Permit (10) CITY OF TIGARD MECHANICAL PERMIT
;N 2 COMMUNITY DEVELOPMENT Permit#: MEC2016-00348
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2016
T f i;; R.p g Parcel: 2S111BA08500
Jurisdiction: Tigard
Site address: 9445 SW MOUNTAIN VIEW LN
Project: BARATTA Subdivision: BRELYNN WOODS Lot: 2
Project Description: (2)exhaust fans
Contractor: RJP INVESTMENTS LLC Owner: POZZI, KATERINA C
17690 BOONES FERRY RD BARATTA,ADAM M
LAKE OSWEGO, OR 97035 9445 SW MOUNTAIN VIEW LN
TIGARD,OR 97224
PHONE: 503-320-0132 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 05/18/2016 $46.64
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 05/18/2016 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 05/18/2016 $43.36
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the ules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-I :i•.. .• m. obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued Byl ataQI Permittee Signature: x
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE, USE ONLY
111 Eiew
Permit No.: `� '/
ill 13125 SW Hall Blvd,Tigard,ORF CEIVE[ H yf�„Ov 37Il Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Date/By:
l lc ,\R n Inspection Line: 503.639.4175 1 8 2016 Date Ready/By: auris: ® See Page 2 for
Internet: www.tigard-or.gov MAYNotified/Method: Supplemental Information
x w nT_. •'''
.. , at # as o .
p "` zr' Mechanical permit fees*are based on the value of the work
0 New construction MI Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demol Other: mechanical materials,equipment,labor,overhead,and profit.
„',.; y .� :#, y, .xs. " .a�} , 'i � , ,. ^a Value:$
J �`4 .. e .d 73 #$ti( % 8w tl"e"s t ae g'. �y� k, ±". - ",
I,.' ,L.' s,..s ,2,�.,. e ..ac,.. .,,, >,ois,V, ,s...saa., 6,,.;'r�,.�,.au ..;a:t,u' w�.t'.E[, 1,:;,1;.:".; �' :d.. i t p. ..I
nd 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
iAc gr.. ax ' 6 a at p £ a " • P �--'"'"---""4"'"'Ne", � � .. Heating/cooling:
,a"-. -1" '""maz5" x .''a.v rr , . ;'" ra'''" w'''. -'"'z , d'''''''
Air Conditioning 46.75
Job site address: f S W ,(,fj Jr-7h,Jl/ ,-w
)p)v/E Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: IT 4/44 6 Q it 9 7 2 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: 3h 61"'r-rA 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
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: 1 Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DEscRjrrI®N,QF WORK Fl Gas fireplace/insert 33.39
" �"`_ �',..„',.•,,,:::: ::.,,,,,L,,..,,,,,,,-.4.::,,, i'
�'�' Flue vent for water heater or gas
e,(.4T-15- e� ! 7 "1 7T7"S fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
# {!' 111 r l''.:'`;'1:';";''''-'''.'-'''-' ..__,-
.'.
Other:
Environmental exhaust and ventilation:
Name: e _e` 4"-- K°1-1-EqL 1 � tq.mT7 Range hood/other kitchen
equipment
33.39
Address: Lit/ J- 5 on toIv �TI}J VL 4,...,,,,
£ 4'I Clothes dryer exhaust 33.39
City/State/ZIP:�a A b rt. 17 1_2ySingle duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(5-V3) 3 d -a L... .-/.. Fax:( ) Attic/crawlspace fans 23.32
:,
0-ii4e iiiOther: 23.32
e----4._N
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: ^pL,,,,,, J Furnace,etc.
Address: /7 4 1 0 r. .+f .1-1-.4.,,,t r ir ,.ret.4 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: (','/,------ 4 S vi C‹I 04._ i-WSW- Water heater
Phone:(SL) 3-i...6 _ Q (3. Fax::( ) Fireplace
Range
E-mail: Barbecue
� r. : Z1 V ` ' Clothes dryer(gas)ar j :-; t c t , . ?
Business name: „5-p Other
Address: ( 7 6 3 6 cl,sal a-41 0.Cit.,�
c Subtotal
City/State/ZIP: /-s- 6 c w� 4,6 b K. Q s
Minimum permit tee($90.00)
Phone:( 2 ) tS Fax:) ( ) Plan review(25%of permit fee)
3 Z -61 3 ZState surcharge(12%of permit fee)
CCB lic.: i‘f Z) 2 TOTAL PERMIT FEE ' /12,0.g19
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: � Li.._l.y\ Date: S //tiI I 4
I:Building.PermitsMEC_PennitApp_040113.doc 440-4617T(1 I.02 COM WEB)
Mechanical Permit Application Cityof Tigard
AA - g
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
,
4 r k ,H:Yob_ :$b *, " r, .,M,yf; ✓
$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 Penriits MEC PennitApp_040113.doc 2