Permit (181) CITY OF TIGARD
R v - COMMUNITY DEVELOPMENT MECHANICAL PERMIT
Permit#:
MEC2017-00953
T(GA D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/04/2017
.
Parcel: 2S111AD01100
Jurisdiction: Tigard
Site address: 14585 SW 87TH AVE
Project: IBOSHI Subdivision: PINEBROOK TERRACE Lot: 8
Project Description: Adding(1)gas line for new range. Also adding(1)gas line for new water heater to be installed at a later time.
Contractor: OWNER Owner: IBOSHI, JOSHUA N &ALEXANDRIA JA
JOSHUA IBOSHE 14585 SW 87TH AVE
14585 SW 87TH AVENUE PORTLAND, OR 97224
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 12/04/2017 $33.39
Type of Use: SF Fuel Piping 12/04/2017 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 12/04/2017 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 12/04/2017 $42.46
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rul-s adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You m. /o•tain a copy of the rules
or direct questions to OUN7, ailing 503.232.1',4 or 1.80fr32.23 .
T
Issued By: 0 , z,; Permittee Si.nature: _ 4
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Call 503.639.4175 by 7:00 a.m.for the next available inspectio . t.-
This permit card shall be kept in a conspicuous place on the job site until c,1,i,•letion of the project.
Approved plans are required on the job site at the time of eac Inspection.
EIV
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Mechanical Permit Applicatio FOR OFFICE USE ONLI'
Ci of Ti and DECReceived
g U2017 Date/By:• i�i Permit No. �--(e.56Other Permit:
IIPI13125 SW Hall Blvd.,Tigard,OR 97223 - L . ) -( '
1S /� Plan Review P
Phone: 503.718.2439 Fax: 503.598.1960 ��"1id iYi Date/By::
Inspection Line: 503.639.4175r�l y
T I G A R D 3 i..�l�_[ !N G ry r' l0 :late Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov '$tri°-jlt-^` otified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE1,- USE CHECKLIST '.
"' Mechanical permit fees*are based on the value of the work
0 New construction 4 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION ,. 4, RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
"S 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building
For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE 1NFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: /t!' �S .9 7 -1, A
7 ✓ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: fiCY4--i(Yt4 Ulp\ .,i-74_a Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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
IDSCRIPTlN OF WORK ,: Gas fireplace/insert 33.39
` `:' Flue vent for water heater or gas
A•1C.\ > be-0,1C i- &Jed{f ky0kr- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
.• PROPERTY OWNER Z q TENANTS;-„
Environmental exhaust and ventilation:
Name: S�sN.t V
Tk3f)y,ARange hood/other kitchen
Address: (4,..i--5
equipment j 33.39
E�1 5 S _AA) ' 7 J4 v Clothes dryer exhaust 33.39
City/State/ZIP: et (i G- 1> OK c'7 Single-duct compartments,
exhausttmen (bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(SUS.) ',..,>F0 _�7 6 Fax:( ) Attic/crawlspace fans 23.32
F ❑.APPLICANT ` 0 CONTACT PERSON ' ' Other: 23.32
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:( ) Fax::( ) Fireplace
Range
E-mail: f
Barbecue
' '"CONTRACTOR"
� " z' Clothes dryer(gas)
Business name: '
MECHANICAL PERMIT FEES*4..i.,,
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee)
CCB lic.:
.7TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: `,, * Fee methodology set by Tri-County Building Industry Service Board
XPrint name: i" vis. a.Y3 t",rt Date: j)..10 i (r 7
I:\Building\Permits\MEC_PermitApp_040113.doe 440-46171(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.
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