Permit (75) CITY OF TIGARD MECHANICAL PERMIT
II „3
COMMUNITY DEVELOPMENT Permit#: MEC2017-01026
T(GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/28/2017
Parcel: 2S102CC04400
Jurisdiction: Tigard
Site address: 13765 SW ASH AVE
Project: BRUNER Subdivision: BEREA Lot: 5
Project Description: Adding(1)range hood and(1)gas line for kitchen remodel.
Contractor: OWNER Owner: BRUNER, IAN M
IAN BRUNER 13765 SW ASH AVE
13765 SW ASH TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-475-0745 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 12/28/2017 $33.39
Type of Use: SF Fuel Piping 12/28/2017 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 12/28/2017 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 12/28/2017 $42.46
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
-44
afphe.„-75 ___
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
s
'Mechanical Permit Applicatio>1 , , ._i ,„g FOR OFFICE USE ONI.I
City of Tigard ��I' 2 8 / Date/By: (
i /r
:2041 PermitNo.:�
I 6......._ /
— ././.' ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 I /0 1j• �+ :�p r: Date/By: Other Permit: - / 1
Inspection Line: 503.639.4175 " ii,;?c
T 1 G A R D p I. g v Date Ready/By: Jure ® See Page 2 for
Internet: www.tigard-or.gov � otified/Method: Supplemental Information
FW�i i,r t1. {s,t0 d�E
TYPE OF WORK ;:
COMMERCIAL FEE* SCIIEUULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction -a-Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
'CATEGORY OF CONSTRUCTION RESIDENTIALEQIIIPMENTI�SYSTEMSFEES*
B-1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION' AND LOCATION Heating/cooling:
'" - Air conditioning 46.75
Job site address: i;7(G,5- S fr,,t 1 sig AV_ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -t„ ') l ,-,;(2___. / G 7 2-L33 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: RUti� k-(T�1trJ� 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
,ESIIIPTION OF WORK' 1'` Y .," 4, .,.. ; Gas fireplace/insert 33.39
Flue vent for water heater or gas
le_i'f(:+(-c-tv tC A.u.:,KeL „etp0 /v. -, rtveN wl A'c--uv •-1t& fireplace _ 23.32
Log lighter(gas) 23.32
0 A mOte2 ' i") AT t-' -ffl-j (._ivt'-„ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
PROPER' 3WNER \;`; ;'❑ TENANT
Environmental exhaust and ventilation:
Name: lawb?keL V ",-7,1L--- Range hood/other kitchen
) equipment 33.39
Address: 2--j 0 S SV✓ .41;&k.4-. ! Clothes dryer exhaust 33.39
City/State/ZIP: •11(1. O / 04 / C ZL Single-duct exhaust(bathrooms,
1-1 toilet compartments,utility rooms) 23.32
Phone:(93 ) 41c 1 5 Fax:( ) Attic/crawlspace fans 23.32
PLICA - ..ONTACT PERSON Other: 23.32
Fuel piping:
Business name: .�z
Ar-e $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: Barbecue
• ,_,CONTRACTOR `. Clothes dryer(gas)
Business name: A T Other: (4„e_ l i M..IC
..-.�;
MECHANICAL PERMIT FEE *.
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00) 010.,:)k..)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) /i)_ UJ
CCB lic.: TOTAL PERMIT FEE /00.`too
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
Print name: tri ,,,, r t_,,U:,A 1C_ Date: 12 i -i
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/2/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation:' Permit Fele. „ ,µ
$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