Permit (82) CITY OF TIGARDMECHANICAit#: L PERMIT
; ig.. .7COMMUNITY DEVELOPMENT PermMEC2017-00713
TIAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2017
C.
Parcel: 2S104AA90181
Jurisdiction:
Site address: 12658 SW KAREN ST 18
Project: BELLWOOD TERRACE CONDOMINIUMS Subdivision: BELLWOOD TERRACE CONDO Lot: 18
Project Description: Replacing(1)dryer vent.
Contractor: RELIABLE HOME IMPROVEMENT INC Owner: BELLWOOD TERRACE LLC
PO BOX 230815 PO BOX 189
TIGARD, OR 97281 YAMHILL, OR 97148
PHONE: 503-481-0240 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Clothes Dryer Exhaust 09/18/2017 $33.39
Type of Use: MF 12%State Surcharge-Mechanical 09/18/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/18/2017 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y.4 may obtain a copy of the rules
or direct questions to OU by calling 503.23 .1987 or 1.800.332.2344. /
,------;
Issued By: .7%,/ A_ Permittee Signature: �/ /
/ /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until .ompletion of e project.
Approved plans are required on the job site at the time of e•ch inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/By: AMPA /MIZZA
" 13125 SW Hall Blvd. 00'0 rifiliff
Tigard,OR 97223, \ Other Permit:II Plan Review
: 3 Date/By:
Phone: 503.718.2439 Fax: 503.598.1960
1
Inspection Line: 503.639A175
7
Date Ready/By: Juris gi See Page 2 for
Internet: www.tigard-or.gov
TIGARD *).0) e01 NNotified/Method::
77-6--- Supplemental Information
IC\ e *05
TYPE OF WORK tc„N
1.. :c,. COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
C, ., %1N,.,..
07; Mechanical permit fees*are based on the value of the work
EI New construction eAddition/alteration/tpc ,E performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: 03\.0) mechanical materials,equipment,labor,overhead,and profit.
Value:$ 4565, e,e,
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
El 1-and 2-family dwelling er6;mercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: w..'3/ sce) KA/FA) Vad id ( Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Ti Tfied Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: itfiL)."-ejtj ,
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
.." /01)e7-/--z). 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
DESCRIPTIoN 4t 0e1YORI‘4 .c4*-P- r ' Gas fireplace/insert 33.39';'• -.'''' Flue vent for water heater or gas
Kelat"'1:2'' 1 Olell 0-/-toc---
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
le4, Other: 23.32
ti„ PROitiT0:0'"* ''''''`I : -,,:''',-I.::: 1, 0 ONANT 311- Environmental exhaust and ventilation:
Name: F.d 2 4-k/&./0 Range hood/other kitchen
equipment 33.39
Address:
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 A,i,IiCO1 * 1: *r :f•-:•: '..'.-,r--."0 v 61,4,TE4V4 7,:st, 1 Other: 23.32
Fuel piping:
Business name: i&t;,/,44-440. lio,z- ZS-79d ?V7-'- - $14.15 for first four;$4.03 for each additional
Contact name: 6 pm).7- yoz/big Furnace,etc.
Gas heat pump
Address: /2506/ c; /e/f/C74) . Wall/suspended/unit heater
City/State/ZIP: 742 iL Water heater
Phone:. 73) Ct if/..-c2,/ 1/ Fax::( ) Fireplace
• ... Range
E-mail: /266 i4-12.Ze ót.0 z.144.AA6 ie 7etz, ' S-ifz Barbecue
'4,.."' '' ''• ''',.:,4 co ' ,, ' :„, ,,,, -', Clothes dryer(gas)
-.7 ,70147-
Other:
Business name: K6Z.,016/-4,Le'' /./.0-y/Le , „.,,, ,"4-A_)-e44---e'-..-7
'''''''' ,,,,, „,..AfEt.ErA'I, 'Al,i';*.* 1 ff,its*
Address: ,0 , d (- .Z.3 4/5 Subtotal
Minimum permit fee($90.00)
City/State/ZIP: ()a ie 7k-iv P
Plan review(25%of permit fee)
Phone:(5e'3) (187---ad.VG Fax:( )
State surcharge(12%of permit fee)
CCB lie.: if& ..3 7 TOTAL PERMIT FEE AO.?)
‘
This permit application itnexhpasirbeseeifnaacpceerpmteitdasisncootmobptlaeitneed within 180
days
after
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: 6SEA-A) 7 ye,z/47-.1) Date: ?...../$„-- - z.,-/-7
I:\Building\Permits\MEC_PernutApp_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_PennitApp_040I 13.doe 2