Permit (15) CITY OF TIGARD MECHANICAL PERMIT
111 ... COMMUNITY DEVELOPMENT Permit#: MEC2017-00481
T[rARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/03/2017
Parcel: 2S103DB04800
Jurisdiction: Tigard
Site address: 11155 SW NOVARE PL
Project: Miller Subdivision: GENESIS NO.2 Lot: 46
Project Description: Bathroom remodel: (2)exhaust fans
Contractor: OWNER Owner: MILLER, DARYL R& DEBORAH H
11555 SW NOVARE PL 7 VIA ARRIBO
TIGARD, OR 97223 RANCHO SANTA MARGARI, CA 92688
PHONE: 949-939-2070 PHONE: 949-939-2070
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 07/03/2017 $46.64
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 07/03/2017 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 07/03/2017 $43.36
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct quetions to OUNC by calling 503.232.1987or 1.800.332.2344.
Issued y: �iL-(,‘f�� F„ Permittee Signature: \� tj/n
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. `
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of TigardE1VED Received
1,1 . Date/By: % Permit No.: Mg,CO2617-elf,417
13125 SW Hall Blvd.,Tigard,O 2 3
= Plan Review
Phone: 503.718.2439 Fax: 503.59 60
TIGARD Inspection Line: 503.639.4175, 2017 Date/By: Other Permit:
Internet: www.tigard-or.gov � Date Ready/By: Jur s: ® See Page 2 for
glCI1 YOi OF TIGARD
RKNotified/Method: Supplemental Information
TYPLr DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
❑ 1-and 2-famil RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
y dwellin g ❑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:
Job site address: t ) 1 5 S s
,,ND O v
Air conditioning 46.75
�t 1,c) P Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: j G.A 2 0 , ®2 C -1 '�-� -3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: y Heat pump 61.06
�\ i L.L' E fe 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
`'A 1--4 '2.0 C�i-`r\ )� G /Y1 _ fireplace O �C�L, eP 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
z.... p• t P<, T46.O ET E am; Other: 23.32
^ - Environmental exhaust and ventilation:
Name: �'"'t Y L . rlrl I LLC 2, Range hood/other kitchen
Address: equipment 33.39
t 5 S % 0\.)A'e€ Clothes dryer exhaust 33.39
City/State/ZIP: -1-l G 2 r c 2 C - 1,-L-2_3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:
( IC\ Q 3S- "�,d Fax ( ) Attic/crawispace fans 23.32 2.
s
�,I? P ,-;,,../.: ` 0 :"A „' flN- 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
. ,w A`...'':` CONTRCTORt _ t
.. . �.. A :mz P,•. , Clothes dryer(gas)
Business name:
D60 Av e� Oth
er:
ex�-
MECHANICAL)PERMIT
FEES* fix"Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00) 94.00
Phone: Plan review(25%of permit fee) ___ ----
( ) Fax:( ) State surcharge(12%of permit fee) Mt.10
CCB lie.: TOTAL PERMIT FEE //y,,ge
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized si as afore. � * Fee methodology set by Tri-County Building Industry Service Board
Print name f _I ) _ I Date: 0-1 cy _.1-7
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11155 SW NOVARE PL, TIGARD, OR, 97223 October 25, 2018 at
11 :34:34 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00481
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor