Permit (136) CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit#: MEC2019-00444
T l(..1 Alt f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/26/2019
Parcel: 2S104DC04600
Jurisdiction: Tigard
Site address: 13529 SW CLEARVIEW PL
Project: NAAS Subdivision: BENCHVIEW ESTATES Lot: 46
Project Description: Adding new gas furnace,gas piping to furnace,duct work,flue,and A/C.
Contractor: A TO Z HEATING AND AIR CONDITIONING Owner: NAAS, JAMELAH A
12811 SE COOPER ST 13529 SW CLEARVIEW PL
PORLAND,OR 97236 TIGARD, OR 97223
PHONE: 503-830-1885 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 06/26/2019 $46.75
Type of Use: SF Furnaces<100K BTU 06/26/2019 $46.75
Class of Work: ALT Type of Const: Duct Work 06/26/2019 $23.32
Occupancy Grp: Flue/Vent For Any of Above 06/26/2019 $23.32
Stories: Fuel Piping 06/26/2019 $14.15
12%State Surcharge-Mechanical 06/26/2019 $18.51
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $172.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: ,4
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Folz OFF1C1: GSI:ON 1,),
City of Tigard Receivedt
Date/By: A- L�� / bep 4 f/
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 ' " Plan Review
Date/By: ���� /� .,
T I G A I D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov (-:;.,_,,:".j >N Notified/Method: Supplemental Information
C0IE �, FEE* SP/EPA/W.7 tsE.CS» K
r TST"
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: _mechanical materials,equipment,labor,overhead,and profit.—
Value:$
CATEGORY OF.CONSTRUCTION
:.t.: *ESIDENT.KAL EQUIPMENT/SYSTEMS FEES*
.-
01_and 2-family dwelling ❑Commercial/industrial ❑Accessory building _ For special information use checklist. _
❑Multi-family 0 Master builder ❑Other: _Description Qty. Ea. Total
JOB SITE INFORMATIONANA LOCATION Heating/cooling:
Air conditioning / 46.75
p
Job site address: l 3 6-2 ? 5W -l a R v i e W PL Furnace 100,000 BTU(ducts/vents) / 46.75
City/State/ZIP: 71 r9 at /2 N/. o/e 9 7203 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
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
ON OF. Gas fireplace/insert 33.39
l `" ` fi 1' "" , $ "*`"' Flue vent for water heater or gas
fit u /2 floe c f')d x ,4/e //'751'a//t /t t7k7 fireplace 23.32
Cl d d h C/ .. a S fine •
/ [4,G�� �/ i f`/n Log lighter(gas) 23.32
V/ (�G T/ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
' '''.:"4:4 - { 'TENANT Other: 23.32
.. ....,, •OR?*'x ... ,,,,, ,i.
r• - Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
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
ry Q APPLIC 1. , ❑;CONTACT PEI ON Other: 23.32
/? �o G' 'eQ.eiiy piping:1
Business name: �,,/ ^ Fuel 14.15 for first four;$4.03 for each additional
Contact name: /j r)of R e 7' Z h LA k- Furnace,etc. /
Address: / 2 '6 1 f 5E 'p d/fie g Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:(503 9 3 Cil --1,5 3 S' Fax::( ) Fireplace
E-mail: atoz /7QCt- 1hc( t., mu i1, Gnge-7 Ba
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: A i 0 Z Il ec l I n7 eJ Other:
l/ MECRANIC.AL PERMIT FEES* ,__
Address: / 2 g 1( S _ C pe(2 3 Subtotal
City/State/ZIP: PO R / CIO t tp9 7 2 3 6 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(5-k9'. ) ? 30 l S U q Fax:( )
State surcharge(12%of permit fee)
CCB lie.: /t3 9 ! S 9 7 iip TOTAL PERMIT FEE
�C ` This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,.. P7 01 12 Qy Z h U k Date: 6—26 - (9
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:
Total Valuation' Permit F'+ee:
$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