Permit (165) CITY OF TIGARDlit MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2019-00125
T I, ,,%,r f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/04/2019
Parcel: 1 S134CB01500
Jurisdiction: Tigard
Site address: 12220 SW SUMMER ST
Project: Carpenter Subdivision: SUMMER HILLS PARK Lot: 16
Project Description: Replacing furnace and A/C unit. Placement of A/C unit must comply with manufacturers requirement.
Contractor: AIRMAXX HEATING&COOLING LLC Owner: CARPENTER, CLIFFORD WAYNE
6924 SW PINE ST 12220 SW SUMMER ST
TIGARD, OR 97223 TIGARD,OR 97223
PHONE: 503-840-7925 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 03/04/2019 $46.75
Type of Use: SF Fumaces<100K BTU 03/04/2019 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/04/2019 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344.
Issued By: 4t :...40
,_,, �7 Permittee Signature: fir
r�>/j�1 i
Call 503.639.4175 by 7:00 a.m.for the next available inspection
This permit card shall be kept in a conspicuous place on the job site until corn.I on of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicatiMf ,. .." FOR OFFICE USE ONLY
City of Tigard Received ��
Date/By: , 1/If( .. /� ��
lig 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev-
i Phone: 503.718.2439 Fax: 503.598.1960Da[eBy:
Other Permit:
T I GA R D Inspection Line: 503.639.4175 , : Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov _ , Notified/Method: Supplemental Information
TYPE OF WORK COMMEl2CiAL FEE* SCHE13 ECKI i1ST
Mechanical permit fees*are based on the value of the work
❑New construction b<ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONS 'RTJCTION ? ''
RESIDEN ®li I,HENT I SYSTEMS FEES*
1-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
*`FORMATION AND * i IO ,x Heating/cooling:
` JO, Ei E i�i , }1 ": Air conditioning I 46.75
Job site address: ' 22.'10 5 j,1.1 S O mp?e y Furnace 100,000 BTU(ducts/vents) il 46.75
City/State/ZIP: 1:4DA 4y1 7 O J 9 7 22`3 Furnace 100,000+BTU(ducts/vents) 54.91
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
k : k #r 1 II)ESCRIPTION OF W ,:ft,'",';,"" 'C Gas fireplace/insert 33.39
' `-P 2- ar r:i'- ` " �� b '' " " Flue vent for water heater or gas
6' • /P a Q'C rai C C'. fireplace 23.32
Log lighter(gas) 23.32
l� O`� Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32 ,OE. ' E i J " 1 Other
. . rxrN. , 0- , 40.-%••••.,,,m,---
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
�` '- 0',AP P rA`N'1'' n' 1 NT,A# ERSON - Other: 23.32
Business name: (� 'I�t + �y Fuel piping:
/'t i r In�Xx n e� ,,,,c, t�J'1f 1 coCr 1 1"YL Lk_ $14.15 for first four;$4.03 for each additional
Contact name: , oak.-1 c�r o.vt Q J J Furnace,etc.
Address: (a l �` �) 9 1 hf? S\ \\)t,V`'1
,f Gas heat pump
� v
Wall/suspended/unit heater
City/State/ZIP: 6 P- 47.71_2_ `3- Water heater
Phone:663) tq 0 9 00_,5 Fax::( ) Fireplace
E-mail: Range
Barbecue
.' z, tCONT.r .A.'..! : a ,. . . `;,. ,;)". Clothes dryer(gas)
Other:
Business name: ,z{w,. ;.
i: - MECHANICA'E}1701'I ,.
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: , 5 LtTOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatur iii * Fee methodology set by Tri-County Building Industry Service Board
II '
Print name: ' j Date:
l:\Building\Permits\ "•'....App_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; : `
$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\Pernvts\MEC_PermitApp_040113.doc 2