Permit (153) CITY OF TIGARD MECHANICAL PERMIT
III
■ COMMUNITY DEVELOPMENT Permit#: MEC2018-00872
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/06/2018
TIGARD g Parcel: 1S134AC03100
Jurisdiction: Tigard
Site address: 10977 SW BLACK DIAMOND WAY
Project: BOITANO Subdivision: HARTS LANDING Lot: 2
Project Description: Replacing furnace and NC.
Contractor: ANDERSON HEATING AND COOLING Owner: BOITANO, JOSEPH&ELIZABETH
PO BOX 1803 10977 SW BLACK DIAMOND WAY
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-522-3801 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 11/06/2018 $46.75
Type of Use: SF Furnaces<100K BTU 11/06/2018 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 11/06/2018 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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 callin. 503.232.1987 or 1.800.332.2344. ,
Issued By: `�/ �. 4.46Permittee Signature.
'
7
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. ( "z=>
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 OFFICEFIUSE ONLY
City of TigardRECEIVE,", eceiveyd FOR
o 4. •
-�ateB : ����� J'� A 7
ill!PI 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 NO V Date/By: Other Permit:
T I C A R D Inspection Line: 503.639.4175 `/ -6 2018 Date Ready/By: Jug ® See Page 2 for
Internet: www.tigard-or.gov
CITYOF LARD Notified/Method: Supplemental Information
r..
BUILDING DIVISION --_:.: ,.
YPE rt.., WORK COMMERCIAL FEE* SCHEDULE ='USEHEC :
Mechanical permit 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
mechanical materials,equipment,labor,overhead,and profit.
0 Demolition ❑Other:
Value:
' s CATEGORY OF CONSTRVI pON
>� .u. ,>: RESIDENTIAt"EQUIPMENT t SYSTEMS FEES"'.
p'I-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
JOB SITE INFRMATION AND LOCATION 1;3; Heating/cooling:
. n Air conditioning ( 46.75
Job site address: /O'/7 f1 s-,,, al 7J,. . 07 Furnace 100,000 BTU(ducts/vents) I 46.75
Furnace 100,000+BTU(ducts/vents) 54.91
City/State/ZIP:
T,•4 ctr'c� ?i,q ZZ3
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Z...,%Z Duct work 23.32
Cross street/directions to job site: S- 70 cy
do 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
° ' Gas fireplace/insert 33.39
y DESC1217 .0) QF WORK n, '. ,"
/ Flue vent for water heater or gas
u/4-C., 12y/riceMC/1'1�' 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
P,uPaT t) Ei ^w. TEN[Ip
}� x.r`O \VNN � a '� 1 Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
,"..70$4-11.51
APPL 0 CONTACT PERSO Other: 23.32
n � Fuel piping:
Business name: /�.'1��/��t,.` //eit Cc[.j;d S° $14.15 for first four;$4.03 for each additional
Contact name: r7 5 -L F' D�L > / Furnace,etc.
Address: ' r _ � Gas heat pump
ZG �� ��' /Cc�lL' Wall/suspended/unit heater
City/State/ZIP: rl'+'lCX�i,s6,` C / `[ ?eC ? Water heater
Fireplace
Phone:(53-C) }36_2-3600 (Fax::( ) _ Range
E-mail: C.�Ad. t- ter,\ K „..,,,,,e... ( l'�vt-t a 4• ,,, Barbecue
,yerekv CONTRACTOR`" ` f trrt Clothes dryer(gas)
k., „-,..„,,5,- .. , ,_...x a a.
Other:
Business name: ,r? n �I z
/7Yt cX t'/ Sf9 n /tTt'c` �� l��c /r�C/c> 1VIECHANI: < uPERMIT FEE
Address: /6 Z ) t 'Tee_ ,A e Subtotal
City/State/ZIP: /7`,„,,c.Y'e T `i' cy - V, 9 Minimum permit fee($90.00)
O�"� // / Plan review(25%of permit fee)
Phone:(530) �.6 -.'?6OO Fax:( ) State surcharge(12%of permit fee)
CCB lic.: / /r 1 7/S/i TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
s�y� days after it has been accepted as complete.
Authorized signature: ,�� 'lf�Z-/`�� * Fee methodology set by Tri-County Building Industry Service Board
Print name: / lcif k E /. t. 4&. 0- Date: 0,,6 2cig
I:\Building\Permits\MEC_PermitApp_040113.doc i440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fe
$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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10977 SW BLACK DIAMOND WAY, TIGARD, November 7, 2018 at
OR, 97223 12:33:07 PM
Record Type: Record ID:
Residential - Mechanical MEC2018-00872
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor