Permit (45) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Permit#: MEC2017-00031
Date Issued: 01/17/2017
TICAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S134CD02600
Jurisdiction: Tigard
Site address: 11850 SW KATHERINE ST
Project: Katherine Subdivision: LERON HEIGHTS NO.3 Lot: 61
Project Description: Installation of(1)bath fan
Contractor: FLUID DEVELOMENT LLC Owner: KATHERINE LLC
10111 NE 14TH CIRCLE 2250 NW FLANDERS ST STE G02
VANCOUVER,WA 98664 PORTLAND, OR 97210
PHONE: 360-281-7079 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 01/17/2017 $23.32
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 01/17/2017 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 01/17/2017 $66.68
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or di questions • •UNC by calling 503.232.1987 or 1.800.332.2344.
ssued By
j Permittee Signature: rk±'` �'®�---
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic f,. 1,.'
�� i FOR OFFICE CSG O'V1.1'
City of Tigard Received /�Z��Ot' 3l
Date/By: /7 / Permit No.:
41 13125 SW Hall Blvd.,Tigard,OR 9722,3.
( Plan Review
I
Phone: 503.718.2439 Fax: 503.598.1)401 6 ,:/ Date/By: Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Jurist
Internet: www.tigard-or.gov See Page 2 for
,., Supplemental Supplemental Information
5�.:a, a`.a`,-aitlk t 361()1
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New constructionE-Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
jai-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
( I
c, , ` \ _ C ( Air conditioning 46.75
Job site address: S0 1&) hIgt I/tZ- X14, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1-1. or 0 q-�A, ,3 Furnace 100,000+BTU(ducts/vents) 54.91
f 11 I Heat pump 61.06
Suite/bldg./apt.no.: Project name: ' ' ^ 23.32
l'c-ru[tet Q L)-Lework
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: 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OR WORK Gas fireplace/insert 33.39
A^0'Kp t -FRA- .. Flue vent for water heater or gas
[�L �� � fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
'' 0 PROPERTY OWNER i.. 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: - equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 1 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON 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:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: I k a a DQ,�e I0(2 Ate ln,-t L.LC_ Other:
Address: t ' (�` p IM G C{ l MECHANICAL PERMIT FEES*
��<< 1 1. Subtotal
t
City/State/ZIP: V p W, (AA 1 Q6 6 CJ Minimum permit fee($90.00) gam'®�
v 1 Plan review(25%of permit fee)
Phone:UL 0) 2 8 1 D Fax:( ) State surcharge(12%of permit fee) / $0
CCB lic.: -400 8o0 8 0.9h., TOTAL PERMIT FEE /;e0.Std
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:£i i/,4/4- Date//i Z'`J 7
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(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\Permits\MEC_PermitApp_040113.doc 2
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
11850 SW KATHERINE ST, TIGARD, OR, 97223
Record Type:
Residential - Mechanical
Inspection Type:
699 Mechanical final
Result:
PASS- NoCofO
Comments:
Corrections completed
Violation Summary:
Tel: 503.718.2439
Inspection Date:
Record ID:
MEC2017-00031
Inspector:
Aaron Cillo-Gobel
Inspector Contractor