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Permit (32) CITY OF TIGARD MECHANICAL PERMIT ffi COMMUNITY DEVELOPMENT Permit#: MEC2018 00210 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/29/2018 TIGARD 13125 2S104BC01200 Jurisdiction: Tigard Site address: 14504 SW FERN ST Project: KAUFER Subdivision: HILLSHIRE HOLLOW Lot: G Project Description: (1)residential boiler and(1)in-slab hydronic hot water system under patio cover. Contractor: OWNER Owner: KAUFER, GREGORY&VALERIE GREG&VALERIE KAUFER 14504 SW FERN ST 14504 PORTLAND, OR 97223 TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Specifics: Description Date Amount Hydronic Hot Water System 03/29/2018 $23.32 Type of Use: SF Residential Boiler(Radiator or Hydronic) 03/29/2018 $23.32 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/29/2018 $10.80 Occupancy Grp: Minimum Fee Adjustment-Mechanical 03/29/2018 $43.36 Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: % Permittee Signature: Gz .""fir Call 503.639.4175 by 7:00 a.m.for the next available inspection date. I This permit card shall be kept in a conspicuous place on the job site until completion of the project. I Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application �f FOR OFFICE USE ONI.I' City of Tigard �; . ed , 411 Permit No.: III 13125 SW Hall Blvd.,Tigard,OR 97223 Vt,f Date By: rf�r r _ Plan Review Phone: 503.718.2439 Fax: 503.598.1960 's ate/By: Other Permit: '� i I GA R D Inspection Line: 503.639.4175 MAR 2 g 20 Date Ready/By: See Page 2 for • Internet: www.tigard-or.gov Notified/Method: _l��.'� Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction Add ition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* rg'I-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: Air conditioning 46.75 Job site address: I L, -C7 1-1-�. -yihr--1 T E-�Nt s?7 ' 1Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: t tI A��j 7gL> '�< ' )2-1,--3 Furnace 100,000+BTU(ducts/vents) 54.91 �A Heat pump 61.06 Suite/bldg./apt.no.: Project name: t�Lk V -�� Ap tp.77hi Duct work 23.32 Cross street/directions to job site: Y Hydronic hot water system / 23.32 023 3a Residential boiler(radiator or hydronic) / 23.32 p • p 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 DESCRIPTION OF WORK Gas fireplace/insert 33.39 S� Flue vent for water heater or gas e113j t t� ? _ li 5�� fireplace 23.32 Log lighter(gas) 23.32 C 1.N1 �"�� ) G � 1) Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 33.39 Address: 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 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name:' jI 5`7Y `l 4 Furnace,etc. Address: I I+,c©u„ �� S� -�-c Gas heat pump t 1 �A Wall/suspended/unit heater City/State/ZIP S l"i 7.7 Water heater Phone:( ) Fax::( ) Fireplace a S I T . 0_, Range E-mail :—T-'w 1�--� C�� Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: MECHANICAL PERMIT FEES* Address: Subtotal /16,Of City/State/ZIP: Minimum permit fee($90.00) IU,,L/4) Phone:( ) Fax:( ) Plan review(25%of permit fee) — State surcharge(12%of permit fee) iQ,ge CCB lic.: TOTAL PERMIT FEE laxly This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized Signa 7 * Fee methodology set by Tri-County Building Industry Service Board Print name: Date: S.-DT—i I:\Building\Permits\MEC_PermitApp_040113.doc' 440-4617T(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. I:\Building\Permits\MEC_PermitApp_040113.doc 2