I I c_A k n Inspection Line: 503.639.4175 Date Ready/By. Juris ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDINGDIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Iddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
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. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: `?) ` MA ^r,`e�S- C1T Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tv3(Nr-� 0\` q 71�+ 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: ] Project name: L.a tf_ \-t._ Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32 _
COCA CC Q� Sk-j G('LL t,■�:e._.- , C~n a
Residential donic boiler(radiator or
hydronic) 23.32
� ' 1 R1�c“S- C V in-wall,ll,in-duct,suspended,not electric),
�/1 q 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
i," ._ /r fireplace 23.32
`��-� Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other:
23.32
PROPERTY OWNER I ❑ TENANT Environmental exhaust and ventilation:
Name: Tr c,L; a 3 Tuaj l ekA.d r t�. 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
jig APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: L is. ..-k tL,�� 3 V� ^„-_ $14.15 for first four;$4.03 for each additional
Contact name: 5 CG, lac G1t FF J� Furnace,etc.
Address:
3 a S A 7 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Co4A 4\Zu5 / Vck. P Ca('3 Water heater
Phone:(SV'S) 367-97 s� Fax::( )
Fireplace
/� Range
E-mail: L,eew�l-(k c�k1 ec)ZC 0 4 tv c,.
�+ y `_Cc) t� Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
C�” �'`�”`` r�V\t MECHANICAL PERMIT FEES*
Address: 'a� 7 - xyi Subtotal-••,
City/State/ZIP: Craii\aL, J S I [„\2 co \3 Minimum permit fee($90.00) 9e ,0-6
"1 1 Plan review(25%of permit fee)
Phone:(9. 3) 3‘ .. Lo Sa-- Fax:( ) State surcharge(12%of permit fee) / , ed
CCB lic.: aC.A C1,(o /Pii/(p TOTAL PERMIT FEE /00, ,p()
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Bo
Print name: �� �Z !, c 1.,� Date: �I{(��a j y
1:(Building\Permit5V�C_PermitApp_040113.doc 440-46`1`7T(I 1/02/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