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Permit
CITY OF TIGARD MECHANICAL PERMIT y 4 COMMUNITY DEVELOPMENT Permit#: MEC2015-00750 Date Issued: 11/04/2015 •71GARU 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109BA02000 Jurisdiction: Tigard Site address: 13917 SW LEAH TER Project: WHIPPS Subdivision: HILLSHIRE SUMMIT Lot: 5 Project Description: Relocating vent hood and 6 ft.of gas piping to range. Contractor: J COLE CONSTRUCTION INC Owner: WHIPPS, ROBERT S&CAROLE J PO BOX 91333 13917 SW LEAH TER PORTLAND, OR 97291 TIGARD, OR 97224 PHONE: 503-516-4936 PHONE: FAX: FEES Specifics: Description Date Amount Range Hood/Other Kitchen 11/04/2015 $33.39 Type of Use: SF Fuel Piping 11/04/2015 $14.15 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 11/04/2015 $10.80 Occupancy Grp: Minimum Fee Adjustment-Mechanical 11/04/2015 $42.46 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 503.232.1987 or 1.800.. . . Issued By: -ermitt Signature: Y ee 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 Received City of Tigard 0 �(\o, O ///y/! -- Permit No.: M�CaD(s W 7g0 V ate Rev ` ,t 11111 I • 1 3125 SW Hall Blvd.,Tigard,OR 972 n Review Phone: 503.718.2439 Fax: 503.598.0�' G:, C.N�Date/By: Other Permit: (2.4.X..,�/)iS ,0 3-93 T I G A R n Inspection Line: 503.639.4175 \� ...s.\ �N Date Read /B Juris: vw Internet: www.tigard-or.gov \ �N Ready/By: Supplemental See Page 2 Information Notified/Method: Supplemental Information ��� 7TH —11"....1110111.M.1.1 a Mechanical permit fees*are based on the value of the work ❑ Ncv< construction ,. Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. t, _ CA : a CUN IYtUd10Ni ►L ./SYSTEMS FEES* AI-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 „ -' T _ , Heating/cooling: .4 �!ST1,� �ATIUN AWD'IL ;�CA'i7UN . .. �,-, . �. ,_ 3, .' ..r Job site address: 139 ii �� f � ^ ,t 6 4- Air conditioning ( ) 46.75 / l� I-f�(its Furnace 100,000 BTU ducts vents 46.75 City/State/ZIP: 1-1 G-A,0 OK, 7 I�� Furnace 100,000+BTU(ducts/vents) 54.91 1 j_44N � .' Heat pump 21.32 Suite/bldg./apt.no.: Project name: l r 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 A .�+ Flue/vent for any of above 23.32 Subdivision: 14((4,SI i#1! 5thevt N u l Lot no.: 5 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas R 1 AeynA/ �L. fireplace 23.32 Aoo V yam, .1 *o& (eeLo cA 1 Log lighter(gas) 2332 IG+�1 �t"t / Wood/pellet stove 33.39 1"f Ova CHAS (uh)tJ Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 . Other: 23.32 T � I, I '•-•:$.-::t� Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 1 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 Other: 23.32 Business name: Fuel piping: $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) Other: Business name: ( ) co„1.C UGir � • _, Address: 1 C3 34:i 5 �w W 009e-9 i �/t,_ "c Subtotal City/State/ZIP: V Cl)IL illocz, Minimum permit fee($90.00) ¶0,Os) Plan review(25%of permit fee) — Phone: t.{93(„ Fax: (12%State surcharge(12 of permit fee) J©, CCB lie.: ZCc, CO . TOTAL PERMIT FEE %b. f` This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signatjr � * Fee methodology set by Tr-County Building Industry Service Board Print name: CO t e— Date: i I 4-1 i 5- I:Building Permits:MEC_PermitApp_0401 I 3.doc 440-46I 7T(11/02/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\Pennits\M EC_PcnnitApp_040 1 13.doc 2