Permit (65) CITY OF TIGARD MECHANICAL PERMIT
N,„
COMMUNITY DEVELOPMENT Permit#: MEC2018-00245
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/12/2018
Parcel: 2S110AD90018
Site address: 14862 SW 109TH AVE Jurisdiction: Tigard
Project: SMITH Subdivision: CANTERBURY WOODS CONDO Lot: 18
Project Description: Mini ductless split system.
Contractor: 24/7 HEATING&COOLING Owner:
20022 SW 71ST AVE SMITH, ROGER A
TUALATIN, OR 97062 3480 NE 26TH ST
LINCOLN CITY, OR 97367
PHONE: 503-804-6534 PHONE:
FAX: 503-213-6067
FEES
Specifics: Description Date Amount
Heat Pump 04/12/2018
Type of Use: SF $61.06
12%State Surcharge-Mechanical 04/12/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/12/2018
Occupancy Grp: $28.94
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.234,
•
Issued By: ermittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti,n d
This permit card shall be kept in a conspicuous place on the job site until completion oft a project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
FOR OFFICE USE ONLY
City of Tigard "hu • • • Received
41 13125 SW Hall Blvd.,Tigard,OR 97223"""' - ... e Date/By: �{ Permit No.:
• ■ , i�1 4 _ r
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
T 1 G A R D Inspection Line: 503.639.4175 ! �? 2018 Date/By: Other Permit:
Internet: www.tigard-or.gov b Date Ready/By: ® See Page 2 for
Notified/Method:
Ulf If (.3 iI tµ 1-'`„-2. rAj�i Supplemental Information
rt ,. E OF` u6 I ,CJIVj ION COMME7 cIA.L=;FEE* SCHEDULE -VSE CHE
CicIyiST
❑New construction 0Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
❑Demolitionperformed.Indicate the value(rounded to the nearest dollar)of all
0 Other: mechanical materials,equipment,labor,overhead,and profit.
.AT Value:$
eEGORY,OF CONSTRUCTION
,�1 and 2-family dwelling ❑Commercial/indusMal ' I ESiD.,f TIAL EQUIPMENT/SYS;TEMS`FEES*,
0 Accessory building
For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description
�� " JOB, ON S 'E INFORMATION AND LOCATION "` 'w xi Heating/cooling: Qty. Total
Job site address: Air conditioning 46.75
�lJZ 1 kt_ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: poy jC P._ 41`.1„LL Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: �^ Heat pump 61.06 6/,�
t J i' Duct work
Cross street/directions to job site: 23.32
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
k � bE-G . .-.-: '' .. v - 23.32
f. "RIPTJON O,F W(31ct( , Gas fir lace/insert
� � � � � ' � 33.39
I h J i I 11/71 Y)1C2(1-6-/-1 -5-AS1/ FFlluelaent for water heater or gas
23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
* TYlowN R :._ . , omTEEl7I 4 / -r Other: 23.32
- ..M3.. x Yd' r3 u. ,. per: .<, f= ... ,. %',. ::,,_
l", Environmental exhaust and ventilation:
Name: ei",
zx 5Y
Range hood/other kitchen
Address: t i �� equipment
UIGZSIN 1�•tt. ` 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: �iv.W` `nn -17 t-1...71 Single-duct exhaust(bathrooms,
Phone:( �) I T [ - toilet compartments,utility rooms) 23.32
�1 31 35' Fax ( )
�* � Attic/ s ace fans
� � � � crawl p
''" '1''LI r , CC?NTAC'I' A * 23.32
,- A' .- >R sQN ;.;a :., Other: 23.32
Business name: Fuel piping:
1 �-7 p-Leevfi� 3 C i \( l �c
Contact name: (�5..c,,, +J� 5 n $14.15 for first four;$4.03 for each additional
Furnace,etc.
Address: 67(.6 s,,,_,,,, r,i,t„.->.-. ...c?-j-- ,64 Gas heat pump
City/State/ZIP: -71-4,,,,_l-t ` -7 2-2-3
Wall/suspended/unit heater
Water heater
Phone: j ) j i i ( S 3 ti I Fax::( ) Fireplace
E-mail: (1'1- c��%-Z.(7 h.,,,-f-<eV,i, rG0h Range
Barbecue
: :s= '' -0' *x : dNT oft ; s* *. Clothes dryer(gas)
Business name: 2,.Li/ 7 Other:
] �ctlrtcl 3
CR7 ( C�:
1, �r- NIECHANICAE ERM4 FEES*Address: %Gl S i-J6...i'ti lcwt .$4
f t
Subtotal ,,(,z
City/State/ZIP:
-771 el.r7/ dc... C:-"r / 1.'7,-) Minimum permit fee($90.00) ''C,&V
Phone:(air)) i Jzit G S,gc/ I Fax:( ) Plan review(25%of permit fee) --
CCB lic.: rp'9/ State surcharge(12%of permit fee)
TOTAL PERMIT FEE P j f V.S
This permit application expires if a permit is not obtained within 180
Authorized signature: ---------
--- t---. days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: ' /�
�- �� .�;')---1/' I Date: Lip 2,��
I:\Building\Permits\MEC_PeimitApp_040113.doc
440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
'otul Vah t ion: .. remit 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 e first$100,000.00 and
$2,608.71 c additional2 a $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits EC_PermitApp_040113.doc 2