Permit INCITY OF TIGARD MECHANICAL PERMIT
a '' COMMUNITY DEVELOPMENT Permit#: MEC2015 00740
4 if. 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/02/2015
TIGARD Parcel: 2S111 DC09300
Jurisdiction: Tigard
Site address: 15750 SW OAKHILL LN
Project: BYERS Subdivision: SUMMERFIELD NO.10 Lot: 564
Project Description: Installation of gas line and range hold for new range.
Contractor: BUDGET HEATING Owner: BYERS, LARRY
13885 SE 177TH CT 15750 SW OAKHILL LN
DAMASCUS, OR 97089 TIGARD, OR 97224
PHONE: 503-233-3133 PHONE:
FAX: 503-558-9050
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 11/02/2015 $33.39
Type of Use: SF Fuel Piping 11/02/2015 $14.15
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/02/2015 $42.46
Occupancy Grp: 12%State Surcharge-Mechanical 11/02/2015 $10.80
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notifi - •. Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire questions to •. C by calling 503.232.1987 or 1.800.332.2344.
�/� //
Issu.d By: ( Permittee Signature: /-�-� Ill
Call 503.639.4175 by 7:00 a.m.for the next available inspection d
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his permit card shall be kept in a conspicuous place on the job site until completi•n of the ec j
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Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application • FOR OFFICE:USE ONLY .. - -
t' City of Tigard Received f
x 5 g � Date/By: l U , i
v 13125 SW Hall Blvd.,Tigard,OR 9�` V '�� ��
Plan Review _
' Phone: 503.718.2439 Fax: 503/5 8349 .) '�� Date/By: Other Permit: / v .
Inspection Line: 503.639.4175 ^Q e / l e 2 or 7
T I G A!l D ( Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov -\ 4:0 Notified/Method: Supplemental Information
TYPE OF �YOR � � .�� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
D Mechanical permit fees*are based on the value of the work
❑ New nstruction dition/alteratma'� V"" rent performed.Indicate the value(rounded to the nearest dollar)of all I•e ❑Other: �1 mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
Lie / RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
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:
Air conditioning 46.75
Job site address:/_5-7...5-0 _se,c) ,,_//e_e_ �A Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: L6,4jz� •77�Dc2' Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: /
Heat pump 61.06
7 �S Duct t work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
/ Residential boiler(radiator or
�// , leJ/�,4e-e--f2-i� /e-e � ' L '/ 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: l��Ec t e.,, ">2.c-e 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
- �Ay dor- - -— fireplace 23.32
6. A f) � Log lighter(gas) 23.32
Wood/firepl stove 33.39
%A p-�p� Wood fireplace/insert 23.32
b Chimney/liner/flue/vent 23.32
Other: 23.32
ROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name: `ete7' -2 ?-j,�/�� Range hood/other kitchen 33 ?��'
r p� equipment 33.39
Address:,�6-z � (/,r1 K.ei/Le_ 6-`,`7 Clothes dryer exhaust 33.39
City/State/ZIP: ---7-26•,...((.., _6 ®r2 �7c. -,/ Single-duct exhaust(bathrooms.
toilet compartments,utility rooms) 23.32
Phone:(97/)...‘-�)_ � 7 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: //
�-f . :?, r,,--z/ $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 I /g-er
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:i ��,�P`f��`7^7 't` K Other:
�� U�! MECHANICAL PERMIT FEES*
Address: /38:9....s- S E / 77, C-7- Subtotal
City/State/ZIP: e/ �.� GJ Minimum permit fee($90.00) 4'0,c0
�Se "� t ��� Plan review(25%of permit fee)
Phone:(6 3) 3/,),.,- 3 Fax:( ) State surcharge(12%of permit fee) ``����
_Li,�: 3V'
CCB lie.: /i 7`1 l5 /7 1/7 TOTAL PERMIT FEE I (00,�
l ! / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized sigtlat e:`r/�/ * Fee methodology set by Tri-County Building Industry Service Board
Print name: Z,et?e,2 y c� Date:/®/� / ._—
I:\13s dd in¢\Perm its\M ECPermitAp40401 13.doe 440-4617T(1 1/02/COMA W E13)
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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