Permit (179) CITY OF TIGARD MECHANICAL PERMIT
r"! !.' COMMUNITY DEVELOPMENT Permit#: MEC2016-00793
T',GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2016
Parcel: 1 S 133AC 14500
Jurisdiction: Tigard
Site address: 13285 SW HAWKS BEARD ST
Project: Scholls Ferry Apartments Subdivision: Lot: 63
Project Description: Gas piping installation in community building for pool heater,island range,and fireplace.
Contractor: CH KRUSE PLUMBING Owner: GRABHORN, BURTON E ESTATE OF
1527 SE 104TH CT 14577 SE ANDERSON RD
VANCOUVER,WA 98664 CLACKAMAS, OR 97011
PHONE: 360-573-4337 PHONE:
FAX: 360-573-5303
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/17/2016 $161.16
Class of Work: ALT Type of Const: VB Plan Review 11/17/2016 $40.29
Occupancy Grp: A-3 Occupancy Load: 12%State Surcharge-Mechanical 11/17/2016 $19.34
Stories: 1 Info Process/Archiving-Sm$0.50(up to 11/17/2016 $1.00
11x17)
Project Valuation: $3,500.00
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>= 100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $221.79
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1 ;!• 32.2344.
Issued By: �- Permittee Signature: e�
7/
Call 503.639.4175 by 7:00 a.m.for the next available inspectio ate.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
FOR OFFICE I.SE ONE
City of Tigard Received . Mlltrilli
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: �, r�� G
Phone: 503.718.2439 Fax: 503.598.1960 Plan Revi - ! , /
TI C l K D Inspection Line: 503.639.4175 RFC, Date/By: r f,, Other Permit:
" I Date Ready 4".. Juris: ��
Internet: www.tigard-or.gov ® See Page 2 for
tt�� 11 J i Notified/Method: 7, Supplemental Information
TYPE OF WORK NUV 1 7 2116 _
COMMERCIAL FEE* SCHIrDULE- USE CHECKLIST
❑New construction tQ R( ARD Mechanical permit fees*are based on the value of the work
❑Addition/alteratlo4bl c n
performed.Indicate the value(rounded to the nearest dollar)of all
3' . I g D I t C. DiVISION mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
CATEGORY OF CONSTRUCTION Value:$ l 5.00
RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND'LOCATION Heating/cooling:
Job site address: l j a �/ n Air conditioning 46.75
3 jj \..kiA_tAi`--- C Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: .1- ti (if Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:'16,-,..N Heat pump 61.06
C j/\7 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
Subdivision: I Lot no.: Other: 23.32
Tax map/parcel no.:
Other fuel appliances:
Water heater 23.32
DESCRIPTION OF ;
.. ,_ 'WOR1� � �` � �" Gas fireplace/insert 33.39
��\ , ,j Flue vent for water heater or gas
Ti- 1. C r t r t N . (-6 wi Vln i,,,It fireplace 23.32
6\ Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PR() ETZTY,OWNER I ( TENANT' ;. Other: 23.32
Name: Environmental exhaust and ventilation:
Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
Phone:( ) toilet compartments,utility rooms) 23.32
Fax:( ) Attic/crawlspace fans 23.32
. 7 I APPLICANT ;. ❑ CONTACT PERSON, Other: 23.32
Business name:(~ \A y_e.ln \r\ \0 0,\,c).\ Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
c ' 1 to 1/\ Y---tr vk Furnace,etc.
Address: 2 1C. ‘-.6 )-4 --- Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
\� '\co _.--- I Water heater
Phone:(7,4,) c -7 - 1-4--;--; Fax::( ) --51'3. Fireplace
E mail: i Range t
0, A�,1e`c-c AF1 Unv►- l'-,-,c---66. 1 Barbecue
m _ CO ' CTOR
_.. .." - Clothes dryer(gas)
Business name: Other. P6&\ `v`r'u‘�- \
Address: ( A v MECHANICAL PERMIT FEES*
f /1,( "` Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) I Fax:( )
State surcharge(12%of permit fee)
CCB lic.: iIr/65 ti 3/ i TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: Ze------, days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
(-:
Print name: /Cul /-2,11/11% ce_ I Date: [f_1 '7- /�" I
I.\Building\Permits\MEC Permit p_040113.doc f- 440-4617T(11/02/COVM/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.
1:\Building\Permits\MEC_PermitApp_040113.doc 2