Permit (36) CITY OF TIGARD <; MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00635
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2017
TIGARD 13125 25103CB00900
Jurisdiction: Tigard
Site address: 13085 SW 124TH AVE
Project: Wilhelm Subdivision: None Lot: None
Project Description: A/C unit installation. Placement of A/C unit must meet manufacture's requirement. 9/21/2017: REPRINT permit to
add furnace and gas piping.
Contractor: TRANTEL HEATING&COOLING Owner: WILHELM, MICHAEL W LIVING TRUST
1440 SE POWELL BLVD BY WILHELM, MICHAEL W TR
PORTLAND, OR 97202 13085 SW 134TH AVE
TIGARD, OR 97223
PHONE: 503-553-9066 PHONE: 503-590-4495
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 08/23/2017 $46.75
Type of Use: SF Furnaces<100K BTU 09/21/2017 $46.75
Class of Work: ALT Type of Const: Fuel Piping 09/21/2017 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 09/21/2017 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
Required Items and Reports(Conditions)
Specialty This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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.
j® �I
Issued By: r� _ Permittee Signature: O6 (fi/`�;"4,67,>077e
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.
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CITY OF TIGARD ., :r` : �j MECHANICAL PERMIT
COMMUNITY DEVELOPMENT,piimanna Permit#: MEC2017-00635
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2017
Parcel: 2S103CB00900
Jurisdiction: Tigard
Site address: 13085 SW 124TH AVE
Project: Wilhelm Subdivision: None Lot: None
Project Description: A/C unit installation. Placement of NC unit must meet manufacture's requirement. 9/21/2017: REPRINT permit to
add furnace and gas piping.
Contractor: TRANTEL HEATING&COOLING Owner: WILHELM, MICHAEL W LIVING TRUST
1440 SE POWELL BLVD BY WILHELM, MICHAEL W TR
PORTLAND, OR 97202 13085 SW 134TH AVE
TIGARD, OR 97223
PHONE: 503-553-9066 PHONE: 503-590-4495
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 08/23/2017 $46.75
Type of Use: SF Furnaces<100K BTU 09/21/2017 $46.75
Class of Work: ALT Type of Const: Fuel Piping 09/21/2017 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 09/21/2017 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
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. ! �j
Issued By:
1,,e0 /- Permittee Signature: oi(f et,,G,e,%'L„
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.
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CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit#: MEC2017-00635
Date Issued: 08/23/2017
-f-E
GPD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25103CB00900
Jurisdiction: Tigard
Site address: 13085 SW 124TH AVE
Project: Wilhelm Subdivision: None Lot: None
Project Description: NC unit installation. Placement of NC unit must meet manufacture's requirement.
Contractor: TRANTEL HEATING&COOLING Owner: WILHELM, MICHAEL W LIVING TRUST
1440 SE POWELL BLVD BY WILHELM, MICHAEL W TR
PORTLAND, OR 97202 13085 SW 134TH AVE
TIGARD, OR 97223
PHONE: 503-553-9066 PHONE: 503-590-4495
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 08/23/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/23/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/23/2017 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by (ling 503.23 987 or 1.800.332.2344.
Issued By: / ✓ Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONE\
Receive �� �� Permit No.:
City of Tigard Date/By:: L/ ��r -
4 13125 S W Hall Blvd.,Tigard,OR 97223 Plan Review
6 ���,
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:14
Inspection Line: 503.639.4175 Date Ready/By: Juns la See Page 2 for
T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction i ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Other: mechanical materials,equipment,labor,overhead,and profit.
El DemolitionValue:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other:
Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION Air conditioning , 46.75t•1K
Job site address: C 3('(j 5 " IA'1 rts it V Furnace 100,000 BTU(ducts/vents) 0 46.75 41.,7 c
rq� Furnace 100,000+BTU(ducts/vents) 54.91
City/State/ZIP: ! ,4,-. v 7 Heatum 61.06
P P
Suite/bldg./apt.no.: Project name: Duct work 23.32
Hydronic hot water system 23.32
Cross street/directions to job site: 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
Other: 23.32
Subdivision: Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
�. 1 Gas fireplace/insert 33.39
' .v 1-- - yx ; w DESC IP'I IOI�i F WORK „,,,,` < , ''F Flue vent for water heater or gas
-
Al c, + f fireplace 23.32
wr n G{. 1'n 5 #J c,9� n 23.32
Log lighter(gas)
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
> rF OPERT OE ``, I
- W ,. : , :* ��
Environmental exhaust and ventilation:
Name: b; 61,E ,, e / 0 k e.,/”1 Range h
ntd/other kitchen
/) u equip33.39
f�
Address: j 3 05 5 u/ I so. 1 /�v-e- Clothes dryer exhaust 33.39
ty 7 c, C) .OR
` c17 n 3 Single-duct exhaust(bathrooms,
City/State/ZIP: t� J� f- toilet compartments,utility rooms) 23.32
Phone:(V O3) 45 rl 0 Z-{,-t l 7 Fax ( ) Attic/crawlspace fans 23.32
.a 23.32
el V. z ONTAC PER ON,, Other:
P , ,. '>' , Y Fuel piping:
axe
PP g:
Business name: T f. -4 JJ �.(, -Z n�5 G Cz20 I fil) $14.15 for first four;$4.03 for each additional
Contact name: '5 LA.) t 1-f--„,m- � J Furnace,etc.
^ Gas heat pump
Address: L 4/ 5 1 r 7k C`uC Wall/suspended/unit heater
City/State/ZIP: Q)r-4-),+r? OP, Cl 7 9,U 0, Water heater
Fireplace
Phone:(505) 1) o c c., Fax::( ) Range
E-mail !,4 1606 (i (,oM S I-t 71 Barbecue
rr a ,, " Clothes dryer(gas)
Other:
Business name: 77`c,,/}1,A) N ` •,' ,44 is l/Ai, / ECIIAI ICA TERMIT E S*sem' . {
Address: _ I • /t/t/p Sfr- �G J(�t/Gam!/ Subtotal
(� Minimum permit fee($90.00)
City/State/ZIP: ��jll�� t,b V� �7 2�� Plan review(25%of permit fee)
Phone:(9 d'Ij) 5 ,i) - 01,i) b Fax:( ) State surcharge(12%of permit fee)
CCB lic.: J5
S^ c Ll IZ J9 // 7 TOTAL PERMIT FEE /DU- gc3
( l This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
.64
d
A4-A4- • Fee methodology set by Tri-County Building Industry Service Board
Authorized signature`s
Print name: J,t,tioA) 5 4.6_QTtc.(, 41, Date: 3) !/
l:\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 Valuations 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_pennitApp_040113.doc 2