Permit CITY OF TIGARD MECHANICAL PERMIT
al
s COMMUNITY DEVELOPMENT Permit#: MEC2014-00429
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/13/2014
Parcel: 1 S135CA00600
Jurisdiction: Tigard
Site address: 11200 SW GREENBURG RD, UNIT#25
Project: Autumn Oaks Subdivision: GREENBURG Lot: 11
Project Description: Replace existing bath fan
Contractor: SHANNON CONTRACTING LLC Owner: AUTUMN OAKS PROPERTIES LLC
22115 NW IMBRIE ST 9320 SW BARBUR BLVD#300
HILLSBORO,OR 97124 PORTLAND, OR 97219
PHONE: 503-913-1339 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 08/13/2014 $69.06
Class of Work: ALT Type of Const: Plan Review 08/13/2014 $17.27
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/13/2014 $8.29
Stories: Investigation Fee 08/13/2014 $90.00
Investigation 12%State Surcharge 08/13/2014 $10.80
Project Valuation: $250.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 1 Vent Systems: Total $195.42
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ou ma a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. --1
Issued B ( �tr Af, 7 Permittee Signature: i
31-"D
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit AppliI�EI`IE FOR OFFICE USE ONLY
City of Tigard
Received Permit No.: G /
`J g DateBy: ��C �( `�6
MI
13125 SW Hall Blvd.,Tigard,OR Plan Review
Phone: 503.718.2439 Fax: 503.50'840W 3 2014 Date/By Other Permit:
T I G A R[� Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov C Y oF'IIGARD Notified/Method: Supplemental Information
s1 T 1_ ' 1 ._ ►l
'E OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overha,and profit.
Value:$ 2 2 •'-'
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
El I-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:
!12 t0 Sty n Le,J b n B Air conditioning 46.75
Job site address: (12 ql', � � f`(>� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: `� ciQ.. , t l zz l Furnace 100,000+BTU(ducts/vents) 54.91
l[ 1 Heat pump 61.06
Suite/bldg./apt.no.: j. Project nam Duct work 23.32
Cross street/directions to job site: s-662' z Hydronic hot water system 23.32
r_ _
çI2a.iJ f9t7 5 hydronic) 23.32
Unit heaters(fuel-type,not electric),
1 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
PTA )C1<-t A Ve_0` Et-))6' fireplace 23.32
Log lighter(gas) 23.32
(y)I(_ Nat/0 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
��( r� C�O�.f' 4ic4 Fuel piping:
Business name: t l..L L' $14.15 for first four;$4.03 for each additional
Contact name: 1,4g,)i NJ S1,604.9‘) Fumace,etc. .
Address: Zzl 1 c t u...) b2i�Y /I Gas heat pump
1 Wall/suspended/unit heater
City/State/ZIP: H, tatxt.0 a 97 Water heater
Fireplace
Phone:() 9,5._/,..33p ax::( ) p •
Range
E-mail:KA/IN C gv ,A, , a,t/ , 6,,.11 — Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: 6 Apt g il6 Other:
MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
/;e, State surcharge(12%of permit fee)
CCB lic.: )Si fg25 4/1;e,//(p TOTAL PERMIT FEE 7/95'y}
t O 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: I Date: .11' /3i/q.
1:\Buitding\Permits C PermitApp_040I 13.doc 440-4617T(111/02/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.
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