Permit (54) CITY OF TIGARD MECHANICAL PERMIT
.7I. COMMUNITY DEVELOPMENT Permit#: MEC2018-00332
I f Af.t.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/07/2018
Parcel: 2S114BD03700
Jurisdiction: Tigard
Site address: 9545 SW RIVERWOOD LN
Project: BAYHA Subdivision: COPPER CREEK STAGE 3 Lot: 77
Project Description: Gas piping for fireplace.
Contractor: SORENSEN PLUMBING Owner: BAYHA, KEVIN R&CARRIE A
19010 SW BONNIE MEADOWS 9545 SW RIVERWOOD LN
ALOHA, OR 97006 TIGARD, OR 97224
PHONE: 503-522-2052 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: SF Fuel Piping 05/07/2018 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 05/07/2018 $10.80
Occupancy Grp: Occupancy Load: Minimum Fee Adjustment-Mechanical 05/07/2018 $75.85
Stories:
Project Valuation: $0.00
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $100.80
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
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 obt,'n_-a---*•y of the rules
or direct questions to OUNC by calling 503.232.1987 . .:10.332.234-
Issued By: - iiittee Signature:
Call •3.639.4175 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 Application FOR OFFICE USE ONLY
City of Tigard Received ,-7
g Date/By: /7rr — Permit No.: /iri i l
1111 iii 13125 SW Hall Blvd.,Tigard,OR 97223 +a f t1 D'7 )
_ ''. lan Review
Phone: 503.718.2439 Fax: 503.598.1960 RECEIVE I ate/By: Other Permit: MST /!, (A)/
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris. ® See Page 2 for
Internet: www.tigard-or.gov
MAY
2018 Notified Method: Supplemental Information
,.,six..i� ,.-.x..v.,y'e` _ .a. .,
,,, TYPE OF wWORICITY OF TIGAR13- ' COMME1 CIAl.FEE*.'SCHEDULE y- IIE CHECia.ISf
X21.I;I (� I* IMechanical permit fees*are based on the value of the work
El New construction Addition/alteratldtNt�br4t• performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition [Other: mechanical materials,equipment,labor,overhead,and profit.
- e Value:
CATEGORY tiF CONSTRUCTION
w RESIDENTIAL EQUIPMENT/SYSTEMS FEES* _�'
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
`` Heating/cooling:
,�, � , .,..:-410B SITE.I!IFOR11fiA'fIO1V AND LOCATION. � t
(� � Air conditioning 46.75
Job site address: 5 7 5 W i V ��� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: T'64Q ` 111 Furnace 100,000+BTU(ducts/vents) 54.91
7 Heat pump 61.06
Suite/bldg./apt.no.:...- Project name: 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: Other: 23.32
Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
" ' Gas fir lace/insert 33.39
W, DESCRIPTION OF WORK 4z eP
, ' Flue vent for water heater or gas
fireplace 23.32
1"'64 berr %' P f‘"2-`
A' M`AA €fir Log lighter(gas) 23.32
tie.) Wood/pellet stove 33.39
p• C
.., wtt 1_'€ • P. , la s(Q.L- Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
' 4:04..4
p,m � a WEp 14;
Other: 23.32� � t{ Q,Pt PER" OE °"'`••` ` -%,..V_ N„
t 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
v' µ 41.3 APPLICANT y TM3 0 dL NTACT PERS6 Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace t PA,1)
Range
E-mail:
Barbecue
igt CONi'RAC140 °' 15"4. Clothes dryer(gas)
Business name: {�lA� c0Qf,..4ç1,Ab PL S W 1 V ..., >, Other:
ll � � `: MEGR NICAL 1J I IIT FEES* :; gh
Address: 110 O S S 1�0 NI l••1/a OA 6AI:1,Iw t 0 Subtotal
City/State/ZIP: L 0 1 4 0 a 9?00'3 Minimum permit fee($90.00) 1 i,�C.
Plan review(25%of permit fee)
Phone:(S151 5 7 Z'Z 051. Fax:( #"----
State surcharge(12%of permit fee) i 0, i'-'d
CCB lic.: 1 i 6 v 3 i V7/h TOTAL PERMIT FEE ie;).-a
v This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized si * Fee methodology set by Tri-County Building Industry Service Board
Print name: tog L curt t‘,45 Date: 5-7. I A
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 Val u tion: 'Permit e
$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