Permit (170) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Permit#: MEC2019-00140
Date Issued: 03/11/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134BD02100
Jurisdiction: Tigard
Site address: 11805 SW SCHOLLWOOD CT
Project: MURTHY Subdivision: ENGLEWOOD NO.2 Lot: 109
Project Description: Gas line to range.
Contractor: OWNER Owner: MURTHY, SAVYASAACHI KESHAVA
SAVYASAACHI KESHAVA MURTHY 11805 SW SCHOLLWOOD CT
11805 SW SCHOLLWOOD CT TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-720-3064 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 03/11/2019 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 03/11/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/11/2019 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 . ;00.332.2344.
Issued By: i Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Folz of FicI: FSI:()NEN
City of Tigard Received
/late/By: i 1 ' Permit No.: _
11111 III 13125 SW Hall Blvd.,Tigard,OR 97223 4 Flan Review �Jy
i Date/B
y:
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
I 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: H See Page 2 for
Internet: www.tigard-or.gov FEB 1 2019 Notified Method: Iiin
Supplemental Information
TY OF f1�alt'+ND
TYPE OF W �a COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
rLfl N( 'DIVISION Mechanical permit fees*are based on the value of the work
❑New construction ilion/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTIONRESIDENTIAL EQUIPMENT!SYSTEMS FEES*
-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
o Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: , ` 8 os- S C.-i Sc IA L L_(. v1) Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: , (r,Aa_D / 7 LZ3 Furnace 100,000+BTU(ducts/vents) 54.91
/ /� Heat pump 61.06
Suite/bldg./apt.no.: Project name: LMS 13 pit A t't -C H 1 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
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
; RIPTION OF.WORI t �, °" .# Gas fireplace/insert 33.39
- j X Flue vent for water heater or gas
�8„y ��_,t._ 2 -t-6-' k c C-Cc,-__. V If.ceL 'jt c--,--c.)Q . fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
D PROPERTY OWNER ' 0 TENANT,*y�},y-,4,-:'' Other: 23.32
_ - �"�_ Environmental exhaust and ventilation:
I Name: $A V !`r is A A.c 14 y_ k >H A4 A ,Lt u 14-r I-} y Range hood/other kitchen
equipment 33.39
Address: ( Lp as SL i s C HOLL-LJ pc,) c_7- Clothes
dryer exhaust 33.39
City/State/ZIP: '' A� Single-duct exhaust(bathrooms,
- i at L� toilet compartments,utility rooms) 23.32
Phone:(cf3) "'7 2_, 3 OU:Y Fax:( ) Attic/crawlspace fans 23.32 .
V. s0 APPLICANT 0 CONTACT' PERSON Other: ' 23.32
Fuel piping:
Business name: ..5- r cx fZ1..,e— $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
Phone:( ) Fax::( ) Fireplace /,
Range i l•/ i r
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
. /ti�� MECHANICAL PERMIT FEES*
Address: Subtotal /i t
City/State/ZIP: Minimum permit fee($90.00) /d 1-
Plan review(25%of permit fee) —
Phone:( ) Fax:( ) State surcharge(12%of permit fee) IL),V
CCB lic.: TOTAL PERMIT FEE jai,.
This permit application expires if a permit is not obtained within 180
Authorized signature. G
/_ days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: SA,;y/ ks-A . ( - 1 !.e r3"N�A V.+i Date: 3) (j)if,11
MEy
I:\Building\Permits\
C_PermitApp_040113.doc t �UP(H Y 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$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