Permit (94) CITY OF TIGARD MECHANICAL PERMIT
st . ' COMMUNITY DEVELOPMENT Permit#: MEC2019-00506
r(G r1 R f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/15/2019
Parcel: 1 S 134AD05600
Jurisdiction: Tigard
Site address: 10720 SW PONDEROSA PL
Project: YE-HEALY Subdivision: BLACK BULL PARK Lot: 23
Project Description: Removing and replacing furnace and adding an NC unit and a heat pump. Placement of NC unit must comply
with manufacturers requirements.
Contractor: PETER STRANCE HEATING&A/C Owner: YE-HEALY, DONG Q
18636 S TERRY MICHAEL DR 10720 SW PONDEROSA PL
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-705-9713
PHONE: 503-969-5873
FAX: 503-631-7646
FEES
Specifics: Description Date Amount
Air Conditioning 07/15/2019 $46.75
Type of Use: SF Furnaces<100K BTU 07/15/2019 $46.75
Class of Work: ALT Type of Const: Heat Pump 07/15/2019 $61.06
Occupancy Grp: 12%State Surcharge-Mechanical 07/15/2019 $18.55
Stories: Investigation Fee 07/15/2019 $90.00
Investigation Mechanical 12%State 07/15/2019 $10.80
Surcharge
Range Hood/Other Kitchen 07/15/2019 $33.39
Clothes Dryer Exhaust 07/15/2019 $33.39
Fuel Fuel Piping 07/15/2019 $14.15
Fuel Types: 12%State Surcharge-Mechanical 07/15/2019 $9.71
Gas Pressure:
Total $364.55
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503/32.1987 0, .800.332.2344.
Issued By: ��w ` Permittee Signature: -"-72,71
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. c
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
City of Tigard ed de,
P
13125 SW Hall Blvd.,Tigard,OR 97223' �t tiM1RDate/By: 7 (5" �2 "`fir�� �`�
Phone: 503.718.2439 Fax: 503.598.1960 "' _¢ro. Plan Review
Date/By: Other Permit:
)_1 ti A R D Inspection Line: 503.639.4175 7 014 Date Ready/By: Juris: la See Page 2 for
Internet: www.tigard-or.gov k J l ,` Notified/Method: Supplemental Information
Mechanical permit fees*are based on thevalue of the work
❑New construction Addition/alteration/replacement J UJ L 1 5 2) performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
.m1
GATE OROF • oN ' Bi Nw G CI >k# Value:$
,. ri
. . " " RESIDENTIAL EQUIPMENT/S
MSFEES*
VI 1-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 STIF: ... TIQ AND"- t x.;
eatm coo mg:
/ , , Air conditioning 46.75
Job site address: J ) No Jw "Icier uss Ss �� Furnace 100,000 BTU(ducts/vents) / 46.75
City/State/ZIP: > ^ k 1.7 2 (_.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
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
Z41,2,,,, Gas fireplace/insert 33.39
" . .' x t ' _ l'-a" ' Flue vent for water heater or gas
1 0 0L a i L (''`C iR ft e /in(e CJ .� fireplace 23.32
Ck I J 0. n 4�� / / Log lighter(gas) 23.32
c ,? / Gtr/C GK- G! Wood/pellet stove 33.39
ki Z�fi-pip . Q Wood fireplace/insert 23.32
IChimney/liner/flue/vent 23.32
#; Other: 23.32
tFR6 . 1t ] TL
.. '_ _ Environmental exhaust and ventilation:
Name: b�.l/l .�(,n Range hood/other kitchen t
-Address/0 ® t,..�� equipment 1 33.39
‘54, / O die 9fe. Clothes dryer exhaust ( 33.39
City/State/ZIP: a6k n D A q 72 2 Single-duct exhaust(bathrooms,
JJ toilet compartments,utility rooms) 23.32
Phone:( 3) l6 7 ` >J Fax ( ) Attic/crawlspace fans 23.32
� lItrr,4 `," ❑ NTA PE+ N Other: 23.32
Fuel piping:
Business name: [[�� j iij r n d e_ ,,e . .. $14.15 for first four;$4.03 for each additional
Contact name: ¶ `F-� j ii z Furnace,etc. .
f Gas heat pump
Address: /r6 ja 5.- ,,I ("<-ildr=11,L4 ( O..
fc Wall/suspended/unit heater
Crty/State/ZIP:
I�q(�(1 C.....47 I Q :r Water heater +------ ----
Phone:(,3 3 ) y,JJ Fax::GSZa) / f76�� Fireplace
Range
E-mail: P,'/k-git e`c0 (117#i q�, n t I Barbecue
E 1'TI AC I'(3R: ..r Clothes dryer(gas)
:� gas: .w . I-
Business name: rt;-� Sn�L �ett1 f/' /¢(_ Other:
J "',',$r . n ik CAL PERMIT FEES*
Address:/k6...? .. 5 7R try /ham/fie q/ /) .-- Subtotal
City/State/ZIP:D it q ail &} 0 1 '7?D 4i Minimum permit fee($90.00)
JJJ . Plan review(25%of permit fee)
Phone:(503 ) 70 t 7i Fax:(?mow d3) X03( 76
y 6 State surcharge(12%of permit fee)
CCB lic.: 7p2 Q/ ? 6(5-72—iiTOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
has been accepted as complete.
Authorized signature: Tri-County Building Industry Service Board
Print name: eel,.,e sl-raxi,` Date: --7-g• ^ /
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 Valtion: 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