Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Permit#: MEC2017-00510
•�"' h IDate Issued: 07/13/2017
T t GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 _, } ' Parcel: 2S115AD00100
Iffefirril Jurisdiction: Tigard
Site address: 10512 SW TUALATIN DR
Project: Barbara Hatton Subdivision: WILLOW-BROOK-FARM Lot: 32
Project Description: Gas line to range,BBQ,pool heater and dryer. 8/9/17:REPRINTED permit to include(2)bathroom exhaust fans,
(1)range hood,and duct work for existing house as well as the addition.
Contractor: J&M CONTRACTOR SERVICES INC Owner: HATTON, FLOYD W&BARBARA W
15604 NE RUID RD 10512 SW TUALATIN DR
AMBOY,WA 98601 TIGARD, OR 97224
PHONE PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 08/09/2017 $23.32
Type of Use: SF Range Hood/Other Kitchen 07/13/2017 $33.39
Class of Work: ALT Type of Const: Single Duct Exhaust(Bathrooms,Toilet, 07/13/2017 $46.64
OccupancyUtility Rooms)
Grp:
Fuel Piping 07/13/2017 $14.15
Stories: 12%State Surcharge-Mechanical 07/13/2017 $14.10
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $131.60
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. �3
Issued By:
�GPermittee Signature: //
Fi+i'
CCC ��� -I/`r'-'
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLI'
City of Tigard Received
¢,, to/By: (� rj / 7 Permit No.: ,t t y
111 . 13125 SW Hall Blvd.,Tigard,OR 97223VE
Ad
C Phone: 503.718.2439 Fax: 503.598.1960EI s, . Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: luris: 0 See Page 2 for
Internet: www.tigard-or.govAUG
Notified/Method: Supplemental Information
9 7217
TYPE OF WORKf,Fn OF TIGARD COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
[ in, A A V Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteratiDIVISION performed.Indicate the value(rounded to the nearest dollar)of all
iqj El Demolition El Other:
ltYll mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total •
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
/
Job site address: 0 5 I Si - r�( cj //el t,',11 DY Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1--,, Qd U 2 Gl -? . z Ci Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 1.1 C'.t t /'v t 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
' " Gas fireplace/insert 33.39
,:� �t= � l" : � I ON'�1�''�V��RK" ...". �', eP
'1 `7.14.1v.- 'CO Flue vent for water heater or gas
t D4-tlir_, k hP
Fc:-, - c � «
cci ci t I,J . 6,y,. rC-1 4,,,;(1, fireplace 23.32
cf (.
/ Log lighter(gas) 23.32
Cc of G i'h 1"'E'1--ct H N 12.4c1.1.A r-ci N 2 ,rM 4:Lc s i- 4Wood/pellet stove 33.39
I r ct 31 y..r? f x A 4t..t s /- -- t..( C. t'4>t'."" it , ,-,‘z I.E. Wood fireplace/insert 23.32
A �� S !
( 0/d�� o f, Chimney/liner/flue/vent 23.32
t 3 Other: 23.32
74' 0 i TY OWNED, , 0 TENANT O.
,,,,>- tel,M, .•x' tee' Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment / 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) a9Z 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
. $t x.1k. [;] CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
�,j/t LQ �.�5 46,ril t_ $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
i
w v%;
CONTRACTORr - Clothes dryer(gas)
�r.
Business name: j re-/V) Ce ; . fr � �
V F;'V - ? CIIANICAL PERMIT FEES*
Address: ^f Q, _ r" �� Subtotal
City/State/ZIP: ^ /,+' �,Q�^�� �j a Minimum permit fee($90.00)
/�/v1 ile t LA4. "1 Ci/ Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: TOTAL PERMIT FEE 3/ . 8
This permit application expires if a permit is not obtai ed within 1 0
days after it has been accepted as complete.
Authorized si tir)jJ)
/ / * Fee methodology set by Tri-County Building Industry Service Board
Print name: / Date: 0 ! 2 l /�
I:\Building\Permits\ C_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