Permit (71) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00429
Date Issued: 06/27/2017
T E GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S101 DA01900
Jurisdiction: Tigard
Site address: 6996 SW VARNS ST
Project: Madrona Recovery Subdivision: YARNS ACRES Lot: 3
Project Description: Relocating floor grilles and a new split system in basement. Installing a new gas line for a generator,exhaust fan,
and dryer vent.
Contractor: SALEM HEATING&SHEET METAL INC Owner: NELSON VIAL LLC
PO BOX 12005 7155 SW VARNES ST#120
SALEM, OR 97309 TIGARD, OR 97223
PHONE: 503-581-1536 PHONE:
FAX: 503-370-3780
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/27/2017 $703.31
Class of Work: ALT Type of Const: VB Plan Review 06/27/2017 $175.83
Occupancy Grp: R-4 Occupancy Load: 12%State Surcharge-Mechanical 06/27/2017 $84.40
Stories: 3 Info Process/Archiving-Lg$2.00(over 06/27/2017 $2.00
11x17)
Project Valuation: $24,000.00 Info Process/Archiving-Sm$0.50(up to 06/27/2017 $4.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 1 0-3 HP:
Fumaces>=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: 1
Heat Pump:
Appliances
Vent Fans: 1 Vent Systems: Total $969.54
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
1503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i
• Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received /? /
- DateBy: (0�/) t 7 Permit No.:�ECt�"i y` 4
" 13125 SW Hall Blvd.,Tigard,OR 97223 �"'
IN
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 li/By: �-- � `1Other Permit: +1' II^h O6.N
TIGARD Inspection Line: 503.639.4175RECEIVE
Ready/B / /�/� loris: See Page 2 foorvInternet: www.tigard-or.gov fied/Method: Supplemental Information
(tcii7cGIfpft i Q PI
TYPE OF WORK JIJN 8 2017 COMMERCIAL FEE* SCHEDULE —USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction 'El Addition/alteration/ , performed.Indicate the value(rounded to the nearest dollar)of all
V iGAR.
El Demolition ❑Other: DIVISION mechanical materials,equipment,labor,overhead,and profit.
�}°Q 'DIYISIO p�. Value:$a1 000'r
CATEGORY OF CONS N RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling NO Commercial/industrial ❑Accessory building For special information use checklist
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
q S4-
Furnace
conditioning 46.75
Job site address: 6� L� j w vcu's ✓, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ""'rt Ifa v Q 9 i 92 Furnace 100,000+BTU(ducts/vents) 54.91
,Suite/bldg./apt.no.: J Project name: 1 Heat pump 61.06
S me, Re(& ( 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
DESCRIPTION OF WORK Gas fireplace/insert 33.39
/ Flue vent for water heater or gas
�e1o4 *f. Floor 6i lxt. A% NefiArvj fireplace 23.32
Net..l S?I tE J1STmM i. EAse&c.-+ Log Wood/pelletlighte (gas23.32
stove 33.39
New Gras line -}u `Genere4yr Wood fireplace/insert 23.32
CAN S1, FAA/ Uhi'� Dr9fr tk Chimney /liner/flue/vent 23.32
0 PROPERTY OW ER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
¢dress: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT` 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$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)
''11 Other:
Business name: sGIl eP1 }ff,++l d. Sicca met,j
MECHANICAL PERMIT FEES*
Address: Pb 8 Us I a4I Subtotal
City/State/ZIP: 4aleM of C'13VG1 Minimum permit fee($90.00)
Bo Plan review(25%of permit fee)
�
Phone:(93) 1,1531 Fax:( ) 5v3- 371-31 Bo State surcharge(12%of permit fee)
CCB lic.: Iso TOTAL PERMIT FEE
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:\ \ E„b+„`, 6/4/1.)6/4/1.)Date: bJ° 1-
/
1:1 BuildingPermitsMEC_PermitApp_0401I3.doc !�+4 440-4617T/(i 1/02/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.
150,000.01 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.
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