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Permit (65) a{ CITY OF TIGARD MECHANICAL PERMIT � 2 ' COMMUNITY DEVELOPMENT Permit#: MEC2017-00829 T f.GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/23/2017 Parcel: 1 S 134AC06900 Jurisdiction: Tigard Site address: 11011 SW GENEVA ST Project: ALWAY Subdivision: JEFFREY ESTATES Lot: 2 Project Description: Replacing furnace in crawl space and installing gas piping to furnace. Contractor: HANSON HEATING Owner: ALWAY, BARBARA L 1916 SE 148TH 11011 SW GENEVA ST PORTLAND, OR 97233 TIGARD, OR 97223 PHONE: 503-891-9138 PHONE: FAX: 503-760-5590 FEES Specifics: Description Date Amount Furnaces<100K BTU 10/23/2017 $46.75 Type of Use: SF Flue/Vent For Any of Above 10/23/2017 $23.32 Class of Work: ALT Type of Const: Fuel Piping 10/23/2017 $14.15 Occupancy Grp: Minimum Fee Adjustment-Mechanical 10/23/2017 $5.78 Stories: 12%State Surcharge-Mechanical 10/23/2017 $10.80 Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-I. -11•I You maY -obtain a cop of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B ' Permittee Signat e: // a7 i i Call 503.639.4175 by 7:00 a.m.for the next availa• e insp• ion date. This permit card shall be kept in a conspicuous place on the job si . ii completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONE1' City of Tigard Received g Date/By: (4 �3 1-7 Permit No.: •r L/2,,, t7 Zp, 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review!�U `7 IIII I s Phone: 503.718.2439 Fax: 503.598.1960 , :y, Other Permit: TI G A R D Inspection Line: 503.639.4175 i C E I ;ead/B Tor Internet: www.tigard-or.gov ,.. y o Bf See Page 2 for o t ed/Method: Supplemental Information OCT 2320 TYPE OF WORK COMMERCIAL FEE* SCHEDULE,— USE CHECKLIST F'rf GARD Mechanical permit fees*are based on the value of the work ❑New construction �f Addition/alteration/ren ��1,r� f h t performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: It G DIVISION 1 1 i+ mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* Nt 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: , Furnace 100,000 BTU(ducts/vents) j4 , © � � .S vv � P_�y'�tJ J9" � 1 � 46.75 '7 City/State/ZIP: 1T:4 'T" /41 tit)'"*+e "'L meq' 7 cz 3 y Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: 014 Duct work 23.32 jr)Cross street/directions to job site: j $1' IT) I a / Hydronic hot water system 23.32 ►►►TTT))) 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 1 23.32 33,5,z Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 r £DECRIP ON 6F0 W F Gas fireplace/insert 33.39 L,',/ � Flue vent for water heater or gas R. - F rust 9-C' � ! ,,,.j fireplace 23.32 � � L �.,„ Log lighter(gas) 23.32 pQ etc' V`AS /i Wood/pellet stove 33.39 ry C.`. Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 "" ;,k PROPER * O NERtZ . '1 ' TENANT:: Other: 23.32 } = _.-'' Environmental exhaust and ventilation: Name: J 4.v,log P L,L., i Range hood/other kitchen c �,� equipment 33.39 Address: l , 8 _ I 4 Clothes dryer exhaust 33.39 City/State/ZIP: f a p,,, oft a 1"J r1 e Single-duct exhaust(bathrooms, Phone: r I- / ! �'( toilet compartments,utility rooms) 23.32 �) I �� Fax ( ) Attic/crawlspace fans 23.32 ' AP ANT •C e\, ` PERSON Other: 23.32 Business na e: 4. Fuel piping: 9_S /v ' / $14.15 for first four;$4.03 for each additional Contact name: ��-�►1E,s J) QY r-5 env Furnace,etc. / /I,l5 Address: jq /'G NS E ! yJ`/`"`FFFcS 6- Gas Wall/suspended/unit City/State/ZIP: 10,..,„ C ` l j� -9'7 7 .33 ✓ Wateheater heater Phone:( g ci ititiv_/ p� Fax:: 6 Fireplace / a ® � Range E-mail: Barbecue 47 = " dt � �/ �.., ', „s �, Clothes dryer(gas) Business name: 4 Jnnsa 66...�c� Other: CAL ERMI'` EES ` Address: � ,,,-C Subtotal 5y City/State/ZIP: Minimum permit fee($90.00) ce, a...-2-: Plan review(25%of permit fee) ...---- Phone: ( ) Fax:( ) State surcharge(12%of permit fee) t CCB lic.: `'y, `4p ' TOTAL PERMIT FEE ac),0 This permit application expires if a permit is not obtained within 80 days after it has been accepted as complete. Authorized signa 0 ,4 � , , % * Fee methodology set by Tri-County Building Industry Service Board Print name: \in-13 S cp. + S• Date: :j q I:\Building\Permits\MEC_PermitApp_040113.doc :-4617T(11 2/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