Permit (109) CITY OF TIGARD MECHANICAL PERMIT
8 COMMUNITY DEVELOPMENT Permit#: MEC2018-00774
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/27/2018
F � ,0 g Parcel: 2S104CA06500
Jurisdiction: Tigard
Site address: 13322 SW HILLSHIRE DR
Project: William Perreia Subdivision: HILLSHIRE Lot: 65
Project Description: Clothes dryer exhaust.
Contractor: OWNER Owner: KOGA,WENDY M
WILLIAM PERREIRA PERREIRA,WILLIAM K
13322 SW HILLSHIRE DR 13322 SW HILLSHIRE DR
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 808-389-2728 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Clothes Dryer Exhaust 09/27/2018 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 09/27/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/27/2018 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1. .2344.
/
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Issued By: ✓. ,, L Permittee Signature:
f
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application -,,,,,r A FOR INE fiS i.li
i •
i City of Tigard ‘',,,,,,;,:•(,, , i',,,,N/ ,,-v- Renewed ,„eni4 _
rermft No.: --,
Date/fiy: '`i 7/7g , /1747,CoVf.,171)7 1:,
lit 13125 SW Hall Blvd.,Tigard,OR 97223 1 '1'.' ' "6''
Phone: 503.7181439 ., , i(1E? Plan Review
hone: 503.718.2439 Fax: 503.598.1960 --9 tv , - Dateigy: Other Permit: rnp„oce.9ejgf;'t'rf):7Y
, Inspection .Line. 503 639.4175
ri(r,NED • _ ,on Date Ready/By: PI See Page 2 for
1 Internet: www.tigard-or.gov / elf, ' i '"'''V'''v votificaimethod: • .., Supplemental Information
TYPE OF WORK'' '' COMMERCIAL FEE* SCHEDULE-USE CRECKIIST
Mechanical permit fees*are based on the value of the work
0 New construction 7Y1,,Addition/aIteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Erp4-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. I Total
Heating/cooling:
JOB SiTP. INFORMATION AND LOCATION Air
conditioning 46.75
Job site address: I ,322.. 6't ) kAA\s\-•,;f, -),sr ..:..-+7,-,,:---r-..;, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -7ear.4 0 e 0 7 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 130,, ejrnt>ni Levonar 5
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
DESCRIPTION OF WORK Gas firernee/ineert 33.39
% % Flue vent for water heater or gas
OVACI laV VIC:17.3 rOalrYl "bp )00,Strriefrt fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
63,PROPERTY OWNER 0 TENANT Other:
,..„_ I Environmental exhaust and ventilation:
Name: t.,,,i% \\\c1/4...vv,\ 'ye_rv.t2,,,,r.isx Range hood/other kitchen
equipment 33.39
Address: i 522_ sv,3 pi,,k\\s),..,,•orc. I-3c,
Clothes dryer exhaust I 33.39 go•51
City/State/ZIP: '71,:90t1,14 0 12, oil'2.2.g Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(80 3eq 27 J3 Fax:( ) Attic/crawlspace fans 2332
RI APPLICANT RI CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: L„,,,..)'i I\it/1/4\V 1 '1).‹.,,y'(e....3Y,C\ Furnace,etc.
heat
Address: (S,3 7 2. St ,) tli-‘,. VS\"‘i v'c-• Dr Gas pumpViall/suspended/unit heater
City/StateJZ1P: *--f I tick V',c‘ 0 f 9 72.2.3 Water heater
Phone:(ç06) 3 6 il 272 e) Fax:'( ) Fireplace
Range
E-mail: („„, ...,1LNar‘o"). 12.e_r C„.;:,ra ce5;) kinl.reswc 11-C°Irv) Barbecue
CONTRACTOR ' Clothes dryer(gas)
Other:
Business name: 014 itveir
MECHANICAL PERMIT FEES*
Address: Subtotal .3.3 ,,49
City/State/ZIP: - Minimum permit fee($90.00) ' C1,00
Plan review(25%of permit fee) -6--
Phone:( ) Fax:( )
State surcharge(12%of permit fee) /), BO
CCB lie.: TOTAL PERMIT FEE ,ird
This permit application expires If a permit is not obtained witIgn-180
days after it has been accepted as complete.
Authorized signature: (....4---e---- --2„z _____;--.. ...... ' Fee methodology set by Tri-County Building Industry Service Board
Print name: tij\,W1/4,0,...y", '?42_,r-,re]\ re\ Date: Al/z I /ia I
IABuildlog\Permits 1 MEC PermitApp 040113.4x 440.46 in'(11/02/COIWWID3)