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Permit
11111 CITY OF TIGARD MECHANICAL PERMIT 3 •� COMMUNITY DEVELOPMENT Permit#: MEC2015-00777 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2015 Parcel: 2S110CB12900 Jurisdiction: TIGARD Site address: 12053 SW AUTUMNVIEW ST Project: Stone Bridge Homes NW Subdivision: SOUTH VIEW HEIGHTS Lot: 17 Project Description: Installation of a/c unit Contractor: COMFORT ZONE HEATING&AIR COND Owner: STONE BRIDGE HOMES NW LLC 1032 NW CORPORATE DR 4230 GALEWOOD ST, STE 100 TROUTDALE, OR 97060 LAKE OSWEGO, OR 97035 PHONE: 503-667-5595 PHONE: FAX: 503-491-8252 FEES Specifics: Description Date Amount Air Conditioning 11/17/2015 $46.75 Type of Use: SF 12%State Surcharge-Mechanical 11/17/2015 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/17/2015 $43.25 Occupancy Grp: Investigation Fee 11/17/2015 $90.00 Stories: Investigation 12%State Surcharge 11/17/2015 $10.80 Fuel Fuel Types: Gas Pressure: Total $201.60 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. o may obtain a copy of the rul- or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued EC (/"�-� Permittee Signature: � Call 503.639.4175 by 7:00 a.m.for the next available inspection ate. 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 AppliatECEIVED FOR OFFICE USE ONLY III City of Tigard 17 2015 Date/By:e /1 /7 /c, Pennit No.: gC 13125 SW Hall Blvd.,Tigard,OR 972 " `^�'�7�� s Phone: 503.718.2439 Fax: 503.5A./.060 Plan Review y OF TIGARD Date/By: Ocher Permit T I G A R t Inspection Line: 503.639.4175 Date Ready/By: Juns ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information _. , , 'F WOOF; 11116iiiiiiMt COMMERCIALJEE* SCHEDULE — USE CHECKLIST 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:S CATEGORY OF CONSTRUCTION 14IFF RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 0.I-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑Other: Description I Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: — Air conditioning f 46.75 _ Job site address: /20 C 3 ��Sppw cj tu.vt►l ta..e -V `1-. Furnace 100,000 BTU(duce:vents) 46.75 City/State/ZIP: 7744 O Furnace 100,000+BTU(duetsvents) 54.91 / "�l1 �y� Heat pump 61.06 Suite/bldg./apt.no.: Project name: c1"ItiltiA) I.1 ,' Ductwork 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 Flue/vent for any of above 23.32 Subdivision: Lot no.:'7 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 ('dcI 4((--f vo it fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent , 23.32 PROPERTY OWNER ❑ TENANT Other: 23.32 j Environmental exhaust and ventilation: _ Name: 5t� f2` , !Q 5 g-- W Range hood/other kitchen equipment 33.39 Address: i f e / wa( y-- SV l ,_ too Clothes dryer exhaust 33.39 City/State/ZIP: CA-- ©BI/ p U � 11` Single-duct exhaust(bathrooms, / toilet compartments,utility rooms) 23.32 Phone:(303.) jip. 15—7'7 Fax:(SO; ) ;1. !;'](.PI 5 Attic/crawlspace fans 23.32 Tics APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: .p Fuel piping: �-Al�JL 1 0OV'e $14.15 for first four;$4.03 for each additional Contact name: 0jydV-L 6Vf Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace i ri•1 1 -,:-.0 , 0yiell S' & J, `,',,,, Barbecue � r—CONTRACTOR Clothes dryer(gas) •� Other: Business name: (OIM*i ! f. 2 jt'�-. 1}esv17 t�1� CtL t MECHANICAL PERMIT FEES* Address: /O 3 L.) dpy o b,i: subtotal ^DOQ City/State/ZIP: I�_ ce 9l 70 4,0 Minimum permit fee($90.00) C/� / rl / Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) ✓v.f'C) CCB lie.: //60Cl/ TOTAL PERMIT FEE /pd.duo This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. Authorized signatureY * Fee methodology set by Tri-County Buildint- ' cPrvice Board Print name: r 04 vz le,- r [�/(� Date: (/ �"]IiS /ts/v%*r #n✓f i �� /00 �v I:Building Permits MEC_PermitAii_040113.doc —"l 440-�7T(ii/02/COM/WEB) , a0/ • ' 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\M EC_PermitApp_0401 13.doc 2