Permit CITY OF TIGARD MECCAL MIT
k_,.. Peit# MEC2018-00907HANIPERCOMMUNITY DEVELOPMENT Date Issued: 11/20/2018
T i r;Art r- 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134CA00714
Jurisdiction: Tigard
Site address: 11960 SW SUMMER CREST DR
Project: FISHER Subdivision: BURLWOOD NO.3 Lot: 3
Project Description: (1)bathroom exhaust fan.
Contractor: OWNER Owner: FISHER, MICHAEL J&BRITTNEY LYN
MICHAEL FISHER 11960 SW SUMMER CREST DR
11960 SW SUMMER CREST DR TIGARD, OR 97223
TIGARD, OR 97223
PHONE:
PHONE: 509-998-5424
FAX:
FEES
Specifics:
Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 11/20/2018 $23.32
Type of Use: SF Utility Rooms)Minimum Fee Adjustment-Mechanical 11/20/2018 $66.68
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 11/20/2018 $10.80
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to C by calling 503. 2.1987 or 1.;00.332.2344.
' ermittee Signature: /J/�/l �lG/
Issued By: ��� cT ��/y'f�"
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONE\'
City of Tigard Received
Date/By: j r j r jP Permit No.: a._
111111 13125 SW Hall Blvd.,Tigard,OR 97223 Nan Review Other Permit:
Ill Phone: 503.718.2439 Fax: 503.598.1960 Date/By: I/' i : ' - +f.
TI G A R D Inspection Line: 503.639.4175Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
'-'." . , ,. TYPES OF.,WORK .';
`CQl%IlYME12�CIr1L EF*. SCIIEDtL,— E C IECK iST'..
Mechanical permit fees*are based on the value of the work
❑New construction "Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
Value:$
CATEGt3It`if=OF CONNIS'IRfON / STEMS FEES*s � x.. tUCl �tESIDE _ Q��NT
g1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
CHeating/cooling:
. A JOB SITE INOIIVIATION AND LOCATION
Air conditioning 46.75
Job site address: I I 4/Go SW 5v mine, Cr(j4- r Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: a Furnace 100,000+BTU(ducts/vents) 54.91
rf:Ja t QZ Z3 Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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
VGas fireplace/insert 33.39
I .. ry• Flue vent for water heater or gas
fireplace 23.32
A61 gc kL,vas Vend /,5 f Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
,ter
Other: 23.32
,s , " 0(** ,° .., ca:' =r 4 • ; a Environmental exhaust and ventilation:
Name: I"l •Circr,( f S), ,t" Range hood/other kitchen
equipment 33.39
Address: �( � s (Lit f4- 04. Clothes dryer exhaust 33.39
q to J V!yl/Jter Single-duct exhaust(bathrooms,
City/State/ZIP: •10i-d ah tj 72-2-37 toilet compartments,utility rooms) I 23.32 3. _
Phone:(5). ) 9 y lj t/Z GJ Fax ( ) Attic/crawispace fans
I 23.32
( `: E i I k r 7 171., .i., z.0 TT PE O14: Other: 23.32
Fuel piping:
Business name: a� ..1G bmie $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: Wall/suspended/unit heater
City/State/ZIP: Water heater
Fireplace
Phone:( ) Fax::( ) Range
E-mail: Barbecue
' • ` O • •. v" S " fir , Clothes dryer(gas)
Other:
Business name: 44 ',..4::
H
Address: Subtotal )-..3l
Minimum permit fee($90.00) C,U.4
City/State/ZIP:
Plan review(25/o of permit fee)
i )
CCB lic.:
Phone:( ) Fax:( ) State surcharge(12%of permit fee) �,
TOTAL PERMIT FE G?. Ob
This permit application expires if a permit is not ob fined within 180
days after it has been accepted as comp ete.
Authorized Signature: \ * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,'Cht.�'( I'tht-r
Date: it- to - -Im j?
�
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:
�.s
Total al iati : ermitFee,
$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