Permit (69) CITY OF TIGARD MECHANICAL PERMIT
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. COMMUNITY DEVELOPMENT Permit#: MEC2019-00575
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2019
Parcel: 25111 BC01300
Jurisdiction: Tigard
Site address: 10150 SW VIEW TER
Project: LOSLI Subdivision: GREENBRIER Lot: 5
Project Description: Relocating range hood vent.
Contractor: EVERGREEN RENOVATIONS Owner: CARMEN LOSLI
14605 SW BONANZA CT 10150 SW VIEW TER
BEAVERTON, OR 97007 TIGARD, OR 97224
PHONE: 503-735-5650 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 08/06/2019 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 08/06/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/06/2019 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted -y the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a .•y of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: �7L��i�"- Permittee Signature: / �/ ,10.111.1r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard y .. f Date/By: (1 /c ,Am Permit No.: /� .) _ct)5 3
III 'I 13125 SW Hall Blvd.,Tigard,OR 972 y^'" €t
�T • Plan Review
Phone: 503.718.2439 Fax: 503.598 1960"" Date/By: Other Permit: v . _.I()
T I GA RD Inspection Line: 503.639.4175 �+( L ���� Date Ready/By: n See Page 2 for
Internet: www.tigard-or.gov r Notified/Method: In
Supplemental Information
TYPE OF VA J M,C i 1;7 �.a COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
.. Mechanical permit fees*are based on the value of the work
o New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
E Demolition Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory buildingg,
For special information use checklist.
Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION
Air conditioning 46.75
Job site address: j'o ' 0 sit\ I Te/ Ct Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ! 44,4 0gi_ CI 7'77,4. Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: A cle I — lO f ' 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas ,
f l o e r cd vty� fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove . 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER I 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: r
(a '/y .1 �s 1 i Range hood/other kitchen
�' equipment 1 33.39 33 3/
Address: 1 V 1 .[?) VI, 74
' Y( Clothes dryer exhaust 33.39
City/State/ZIP: '� el Single-duct exhaust(bathrooms,
+ I �� d toilet compartments,utility rooms) 23.32
Phone:(54), 5'ii..- .11 L Fax:( ) Attic/crawlspace fans g.APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: r e+ t 4
�"4 1 �'�Y $14.15 for first four;$4.03 for each additional
Contact name: a,zuk
Furnace,etc.
Si"; 60,114.0.741
, Gas heat pump
Address: l &li 5 ,J W .t4 0 .ier
� � LI- Wall/suspended/unit heater
Phone:( 's r9 -1 .: 17 S Fax::( ) Fireplace
J Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
��` � i'1' < ""�i MECHANICAL PERMIT FEES*
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Address: i,�' iAl kle.,,10�/1 t Subtotal f .,3G/
fee
City/State/ZIP: � � �ti'�<'� ��- ��' ") Minimum permit ($90.00) qv.i.'C.J
Plan review(25%of permit fee)
Phone:(3c,i1"35.�.5 64,'S Fax:( ) State surcharge(12%of permit fee) 161.,a
CCB lic.: i 4Y 1r 1J4 TOTAL PERMIT FEE l Q?
It. V it This permit application expires if a permit is not obtained within 180
,,�'��/ days after it has been accepted as complete.
Authorized signature: Y ;2,4 * Fee methodology set by Tri-County Building Industry Service Board
Print name: i g ow(may/ Date: 8 /ie he (
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I:\Buildingermits\MECC_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 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.
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