Permit (169) 1l005ihi .,� CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENTPermit#: MEC2017-
60
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/31/2017
Parcel: 2S108AB05300
Jurisdiction: Tigard
Site address: 14173 SW 155TH TER
Project: Reed Subdivision: BRENTWOOD ESTATES Lot: 15
Project Description: Install 10'of gas piping for barbecue.
Contractor: JAVAZ HEATING AND COOLING Owner: REED, BRIAN M&JENNIFER A
12009 REES ST NE 14173 SW 155TH TER
DONALD, OR 97020 TIGARD, OR 97224
PHONE: 503-310-9416 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 07/31/2017 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 07/31/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 07/31/2017 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:.„, / / _ Permittee Signature: ..._
5
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicfECEIVED FOR OFFICE USE ONLY
Cid,of Tigard Received
�.
13125 SW Hall Blvd.,Tigard,OR 97223,1UL 3 I 2017
Pl
Date/By: 'ermitN �C�f 7-0056 0
C Phone: 503.718.2439 Fax: 503.598.1960 an Review
Date/By: Other Permit:
D
T 1 G A R D Inspection Line: 503.639.4175 CITY OF T lGARD Date Ready/By: kris: fa See Page t for
Internet: www.tigard-or.gov BUILDING
DIVISION Notified/Method: Supplemental Information
TYPE OF WORK DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
El New construction VA Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
LJ and 2-family dwelling ❑Commercial/indusMal 0 Accessory building
Multi-familyFor special information use checklist.
0Master builder 0Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: /1/ (,5---‘5,----731 e Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: sf, - Q 2,2_1— Furnace 100,000+BTU(ducts/vents) 54.91
,. 1 - Heat pump 61.06
Suite/bldg./apt.no.: Project name: 6,...,,,,...5- Lir) Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
/�j�
Residential boiler(radiator or
o ,- .c- &)i i4c-on , -, k ., ( czAlei hydronic) 23.32
��51l i I S� TYI Z cO Sty C ' Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
ce.c-4-, 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
`g• - - , Gas fireplace/insert 33.39
;' DESCRIPTION 43 F''WORK-"t , eP
/� Flue vent for water heater or gas
/0 P f6z fi �.l,i •�lei-e_- iJ8 fireplace 23.32
` ( (^ Log lighter(gas) 23.32
"\ L162-ee- �' 1 C F----:c-\-A— I G Ie C. 4'L25-e-
]�' L t ll j / Wood/pellet stove 33.39
N-^t::/" Lire. 1 cL\T �--�D IC-'_fl"-" erc Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32,x Other: 23.32
ROPER {® . y 0 TENANT
., -`- . ',;; -: 4' Environmental exhaust and ventilation:
Name: 4.f-.,'� = / Range hood/other kitchen
Address: /1// 73 � 15SS equipment 33.39
'c Clothes dryer exhaust 33.39
City/State/ZIP: X 2 /7 zz`�1 Single-duct exhaust(bathrooms,
t`�' , , toilet compartments,utility rooms) 23.32
Phone:($-7 7g) )c' Fax:( ) Attic/crawlspace fans 23.32
- , 23.32. .Amt" <rx�. -% _ `` Other:
� ® . . _ ,�. • �.., �''' ONTACTPEItSON , ,
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:( ) n Fax::( ) Fireplace
/( Range
E-mail: 6 Teat's x 3 M A`I - cmc Barbecue /
a» r CONTRACTOR `,, Clothes dryer(gas)
Business name: L / Other:
��✓Gc Z (_l�GG�'71 L a (‘Ciel//Wit , MECHA1lICAep RMPI 1~E i .;
Address: //o i'19 57--- A >�
Subtotal
City/State/ZIP: ,2kepft9y6,ce ' "X- '91,07020Minimum permitfee($90.00) Cie ,
Plan review(25%of permit fee)
Phone:(S23) s ?ya Fax:( ) State surcharge(12%of permit fee) /0 ,p
/ C
CCB lie.: Z'E,;3S/ rr/?_3 /1. TOTAL PERMIT FEE /(,)Q , f.
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: c")---- C. * Fee methodology set by Tri-County Building Industry Service Board
Print name: e_...,
�,t /// Date: '7/?)0 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\Pennits\MEC_PennitApp_040113.doc 2