Permit CITY OF TIGARD MECHANICAL PERMIT
3111 * COMMUNITY DEVELOPMENT Permit#: MEC2014-00354
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2014
Parcel: 151 34AD00100
Jurisdiction: Tigard
Site address: 11352 SW IRONWOOD LP
Project: Wickward Subdivision: ENGLEWOOD Lot: 20
Project Description: Install furnace and a/c. Placement of a/c must meet manufacturer's clearance requirements.
Contractor: B&S HEATING&AIR CONDITIONING LLC Owner: WICKWARD, MICHAEL&SUSAN
PO BOX 1623 2940 SW RIDGEWOOD AVE
OREGON CITY,OR 97045 PORTLAND, OR 97225
PHONE: 503-720-5608 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 07/14/2014 $46.75
Type of Use: SF Furnaces<100K BTU 07/14/2014 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 07/14/2014 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted . the Oregon
Utility • • ation - -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y' may obtain •.py of the rules
or di •ct questions to OU by in 503.232.1987 or 1.800.332.2344.
/
Iss ed By: ` 410 Permittee Signature: �/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicat'p r r FOR OFFICE USE ONLY
City of Tigard !drily rL Received
g \\\ 11SM�� DateBy: 7i, �e�a Permit No: rig. 003sI
rieri
13125 SW Hall Blvd.,Tigard,OR1 9 ((
Phone: 503.718.2439 Fax: 503.598.1 Plan Review
L 14 2014 Date/By: Other Permit
T I G A R l) Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
_ CITY± -IIGARi3
TYPE OR COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
All-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 46.75 114 i,,
Job site address: i f 352_, SW 3d`N 0°a L'rI ' Furnace 100,000 BTU(ducts/vents) 46.75 tWo•75
City/State/ZIP: Ti(drA'a t 64. c-1 ZZ3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: ULD1 c 4L\(.Jf-t2'.1D 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
tl(i G 4 C 0 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
❑ PROPERTY OWNER ❑ 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 .
❑ APPLICANT ❑ CONTACT PERSON Other: _ 23.32
Fuel piping:
Business name: $14.15 for first four;$4.03 for each additional_
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas) _
Other:
Business name: 3 t S 44c4rj+v-, � Ac MECHANICAL PERMIT FEES*
Address: So x 16Z,� J Subtotal 9 3.50
City/State/ZIP: Or t1 Minimum permit fee($90.00)
Plan review(25%of permit fee) ��
Phone:(,e3 ) 720--540g Fax:( ) State surcharge(12%of permit fee) 1I'F-'A'
CCB tic.: ,inz TOTAL PERMIT FEE /QS/.734
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 Board
Print name: ova,- Afr,On C Date: 7-)9. y
1:\Building\Permits\MEC_PermitApp_0401 I3.doc 440.4617T(1 I/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_040II3.doc 2