Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2015-00553
T(CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/12/2015
Parcel: 2S 1038800700
Jurisdiction: Tigard
Site address: 12545 SW 124TH AVE
Project: Yinger Subdivision: BROOKWAY Lot: 7
Project Description: Adding bath fan.
Contractor: NW RESIDENTIAL Owner: YINGER FAMILY REVOCABLE TRUST
PO BOX 230635 BY YINGER, KENT L&DEBORAH L TRS
TIGARD, OR 97281 12545 SW 124TH AVE
PORTLAND, OR 97223
PHONE: 503-860-2631 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 08/12/2015 $23.32
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/12/2015 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 08/12/2015 $66.68
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific tinn Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir questions to OS.C b .Ili . 503.232.1987 or 1.800.332.2344.
Is ued By: t , 0 424A-1-4 Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection da
This permit card shall be kept in a conspicuous place on the job site until comp)=ti• • he project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY /��
City of Tigard R Received r , , Permit No.: ill_/c.-//1`-66,-53
13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I I,, \i,I 1 Inspection Line: 503.639.4175 AUG 12 2015 Date Ready/By: Juri s: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For spedal information use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
Heating/cooling:
' ` l n��� �! Air conditioning 46.75
Job site address: / 5 L A .' Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: '7-7,,,f,>D 6-g. q 7223 Furnace 100,000+BTU(ducts/vents) 54.91
y Heat pump 61.06
Suite/bldg./apt.no.: I Project name: /Ai d'>/- Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
(A/kwJirr 4 r24Td 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
i/1/414- f v47 { 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
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, f
toilet compartments,utility rooms) / 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
Other: _ 23.32
Fuel piping:
Business name: ikiliti 45/06J-0.1t A/C
$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:( ) I Fax::( ) Fireplace
Range
E-mail:
Barbecue
Clothes dryer(gas)
Business name: d,,/ A6100JTfAt, //J& Other:
Address: lb 130X 2-303 5 Subtotal
City/State/ZIP: �(L '9 �Z5-I Minimum permit fee($90.00) 90't'C
Plan review(25%of permit fee)
Phone:(i; ) Y p —Z 63 1 Fax:( ) State surcharge(12%of permit fee) /0.tC
CCB lic.: / Z`f14 /4//7 TOTAL PERMIT FEE /610,W
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: (244-7,l Ff 1. \ 5t [Date: g/j-Zh S
I:\Building\Permits MEC_PermitApp_040113.doe 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil Fee Schedule:
- 4. .1 I
$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:\BuildingWermits\MEC_PermitApp_040113.doc 2