Permit (181) CITY OF TIGARD MECHANICAL PERMIT
'P911 ' ' COMMUNITY DEVELOPMENT Permit#:
M EC2018-00059
T r ;. r r 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2018
Parcel: 2S 111 DC08200
Site address: 15705 SW OAKHILL LN Jurisdiction: Tigard
Project: Anderson Subdivision: SUMMERFIELD NO.10 Lot: 575
Project Description: Replace(1)furnace.
Contractor: ACE ALL CLIMATE ENGINEERING LLC Owner:
ANDERSON,JANET M LIVING TRUST
PO BOX 3733 15705 SW OAK HILL LN
SALEM, OR 97302 TIGARD, OR 97224
PHONE: 503-991-5580 PHONE:
FAX: 888-296-0121
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 01/24/2018 $46.75
Type of Use: SFA 12%State Surcharge-Mechanical 01/24/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/24/2018 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 4,e.r4z&o'v,,W‘.
Permittee Signature: /
`r(/ L
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicata .: , V :
FOR OFFICE USE O S'LV
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 ; s 4 /di Date/By: i A Permit No.: ����
`,{,i'; '1
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review f
Ins ection Line: 503.639.4175 Date/By: Other Permit:
TIGARD p
Internet: www.tigard-or.gov ,r S ra yJ l"i i C y a Date Ready /By: Juris: H See Page 2 for
' Notified/Method:
X t t t V t w 6'� C 1'kl ci i Supplemental Information
i,A r ,‘,4i . �tl
TYPE OF WORT{" COMMERCIAL FEE'S SCHEDULE –;U,SE,C:11E0 :IST
Mechanical permit fees*are based on the value of the work
El New construction 0 Addition/alteration/replacement
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CON$
a �.
's! O ., r . :TIfiJC1°I(1N RESIDENTIAL EQUIPMENT I SYSTEMS FEES*,
and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
■ Multi-family 0 Master builder 0 Other: Description
ri � 1 Qty. I Ea. 1 Total
JOB BITE INFORMATION.AND LOCATION Heating/cooling:
Job site address:/)2c2_5--- S 6., e �� Air conditioning 46.75
c �iZ �� Furnace 100,000 BTU(ducts/vents) / 46.75 y(;f 7 S
City/State/ZIP: C,71 . 7 Y Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name: Heat pump 61.06
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: I Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
: 1.,,,.: .-i-
z 'DESCRIPTIDN'"OFgwok
Gas fn•eplace/insert 33.39
Flue vent for water heater or gas
Gi G c.,,,,_ .—F-' fireplace
23.32
k�
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PRO R
," ETY'�O Vl'11TER 1;,= 0
ENi TS4. Other: 23.32
/ Environmental exhaust and ventilation:
Name:
3�'Z 7' fr4d•r'� j .•� Range hood/other kitchen
Address:/c76)j- S e.-„/ t f,.../7,7/. 4,„7equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: 7� r v) C` 97 n e( Single-duct exhaust(bathrooms,
Phone:( ) cf toilet compartments,utility rooms) 23.32
Fax:( )
Attic/crawlspace fans 23.32
.APPLICANT.` " ONTACT PERSON Other: 23.32
Business name: Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Furnace,etc.
Address: Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( ) Water heater
I Fax::( ) Fireplace
E-mail: Range
Barbecue
.CONTRAcFOI E Clothes dryer(gas)
Business name. �� G2 / �� Other:
r _ 7`— 2---
7
Address: / �c` ?C MECHAIVICAI'PERMIT FEES*,
Y7s-� S��lHt .C.�« �[J sf' Subtotal
� dZc � Minimum permit fee($90.00)
City/State/ZIP:
1
Phone:Qj/ ) �6Q– ��5 I Fax:( ) Plan review(25%of permit fee)
CCB lac.: �/ i /�^ State surcharge(12%of permit fee)
��y�� / G G 7 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
,.. ,:...„.,,,,c/
Authorized signature: C days after it has been accepted as complete.
* Fee methodology set by Tri-CountyBuilding Industry Service Board
I Print name: i Date:
l -�r c-, J
I:\Building\Permits\MEC_PerniltApp_040113.doc
440-4617T(I 1/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee' `x
$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