Permit (97) l'ilCITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT Permit#: MEC2018-00823
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2018
T[GAR Parcel: 1S125DC08600
Jurisdiction: Tigard
Site address: 7144 SW ASH CREEK CT
Project: Priebe Basement Subdivision: ASH CREEK ESTATES Lot: 19
Project Description: (1)Gas fireplace insert installation.
Contractor: MOUNTAINWOOD HOMES INC Owner: PRIEBE, DIANE WELTY
PO BOX 2257 7144 SW ASH CREEK CT
BEAVERTON, OR 97075-2257 TIGARD, OR 97223
PHONE: 503-746-7338 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 10/17/2018 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 10/17/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/17/2018 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started wijhiu_...18,0_days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Orego
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 7
\ r. ter'
Issued By: gnature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti n date.
This permit card shall be kept in a conspicuous place on the job site until completion the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard . * ` ! � ;. ate/By:eceived 101 ��-, Permit V ` *'
w III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
11 Phone: 503.718.2439 Fax: 503.598.1960
' Date/By: Other Permit:
i f ,� ; i:
Inspection Line: 503.639.4175 1 tDate Ready/By:TIGAKU72
See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
i 'iri ')r i,, (rA FM
O=RF mf r} 'DIVISION V 0 CO CIA '- ' SCHLDULE USE Cl KLIST
OM Mechanical t fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
O Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
, Value:$
+ '-g.::'-'f'n-7:_ CATBtt r. OF CONSTRUCTION ,;; •
• ::'`' ; RESIDENTIAL n,NT/SYSTEMS S FEES* .
a1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
El Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFOHmATION AND -A Or4 .-I
Air conditioning 46.75
Job site address: _7)Lf l_( Ct ' * Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:iJ61C,t^c/ t 12 9 7 -.2--__3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Fr 1,6, 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
= °tr,,zp,kgs. - Gas fireplace/insert i 33.39 33.31;
Flue vent for water heater or gas
fireplace 23.32
1) _ Log lighter(gas) 23.32
4 i ü we-r^'� Fl r<-hc"d" C' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
( PROPERT ' O R .; z:: , T NANT r #.
'rt n" ,' •• Environmental exhaust and ventilation:
Name: .�, t. rl e,) Range hood/other kitchen
equipment 33.39
Address: /ziY ,St.A.) Yi h C�c'-� Clothes dryer exhaust 33.39
City/State/ZIP: Ti j a h� ,�! C),� 9 '22 2 3 Single-duct exhaust(bathrooms,
7 toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
.' st 4 ,APPLIC # .�x o I ., 'ERSON APS Othef: 23.32
�/ Fuel piping:
Business name: Y j0 Ui`ITGi/NVQ 1 <7 G41�� $14.15 for first four;$4.03 for each additional
Contact name: K. Furnace,etc.
Address:6_3 / 3C,tir A l„pl.,664.3 / Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: /12. -e,„1 L.„,)c /7r1I ,; l "7 2C�,e Water heater
`1Fireplace
Phone:(eX0 -7 e(O-- 7 j 3�l_`� Fax::( ) Range -
E-mail: �'
�7�C_'`lVl/�Y L'" n'lCh.l,T,,i C1.1,�00(tl/1 C`)L•t,t>- r c‘241 Barbecue
Titi 1`' iTRACTOR , t1" " Clothes dryer(gas)
14,,,,,, �. � � • Wit: W •a
Business name: 7--a./ fi
e j d /*,,r�tG Other:
J Cit 5} 1 U"PEI2MIT FEE
Address: 63 ).-14 ez,e,) it); C� , Subtotal 53 .
City/State/ZIP: ) {/4c_,- t-../ (`j C 7000 Minimum permit fee($90.00) r(Ut/U
Plan review(25%of permit fee)
Phone:(50 3) 7Y6 7 33k3 Fax:( ) State surcharge(12%of permit fee) -----
CCB lic.: ' TOTAL PERMIT FEE 8d- F
I � '"--1/
' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:�! ,!7 * Fee methodology set by Tri-County Building Industry Service Board
Print name:/1 r'�t, e, .. Date:
I:\Building\Permits\MEC_Permit 040113.d c 440-4617T(11/02/COM/WEB),
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuations Permit Poi';''.53
$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_PemvtApp_040113.doc 2