Permit (39) CITY OF TIGARD MECHANICAL PERMIT
Ii' COMMUNITY DEVELOPMENT Permit#: MEC2018 00430
T E t3,1 f..D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2018
Parcel: 2S 104CA06500
Jurisdiction: Tigard
Site address: 13322 SW HILLSHIRE DR
Project: Perreira Subdivision: HILLSHIRE Lot: 65
Project Description: Install(2)exhaust fans for basement bathroom
Contractor: OWNER Owner: KOGA,WENDY M
WILLIAM PERREIRA PERREIRA,WILLIAM K
13322 SW HILLSHIRE DR 13322 SW HILLSHIRE DR
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 808-389-2728 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 06/08/2018 $46.64
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/08/2018 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 06/08/2018 $43.36
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: % `�/
�e---- Permittee Signature: eN6,"7_,,,, oz /ei. j. 0-/�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicat ` '‘
I E
FOR OFFICE USE ONLY
City of Tigard Received /
Dal G s� Permit NMC/•''7�`t�/�J
" 13125 SW Hall Blvd.,Tigard,OR 97223 JUN
N! y' �`� l•�t✓ G / V
Phone: 503.718.2439 Fax: 503.598.1960 V'V 2018 Den By:RevOther Permit:
Dere/By:
Inspection Line: 503.639.4175 i Date Read/B kw".
® Sce Pa e 2 for
TIGARD Internet: www.tigard-or.gov kit 1 � h �t Ready/By:
t Notified/Melho /I44y Supplemental h�ta•mntton
TYPE OF WORT{/ eAuthoriz dsignature:
❑New construction ®Addition/alteration/replacement
Print name:
❑Demolition ❑Other:
CATEGORY OF CONSTRUCTION COMMERCIAL FEE* SCHEDULE'— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessoty building performed.Indicate the value(rounded to the nearest dollar)of all
0 Multi-famil mechanical materials,equipment,labor,overhead,and profit.
y ❑Master builder ❑Other:
Value:$
JOB SITE INFORMATION AND LOCATION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Job site address:13322 SW Hillshire Dr For special information use checklist.
Description Qty. Ea. Total
City/State/ZIP:Tigard,OR 97223
Heating/cooling:
Suite/bldg./apt.no.: Project name:basement bathroom inst Air conditioning 46.75
Cross street/directions to job site: Furnace 100,000 BTU(ducts/vents) 46.75
Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Duct work 23.32
Hydronic hot water system 23.32
Residential boiler(radiator or
Subdivision:Hillshire Lot no.:65 hydronic) 23.32
Unit heaters(fuel-type,not electric),
Tax map/parcel no.:2S104CA06500 in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
DESCRIPTION OF WORK Other: 23.32
exhaust fans for basement bathroom installation Other fuel appliances:
Water heater 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
El PROPERTY OWNER ❑ TENANT Wood/pellet stove
33.39
Name:William Ferreira Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Address:13322 SW Hillshire Dr Other: 23.32
City/State/ZIP:Tigard,OR 97223 Environmental exhaust and ventilation:
Range hood/other kitchen
Phone:(808)389-2728 Fax:( ) equipment 33.39
® APPLICANT ®;CONTACT PERSON Clothes dryer exhaust 3339
Single-duct exhaust(bathrooms,
Business name: toilet compartments,utility rooms) 2 23.32 46.64
Contact name:William Ferreira
a Attic/crawlspace fans 23.32
Other: 23.32
Address:13322 SW Hillshire Dr Fuel piping:
City/State/ZIP:Tigard,OR 97223 $14.15 for first four;$4.03 for each additional
Furnace,etc.
Phone:(808)389-2728 Fax::( ) Gas heat pump
E-mail:william.perreira@lamresearelt.com lamresearch.com Wall/suspended/unit heater
CONTRACTOR Water heater
Fireplace
Business name: Range
Address: Barbecue
City/State/ZIP: Clothes dryer(gas)
Other:
Phone:( ) Fax:( ) MECIIANICALPERMIT FEES*
CCB tic.: Subtotal 46.64
Minimum7permit fee($90.00) 90,e
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Plan review(25%of permit fee) \ 1 AV\
(�V1/�State surcharge(12%of permit fee) 5.60V VU�1 ' '
TOTAL PERMIT FEE 90.00
This permit application expires if a permit is not obtained within 180 I 5 I U
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days after y has been accepted as complete, ' 1 4/�`JY (�J/(/
* Fee methodology set by Tri-County
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Building Industry Service Board \ A '
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