Permit (51) CITY OF TIGARD MECHANICAL PERMIT
.11111,--
COMMUNITY DEVELOPMENT Permit#: MEC2017-00351
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/23/2017
T E"f' Parcel: 1S 136AB04900
Jurisdiction: Tigard
Site address: 10349 SW 71ST AVE
Project: MICHAEL Subdivision: MAPLELEAF Lot: 7
Project Description: (1)exhaust fan for new bathroom in laundry room,and replacing(1)furnace.
Contractor: RICHARD PARKER CONTRACTOR LLC Owner: MICHAEL,JOHN W&LEESA I
6944 SE EILEEN LANE 10349 SW 71ST AVE
HILLSBORO, OR 97123 TIGARD, OR 97223
PHONE: 503-347-7087 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 05/23/2017 $46.75
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 05/23/2017 $23.32
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: 12%State Surcharge-Mechanical 05/23/2017 $10.80
Stories: Minimum Fee Adjustment-Mechanical 05/23/2017 $19.93
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct que ' ns to OU by calling 503.232.1987 or 1.800.332.2344.
Issued y: Permittee Signature: Ar
4/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Vb., Received
F Date/By: /t) Permit No.: ._i/ "�jlIl 13125 SW Hall Blvd.,Tigard,OR 972 - v MG C Phone: 503.718.2439 Fax: 503.598.19 an Review
Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 01 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov \\ � Notified/Method: ' ......co Supplemental Information
14
TYPE OF WORK��++1' IY t15„ COMMERCIAL FEE* SCHEDULE-USE CHECKLIST
O k C,131'' Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/rpc t, , performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ Other: INIk)1.1" mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description P Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: /v l f f �/� � Air conditioning 46.75
r Furnace 100,000 BTU(ducts/vents) 1 46.75 Lk j; "
City/State/ZIP: / ,rd i 0Q 9?2'?3 Furnace 100,000+BTU(ducts/vents) 54.91
v� Heat pump 61.06
Suite/bldg./apt.no.: Project name: in,'ctze/
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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23,32
r
DESCRIPTION OF" l :" . % Gas fireplace/insert 33.39
�' Flue vent for water heater or gas
. ;(. L r' C `-�+z;,) .7" ' c'( J I'd 4,( t'°r r'r AL1 1'i c. fireplace 23.32
J� �, f > j 4A,-,15-75 v Log lighter(gas) 23.32
%.~•'L -ii s tr L. &—.i 1C'lf r�..ZiYY`Y f !'l�.`,),..
\ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
- fir., �_, Other: 23.32
❑PROPERT<: •
"" Environmental exhaust and ventilation:
Name: /, q �J/(j / Range hood/other kitchen
t ( equipment 33.39
Address: �� `�C/ S l S t A Ve44(/Q.>
Clothes dryer exhaust t t')f Nin() 0 33.39
City/State/ZIP: /l af14 ok7 Cj?223 Single-duct exhaust(bathrooms,
7 / toilet compartments,utility rooms) 1 23.32 3 jt
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
,.. ''10APPLICANT , ' CTE.' , 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: j�,, �r -'' t ) Tj� Other:
i i., C f rte`^C/_,A�r� � l./�'(.,; �,Y'(,,C. ', G L'.L.- *4 ^� MECii iNICAL;PERM' T F` *
Address: 6 l Ll LI sl. CT tx-�t-f"l &Li ` � .
/ Q-7 Subtotal ��)
1 7(2 ,
City/State/ZIP: ��G�� hG�f ��.� Minimum permit fee($90.00)
Phone: Plan review(25%of permit fee) ""
( �) Q 7`CY7 Fax:( ) /t
State surcharge(12%of permit fee) ',
CCB lic.: oC S 'i, i TOTAL PERMIT FEE jf'
/6e,
This permit application expires if a permit is not obt ned within 180
77,0Pdays after it has been accepted as complete.
Authorized signatur * Fee methodology set by
� Iv>'iwE
Tri-County Building Industry Service Board oard
t
Print name: 0617,1g/ / (11(.t--(<:�� Dat -- 1/ 'P � fsC,
I:\Building\Permits\MEC_PermitApp_040113.doc 4404617T(11/02/COB) �•''(i / eOV C(iC f?%,2
y
563-2/ — Fi-
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