Permit (198) CITY OF TIGARD MECHANICAL PERMIT
'11COMMUNITY DEVELOPMENT Permit#: MEC2018-00677
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2018
Dg Parcel: 2S104CD01700
Jurisdiction: Tigard
Site address: 13957 SW MISTLETOE DR
Project: HAYES V ENTERPRISES Subdivision: HILLSHIRE ESTATES Lot: 17
Project Description: Installing fireplace and venting.
Contractor: EMERALD OUTDOOR LIVING INC Owner: HAYES V ENTERPRISES LLC
2520 SILVERTON RD NE 13957 MISTLETOE DR
SALEM, OR 97301 PORTLAND, OR 97223
PHONE: 503-370-9355 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 08/27/2018 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 08/27/2018 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: 12%State Surcharge-Mechanical 08/27/2018 $10.80
Stories: Minimum Fee Adjustment-Mechanical 08/27/2018 $33.29
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 ou may •otain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio e.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigardtik ..:.�� Dat iveYd
_ // / ` Permit Noid _ O
13125 SW Hall Blvd.,Tigard,OR 97223 v
= Phone: 503.718.2439 Fax: 503.598.1960A 1( 2 L 7 i 018 Plan Review
Date/By: Other Permit:
TI C;A R O Inspection Line: 503.639.4175 Date Ready/By: Juris: 10 See Page 2 for
Internet: www.tigard-or.gov ( Notified/Method: Supplemental Information
~COMMERCIAL *°TEESCHEDULE.--USE CHECCELIS
?� �... :=x 'TYPE'b�`vVORK T,
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OI h)STRUCTI(')1�1 44''''''';',,,F
`} '2;.f.,,,,7:,'
nom" RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
al 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
E l Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
� V Heating/cooling:
JOB SITE I1VEO)gtiV �QNr.AND LOCATION 3.. �.;;
sqtr
,
Air conditioning 46.75
Job site address: < 11 Si , .
3 _ CGt Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: .-/ ✓2-C Furnace 100,000+BTU(ducts/vents) 54.91
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
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
,'_ '� ' 7 r r Gas fireplace/insert 33.39
F / Flue vent for water heater or gas
V\S Jew. NHG r ela 1.,-„C12 fireplace ( 23.32
,/� Log lighter(gas) 23.32
_Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
z � Other: 23.32
.x.r' PRQI}ERT IDWNEIx ...'r ,a " :4 k4 ,s"- TANI, J4' ,
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
,,,,,,!---,,,,,e,'" `t Other: 23.32
APPLICANT 0 CONTACT PERSON ,
/� _ Fuel piping:
Business name: Ck Uf�1' Jit- � 0)fry" )"��, C/','i'
z (X. $14.15 for first four;$4.03 for each additional
Contact name: C" ^i. .s �L.L9Q Furnace,etc.
Address: 2 5-z ;J l /L Laa 71)irNs J ) -( /L/ Gas heat pump
C' Wall/suspended/unit heater
City/State/ZIP: 5 Aj Le, t a ''� ci 7<3 0 / Water heater
Phone:G03) -1--.. 1;) 3 7� -9'73�� Fax: :( )
Fireplace
Range
E-mail:e �, Z�ytA;T0-i
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.
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