Permit (201) CITY OF TIGARD• MECHANICAL PERMIT
III • COMMUNITY DEVELOPMENT
Permit#: MEC2018-00693
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/30/2018
T t i;A It.D9 Parcel: 1S133CD01900
Jurisdiction: Tigard
Site address: 11774 SW SWENDON LOOP
Project: Rust Subdivision: COTSWALD MEADOWS Lot: 17
Project Description: Installing new furnace and range hood.
Contractor: CENTRAL AIR LLC Owner: RUST, MARK ALAN AND
PO BOX 433 MERRILL JEAN
CLACKAMAS, OR 97015 11774 SW SWENDON LOOP
TIGARD, OR 97223
PHONE: 503-656-1908 PHONE:
FAX: 503-650-3898
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 08/30/2018 $46.75
Type of Use: SF Range Hood/Other Kitchen 08/30/2018 $33.39
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/30/2018 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 08/30/2018 $9.86
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 , • is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to '•Ilow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009'. 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: Of/ Permittee Signature:
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 Received
% Date/By: 01 y or— Permit No.:/-ty
„it."fo CP
71
13125 SW Hall Blvd.,Tigard,OR 97223' Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Other Permit: Alp , ,r 40, ,'
T I C A R D Inspection Line: 503.639.4175 A Li i,i 3 2 01 Date Ready/By: Jur s: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
6Li_t_iet,".i.a L1i"t�'s;,)slii� COMMEI IAL FEE* SCIIED I 'USEClIEC IIS1 x
TYPE OF WORK
` Mechanical permit fees*are based on the value of the work
❑New constructio ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
O Demolition Other: /N4 act& mechanical materials,equipment,labor,overhead,and profit.
Value:$45-00.00
CATEGORY OF CONSTRUCTION, v. _ �x"
RESIDTIAL 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
�{« ' JOB SITE -INFORMATION AND LOCATION
?" Heating/cooling:
Air conditioning 46.75
Job site address: I 1 1 VA SW S WINKS 1 LP 5t.�t^'A/ Furnace 100,000 BTU(ducts/vents) ) 46.75 4L7-5
City/State/ZIP: 1 1c.,A4..QFurnace 100,000+BTU(ducts/vents) 54.91
1
o - '' Heat pump 61.06
Suite/bldg./apt.no.: Project name: Fes+
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
1 DESCRIPTION (iF 'ORK ,_. ,,,,. Gas fireplace/insert 33.39
Flue vent for water heater or gas
I l4 , V-11 It.141,1-4iti fireplace 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
s PROPER : .'; TENANTA,. 17
"- '�,.,, ;. ;at" '*21 Environmental exhaust and ventilation:
Name: Cap, ),,,(r (7 AAA Range hood/other kitchen
3
equipment 1 33.39 33
Address: PN- Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(5db ) l 1-*i ),.. Fax:( ) Attic/crawlspace fans 23.32
': APPLICANT RSON ::' Other: 23.32
;� x" > �� -�°r:, ..... Fuel piping:
Business name: kiC.n4uAti 0.,t¢('s11.,p-rt tM $14.15 for first four;$4.03 for each additional
Contact name: ✓� tK},t-1 LJ/l�s Furnace,etc.
Address: 'I//[ V�+1 3 IS- t� �''- ' Gas heat pump
'J r Wall/suspended/unit heater
City/State/ZIP: 2 c11 -AMD OIL G112.1L4 Water heater
Phone:(5ts) ) c 71,-3t,t 1m Fax::( ) Fireplace
Range
E-mail: d (LIAN►Ltgi.e,f„tud :'Lto .(fit Barbecue
' . .
CO V'OR r, Clothes dryer(gas)
Other:
Business name: ��H CAM-Alt-VI-L. t� MENICAL PERMITFEE
m
Address: e0:40.4 �{ 3
Subtotal
City/State/ZIP: l_. ct44.4Ia.3 ,, X97 p I S Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(5tJ ) LS(,-J%0g Fax:( ) State surcharge(12%of pemnit fee)
CCB lic.: 1 13 L•2 u 04619E1 TOTAL PERMIT FEE ((a-j,02..)
This permit application expires if a permit is not obtained within 180
q days after it has been accepted as complete.
Authorized signature -. Wim.-(��1/ * Fee methodology set by Tri-County Building Industry Service Board
Print name: c(j,A,n:ti.i W trki.S Date: 71 jilt Ii
I:\Building\Permits\MEC PermitApp_040113.doc 440-46171(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: z'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