Permit CITY OF TIGARD MECHANICAL PERMIT
IPermit#: MEC2018-00729
s COMMUNITY DEVELOPMENT
Date Issued: 09/12/2018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S125DA07800
Jurisdiction: Tigard
Site address: 9185 SW 69TH AVE
Project: Brown Subdivision: KINGS VIEW Lot: 75
Project Description: Duct work and(2)bathroom exhaust fans for previously completed work in bathrooms.
Contractor: OWNER Owner: BROWN, REBECCA E
9185 SW 69TH AVE 9185 SW 69TH AVE
TIGARD, OR 97223 PORTLAND, OR 97223
PHONE: 503-245-3938 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 09/12/2018 $23.32
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 09/12/2018 $46.64
Class of Work: ALT Type of Const: Utility Rooms)
12%State Surcharge-Mechanical 09/12/2018 $10.80
Occupancy Grp:
Minimum Fee Adjustment-Mechanical 09/12/2018 $20.04
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. \, �t
Issued By: Permittee Signature: :_k.. � .C"..lC-- ., l C � C•r Y�--
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ReceivedDate/By: /�/ - PermitNo.:
��j 'g�i�T(...D 7 q
11111
u 13125 SW Hall Blvd.,Tigard,OR 97 yds` � � `� '
I Phone: 503.718.2439 Fax: 503.598. 9k t' - VDPlan Review
Date/By: Other Permit:�'1 � uy�y
Inspection Line: 503.639.4175 """ 't'`u �"�
T I G A R D p 4y Q Q Date Ready/By: loris: See Page 2 for
Internet: www.tigard-or.gov SEP U OO Notified/Method: Supplemental Information
TYPE OF `tooCt 14MERCIt i FEE* SCHEDULE- USE CH}±CRUST
�NG V S ON Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
.CATEGORY I'OF N8T UCTIOl1l. - ,
. ,REPk4NT.L,,EQII11'lvi'r ut/SYSTEMS FEES*
g_1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Jos SITE INFO '0II'i ND LOCATION
Heating/cooling:
�A✓ Air conditioning 46.75
Job site address:q I 5 O✓` Le q..�,1),1 G Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:` '(6 _,0 OR C 7 )._.- -, -- Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32 ,� 3, .
Cross street/directions to job site: S.V i (ø (-/ / Av t �-+t i �. 3 Hydronic hot water system 23.32
"`� Residential boiler(radiator or
4-e ivrb r hydronic) 23.32
(J 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.: 1
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
` DESCR PTI 06.0 t eRK Gas fireplace/insert 33.39
` ,/�akFlue vent for water heater or gas
.Pt.`7 ,t A € "_et- -to ' ,t.1 b&-e14 - Y.L./' f9 + fireplace 23.32
tLe -L4Le f Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
'4' ." ® ,, s R r ::. TENANT::" ..
Other: 23.32
Environmental exhaust and ventilation:
Name: Re er(3-A j3 Q ,A..,--/„; Range hood/other kitchen
equipment 33.39
t� • t
Address: g O !� (o1 04 A/� Clothes dryer exhaust 33.39
City/State/ZIP:TCrictit "t Single-duct exhaust(bathrooms,
��; /,y"?..-Z toilet compartments,utility rooms) 23.32 "6.(„4/
Phone:(9)3) ).(. ' e 3 8 Fax:( ) Attic/crawlspace fans 23.32
`t1. 4. ,,e '[Q CONTACT PERSON 1 I Other: 23.32
Fuel piping:
Business name: car,te S
Gi Gt tt1.-C $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
Range
E-mail: Barbecue
� CO , , ...„-u�, Clothes dryer(gas)
Other:
Business name: �"
aZ-��11l�i' MECHArTIC�ILPERItiiiT'FEE
Address: Subtotal 619 4.6
City/State/ZIP:
Minimum permit fee($90.00) IV.Gi
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) /a..f7J
CCB lic.: TOTAL PERMIT FEE LULL,S..0
This permit application expires if a permit is not obtained withinll80
��y � days after it has been accepted as complete.
Authorized signature: r„L,e,ra".._ & , arb-w-1-.._
* Fee methodology set by Tri-County Building Industry Service Board
Print name: Refc'X1l"'c1_ a" it, Date: W/!2( 1 8
W. !
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 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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2