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Permit y n CITY OF TIGARD MECHANICAL PERMIT '`1 1 ' COMMUNITY DEVELOPMENT Permit#: MEC2015-00146 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2015 Parcel: 1 S125DC00201 Jurisdiction: Tigard Site address: 9720 SW 74TH AVE Project: SCHMITT Subdivision: BOULEVARD HEIGHTS Lot: 26 Project Description: Furnace replacement. Contractor: OWNER Owner: SCHMITT, PATRICK D&PATRICIA J PAT SCHMITT 9720 SW 74TH AVE 9720 SW 74TH AVE TIGARD, OR 97223 TIGARD,OR 97223 PHONE: 503-245-8172 PHONE: FAX: FEES Specifics: Description Date Amount Furnaces<100K BTU 03/23/2015 $46.75 Type of Use: SF 12%State Surcharge-Mechanical 03/23/2015 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/23/2015 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans, This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1983 nL.1_8U0.3 2 2344. / Issued By: �` Permittee Signature: /t �� / /"/�/ %' 1I Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY UPI City of Tigard Received DateBy: ' Permit No.: „-)—_- 13125 SW Hall Blvd.,Tigard, 97223 "�' Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T 1 G A R D Inspection Line: 503.639.4175 RECEIVED Date Ready/By: la See Page 2 for Internet: w Supplemental p { Notified/Method: Supplemental Information TYPE OF woRMAK 2 3 Z015 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alter ��er� ARD performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition []Other: BUILDING DIVISION mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* Er-1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: ` 724! . 7g�� Air conditioning 46.75 Job site address: C/9+/��t('/ Furnace 100,000 BTU(ducts/vents) i 46.75 /4(0475'' City/State/ZIP: 7J( ,47 97715 Furnace 100,000+BTU(ducts/vents) 54.91 Y I Heat pump 61.06 Suite/bldg./apt.no.: 1 i) Project name: Duct work 23.32 Cross street/directions to J "� �/ob site: / S �� 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 Other: 23.32 Subdivision: Lot no.: - 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 1:52,e/ q 6 r1".✓7�6 fireplace 23.32 `mss Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 _ 1 PROPERTY OWNER ❑ TENANT Other: 23.32 /,,---,,� Environmental exhaust and ventilation: Name. to A / Range hood/other kitchen Address: 9720 5(' l? ',4h1'4 Clothes dryer 33.39 L r/ �6 Clothes dryer erchaust 33.39 City/State/ZIP: Tj6,A4,61 ©� Single-duct exhaust(bathrooms, ` toilet compartments,utility rooms) 23.32 Phone:(1 3 4t5 ie Fax:( ) Attic/crawlspace fans 23.32 [APPLICANT ❑ CONTACT PERSON Other: i I 23.32 Business name: Fuel piping: $14.15 for first four;54.03 for each additional Contact name: y�4$c/2i7/.f'7 Furnace,etc. _ Address: /�0�7 . 1,4/ �/'ffj/440� Gas heat pump Wall/suspended/unit heater City/State/ZIP7 .�' /)��t f. 9.7223 Water heater Phone:(r�3)29 1,,, '/72_ Fax::( ) Fireplace ""'✓ 7�.7 Range _ E-mail: Barbecue • CONTRACTOR Clothes dryer(gas) • Business name: � ��oo Other: 't L MECHANICAL PERMIT FEES* Address: Subtotal ,. )- City/State/ZIP: Minimum permit fee($90.00) Q.4) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) 10.17) _ CCB lic.: TOTAL PERMIT FEE _ I a,. 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 4,2P9•1?, ......o. Print name: . !/'l7 I,44 ,e2„.. ..60,7,7,71-Date: A5 I:\Building\Permits\MEC PermitApp_o40113.doc lTT /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_040I 13.doc 2