Permit (248) CITY OF TIGARD MECHANICAL PERMIT
11111 I COMMUNITY DEVELOPMENT Permit#: MEC2018-00469
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2018
T t c. ; R« g Parcel: 2S104DA18800
Jurisdiction: Tigard
Site address: 13355 SW KINGSTON PL
Project: Dessert Subdivision:JUAIL HOLLOW SOUTH TOWNHOME; Lot: 14
Project Description: Radon mitigation.
Contractor: CASCADE RADON INC Owner: DESSART, DONALD&MECHELLE
12839 NE AIRPORT WAY 13355 SW KINGSTON PL
PORTLAND, OR 97230 TIGARD, OR 97223
PHONE: 503-421-4813 PHONE: 503-367-5348
FAX: 503-281-6170
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 07/03/2018 $115.11
Class of Work: ALT Type of Const: VB Plan Review 07/03/2018 $28.78
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 07/03/2018 $13.81
Stories: Info Process/Archiving-Sm$0.50(up to 07/03/2018 $5.00
11x17)
Project Valuation: $2,000.00
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 $162.70
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Radon
Duct Work: mitigation
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy okthe rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
/ , / • ature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application_ FOR OFFICE USE ONLY
City of Tigard Cr •/. r , •Received ����/�ps/� �/ C
Date/By: ( finer/%- Pe/vGGLA04.-0 ti ,
1111 0 13125 SW Hall Blvd.,Tigard,OR 97223 /
_ Phone: 503.718.2439 Fax: 503.598.1960 JUN A " 2018 Plan Review
Date/By: �� Other Permit:
T l c-ARD Inspection Line: 503.639.4175 Date Ready/By: loris: la See Page 2 for
Internet: www.tigard-or.gov GT?'`', ',` fi' Notified/Method- `1> LSupplemental Information
,
BUi Li._:; , �`N
.� � ,9?i+..�;ON (
* ''.--i-:,'''' FE OF WORK ' . 11 MERCIAL FEE" SCHEDULE 2}LSE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and
t.
Value:$ Z 000-
f
CATEGORY OF CONSTRUCTION i * . I I" s' : ,; RESIDENT IQIPMENT/SS MS FEESc,
0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
ult1 family 0 Master builder 0 Other: Description Qty. Ea. Total
'+. ve JOB SITE INFORMATIONY LOCATIONIK a Heating/cooling:
Air conditioning 46.75
Job site address: 19)3 5 t A, /�'i tato A `p Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: .1 a rd, , 0--K.,, ct'rz 3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: `J Project name: i t j4 0b Heat pump 23.32
I 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: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
£ ten.:"
C E,SCRIPTION 0. ® ' v= 'x Gas fireplace/insert 33.39
Flue vent for water heater or gas
-KaclOn tklil Ciah 0 n fir-.lace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
m OPERTY,,OWNEE` '''''.,47 ❑ rANT 4.-...., Environmental exhaust and ventilation:
Name: M t i v 1ue_ .-Drk' Range hood/other kitchen
W� �,- i equipment 33.39
Address: 13 )6 5 4J W K.\Yt `5O'' V t.. Clothes dryer exhaust 33.39
City/State/ZIP: ( � C y Single-duct exhaust(bathrooms,
�� i 1 `f ' �^� toilet compartments,utility rooms) 23.32
Phone:(605) ` - Fax:( ) Attic/crawlspace fans 23.32
# Other: 23.32: ' =c 6
« � I:iCANT „ -Vzt- 7*� +_ �`'CON'C� &.-6-14 � "
Fuel .i h in::
Business C
name: e� �t'J 1 f(IO t 1 t�/�.�'3C, �C K. $14.15 for first four;$4.03 for each additional
Contact name: I 1 CO 1 p CO 1( (A3 Furnace,etc.
Address: 1 Z ��C N� / If-p0 r f Y _ 9 Gas heat pump
i ` j Wall/suspended/unit heater
City/State/ZIP: or-kt 7 n/� i CZ. (1 1Z?�0 1 Water heater
Phone:Q:303 HC '�t51. Fax::( ) Fireplace
Ranle
E-mail: r ce tel, c do C1Vf. cam Barbecue
CONT R T "s , ,. n Clothes dryer(gas)
Business name: RadOther:
�� T� �i f l ..,.. , .NikamNIC lCtvlftwES.,I"� r _
Address: 1 z_659_ NE A(r r.i- V V a 51� l Subtotal
City/State/ZIP: i o Minimum permit fee($90.00)
-��� ��� °
,, � Plan review(25%of permit fee)
Phone:( L 1_ n 171 Fax:( ) State surcharge(12%of permit fee)
CCB lic.: [ •bTOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature • Fee methodology set by Tri-County Building Industry Service Board
Print name:A / it, .Aii - + /A - Date: '. 0 l
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:
Valugt :m Permit Fee:
Total �."Qn:
$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