Permit CITY OF TIGARD MECHANICAL PERMIT
': COMMUNITY DEVELOPMENT Permit#: MEC2018-00179
TfGAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/19/2018
Parcel: 2S104CB02700
Site address: 13076 SW ASCENSION DR Jurisdiction: Tigard
Project: SCOTT Subdivision: HILLSHIRE WOODS Lot: 73
Project Description: Gas piping for new 20 x 40 sf swimming pool.
Contractor: BLUE MOUNTAIN POOLS INC Owner: SCOTT,ALIZA L
13121 S WARNOCK RD 13076 SW ASCENSION DR
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-760-4554 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 03/19/2018 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 03/19/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/19/2018
Occupancy Grp: $75.85
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.8.A-322044—
Issued By:
re: Adi
Call 503.639.4175 by 7:00 a.m.for the next available inspec,•n date. fr
This permit card shall be kept in a conspicuous place on the job site un ` completion of the project. /
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard , "V Received
�t Date/By: efi ��/ Permit No.:
l'ilh13125 SW Hall Blvd.,Tigard,OR 97223 •
C Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
9 `) (� Date/By: Other Permit: '-r _ _ ,.,` '
TIGARD Inspection Line: 503.639.4175 MAR 1 2018 t - L
Date Ready/By: ® See Page for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY Y Oh CIGARSif
a
_ TYPJ OF w LDtNG DIVISION COMMERCIAL FSE* SCHE ILE:- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction .ffl.Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF C9NSTRUCTION RESIDENTIAL EQUIPMENT l SYSTEMS FEES*
J1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description
Qty. Ea. Total
JOB SITE INFORMATION AND.~LOCATION Heating/cooling:
Job site address: /3 � /-,1 S `
0 76 _ Cn Air conditioning 46.75
/�c.c'`� /-9/1L�r" Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ..----/ �/ Furnace 100,000+BTU(ducts/vents) 54.91
1 4 „C}Gi6
Suite/bldg./apt.no.: j Project name: // Heat pump 61.06
.Sk �/CP T` T 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
I,` ` ,", r 6 . , i N OF , Gas fireplace/insert 33.39
1-q....5,
/ )' ""/ . J Flue vent for water heater or gas
-qj /1'i to ( j 7"19 0e/ 4ea!'P,. fireplace 23.32
7-e
,, t / / / Log lighter(gas) 23.32
�(/e 0/ c j ' '4 � r /(/ W 4 to hal Wood/pellet stove 33.39
4'.__j(2 (i'(P its i" Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.320,PROPRRTY OWIE . , F Other:R ,41 r
,-t- Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
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
" —,:f0
APPL4CANT >. r ., Other: 23.32
� ���.CU�'I'AC�PERSO��;
Business name: 74,,„A,„
/fFuel piping:
.7rl N / '(,LA h T o,',4 / )/J' $14.15 for first four;$4.03 for each additional
Contact name: r i,fsS Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
i. „ C71:9R , 7,„,,,,,. 4:u Clothesdryer(gas)
Business name: / j
Other: %JI
.3/uC dti.h4,i� %pc•'i( "" R rF 5* J �r#
ME CAI iiE
Address: °~ "-
Subtotal f 4,(5-
City/State/ZIP:
City/State/ZIP: Minimum permit fee($90.00) l'O,t14;
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) �ii rt
CCB lic.: 3 ,i-C-' TOTAL TOTAL PERMIT FEE j 01;),S0
r✓ This permit application expires if a permit is not obtained within 180
/I. days after it has been accepted as complete.
Authorized signature: - * Fee methodology set by Tri-County Building Industry Service Board
Print name: _1 .� 7w u .4 Date: /c1 (6-
I:\Building\Permits\MEC_PermitApp_040113.doc 441/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total aivation: ' 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_PuinitApp_040113.doc 2