Permit (81) CITY OF TIGARD MECHANICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit#: MEC2018-00229
T(CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/09/2018
Parcel: 2S110AD04900
Jurisdiction: Tigard
Site address: 14810 SW 106TH AVE
Project: KOLLAR Subdivision: LANG HILL NO.2 Lot: 43
Project Description: (1)range hood and(3)bathroom exhaust fans.
Contractor: OWNER Owner: KOLLAR, STACY
STACY KOLLAR EVANS, JOHN IV
14810 SW 106TH AVE 14810 SW 106TH AVE
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 04/09/2018 $33.39
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 04/09/2018 $69.96
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: 12%State Surcharge-Mechanical 04/09/2018 $12.40
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $115.75
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. "pecia • Co.- and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if wor is not sta ed within s I days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foil• the rule adopted by the •regon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ••. obtain a copy of th- rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. `
�� 4111.
Issued By: •- •••tee Signatu
-"A IIIWW
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of th• : •
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application r, 4 :
',I 1, sI.,. FOR OFFICE t SE oN t
City of Tigard t . ' ` Received _
: 4 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: /1 Permit No.:
i Plan Review n��C )/� 1'
Phone: 503.718.2439 Fax: 503.598.1960 ,�
11 S 7 �� ' Date/By: Other Permit:Mee for y��
TI G A R D Inspection Line: 503.639.4175 t� �!!�i A A
Internet: www.tigard-or.gov , e Ready/By: 7uds: I See Page 2 for
aA fied Method: Supplemental Information
TYPE OF WORK X, iy k `L`' ••;u COMMERCIAL.FEE* SCH1IDUL
.g - USE CHECKLIST
❑New construction Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
yr 1-and 2-familyRESIDENTIAL EQUIPMENT/"SYSTEMS FEES*
dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: j'/g 10 �/t/ OQ/"Y- 4 0 0 Air conditioning 46.75
(�V L [(�' Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -1 /(n' /7 n 71,... .... Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: !/�/ I Project name: Heat pump
Duct work T 61.06
! 0 `/ t'—�� / V 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
C✓ ` r�` 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
M //C
Subdivision: Cir, t%� l I Lot no.: Other: 23.32
Tax map/parcel no.:
/
c! / Other fuel appliances:
Water heater 23.32
DESCRIPTION OF *)RK % ' "4 Gas fireplace/insert 33.39
1, aC 7 3 6l hl---0 �1 7 Flue vent for water heater or gas
�p-y��;� � 5 �� fireplace 23.32
67 i ? li ,Aa/l- Log lighter(gas) 23.32
Wood/pellet stove 33.39
�� Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
:4)4
PROP RTY OWNER- . gg N, > N , 4 T.3 Other:
J . � :- ., . 23.32
Name: �e,j�►'lf `" Environmental exhaust and ventilation:
CTt/T I7 //c r(5/0/1 11 /� - . . $ Range hood/other kitchen
Address: / f ��q/ / ,vy r� equipment 33.39 j
(. / I �C Clothes dryer exhaust 33.39
City/State/ZIP:
y 0 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) `3 23.32 6,4t.16
Phone: 3 C , ,2
3) 1gq ) ($d�) 4,, ,., y Attic/crawlspace fans 23.32
APPLICANT CONTACT PRRSOI+I,v -, 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
Water heater
Phone:( ) I Fax::( ) Fireplace
E-mail: Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: eat jAre✓' Other:
Address: MECHANICAL PERMIT FEES* `
Subtotal Ic) 15--
City/State/ZIP: 4141. Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) I Fax:( )
State surcharge(12%of permit fee) `).{.I e,
CCB lic.: I/ TOTAL PERMIT FEE
�1� 1/ f CSS n 180
// This permit application expires if a permit is not obtained within 180
Authorized signs t � ; ` days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: I s Date: it (� / •
9 I
I:\Building\Permits\MEC_PermitApp_04 13.doc 440-46 7T(Il/0.'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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14810 SW 106TH AVE, TIGARD, OR, 97224 October 24, 2018 at
7:29:36 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00229
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor