Permit (177) CITY OF TIGARD MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT
Permit#: MEC2018-00715
Date Issued: 09/10/2018
TfaaA I 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S104BA15100
Jurisdiction: Tigard
Site address: 13510 SW LIDEN DR
Project: PLUEMJIT Subdivision: CASTLE HILL NO.3 Lot: 181
Project Description: Adding(1)exhaust fan for bathroom.
Contractor: D&I DEVELOPMENT LLC Owner: PLUEMJIT, CHANISDA
1455 NW IRVING ST SUITE 200 13510 SW LIDEN DR
PORTLAND, OR 97209 TIGARD, OR 97223
PHONE: 503-367-0044 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 09/10/2018 $23.32
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 09/10/2018 $10.80
Minimum Fee Adjustment-Mechanical 09/10/2018 $66.68
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o• -:n copy of the rules
or direct questions to OUNC by calling 503.232.1987 or = 2344.
Issued By: , - Permittee Signature:
. ��
Call 503.639.4175 by 7:00 a.m.for the next available in- �1��
This permit card shall be kept in a conspicuous place on the job -i e until = pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application. , , , _ FOR OFFICE USE HEONLYDuLE_
City of Tigard i -i s .
RE C „11ri 11, ir..,:ii,3-
y: el MillrIM Permit No.: 77.-,o, iy)7/
..r.or —,.., ,
II . 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
: a Phone: 503.718.2439 Fax: 503.598.1960 . Date/By: Other Permit:
Inspection Line: 503.639.4175 S E P 1 0 L)018 Date Ready/By: MI
TIGARD Ed See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
Ci'1'1' oF
r k_. >t 0 4o—trAk, _
**.**- COMMERCIAL FEE* SC USE CHECKLIST
YFE OF w*ILDINCIAvICION '
, Mechanical permit fees*are based on the value of the work
E New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
1=1 Demolition 1=1 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION ' -'2.......— • '''' -;.v.--....• • ••"- ' ,- ;
''''' • aurmpENTIAL EQUthVIEN utSYSTEMS FEES*
1-and 2-family dwelling 0 Commercial/industrial ID Accessory building For special information use checklist.
1=1 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
' •-•'f.,- = JOB SITE INFORMATION AND LOCATION -
,--- , •• Air conditioning 46.75
,
Job site address: / 3 )1f(..)
3h74e-lc,-, 19K- Furnace 100,000 BTU(ducts/vents) 46.75 _
City/State/ZIP: /rd ()4) Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Eiey1727-
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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
,,,p.,,:,2-c.,..-- •...t--7., :.4*-',.,. Gas fireplace/insert 33.39
DESCRIPTION OF WORK 9"' ' - 1° - '.°•tt„,1,
t 't ,t ttit,' tt t''
, Flue vent for water heater or gas
61(6(t4f (V-a71-7)/ h 1)1/7 r(f7/-7 fireplace 23.32
C) Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
[4-PROPER °A, '• r-i'iii.4.,,,,,, ,, .., 444,,,41. Other:
= V,244 4,' 4-4; -4.. -&-"., '17.!-' ''''' Environmental exhaust and ventilation:
Name: /?Ci/i/j,' 3 0,r& /6" ,)-y 7 / Range hood/other kitchen
equipment . 33.39
Address: I 7 li ° .5Y1. 2_1</,-7,. /9 _
Clothes dryer exhaust 33.39
City/State/ZIP: -) t)--6.--prei till. Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) / 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
'4415comila, pERsoN Other: 23.32
Fuel piping:
Business name: /) . .-T 0e-e-X-4V0 avt-' 11- $14.15 for first four;$4.03 for each additional
Contact name: --t)'- ,/,. ,/-"-;-e-et- z- ‘" 6 Furnace,etc.
Address: /1{1 C A/41/ __Er- ie.:7 5:./.• Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: p,,, 1 (-6-,--,,,' Cf 2 '1072.0 i) Water heater
Phone:( 4;i') i> 72 -9,s-- Fax::( ) Fireplace
Range
E-mail: Barbecue
4*RA 1.°#t° s, t:„;,*ttf•, , , Clothes dryer(gas)
Business name: bli Pez/ve- --,-/- Other:
MECHANICAL PERT FEES*
Address: ,>61 'W QC' ceee Subtotal
City/State/ZIP: Minimum permit fee($90.00) i',....c:/€_.)
Plan review(25%of permit fee)
Phone:( rD)) 72 9 ,-9`3 j2> Fax:( ) State surcharge(12%of permit fee) 4),itz)
CCB lie.: 7//82 elx' TOTAL PERMIT FEE At)
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: ,..r r ..„,001e,...ki4,C/4/a Date: 0 9./e-o/ 24/
_
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 Valua rwo9 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