Permit (73) CITY OF TIGARD MECHANICAL PERMIT
111 1 ' COMMUNITY DEVELOPMENT Permit#: MEC2019-00576
T I
(1A It.f3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2019
/-, Parcel: 1S134CD03600
'` Jurisdiction: Tigard
Site address: 11950 SW KATHERINE ST
Project: Baccellieri Subdivision: LERON HEIGHTS NO.3 Lot: 63
Project Description: Installing(1)bathroom fan.
Contractor: OWNER Owner: BACCELLIERI, FRANCES D TRUST
FRANK! BACCELLIERI 11950 SW KATHERINE ST
11950 SW KATHERINE STREET TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-476-4482 PHONE: 503-476-4482
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 08/06/2019 $23.32
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/06/2019 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 08/06/2019 $66.68
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 or 1.800.332.2344.
Issued By: / , Permittee Signature: Sne-
Call
503.639.4175 by7:00 a.m.for the next available inspection
M 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.
uCITY OF TIGARD MECHANICAL PERMIT
P!1 . COMMUNITY DEVELOPMENT Permit#: MEC2019-00576
TIGAB.L 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2019
Parcel: 1S134CD03600
Jurisdiction: Tigard
Site address: 11950 SW KATHERINE ST
Project: Baccellieri Subdivision: LERON HEIGHTS NO.3 Lot: 63
Project Description: Installing(1)bathroom fan.
Contractor: OWNER Owner: BACCELLIERI, FRANCES D TRUST
11950 SW KATHERINE ST
TIGARD, OR 97223
PHONE: PHONE: 503-476-4482
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 08/06/2019 $23.32
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/06/2019 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 08/06/2019 $66.68
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503/32.1987 or 1.800.332.2344. _
Issued By: �. // Permittee S e: All)0111.12
yv
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicationFOR OFFICE USE ONLY
• Received
City of Tigard Date/By: �� ` .
- �'1 13125 SW Hall Blvd.,Tigard,OR 97223 , Plan Review �/
Phone: 503.718.2439 Fax: 503.598.1960 �`,.l a`„8? Date/By: >
T l i.) Inspection Line: 503.639.4175 Date Ready By: Juris. Et See Page 2 for
' Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE,QF WORK . + COMMERCIAL FEE*,,SCHEDULE ,USE.CHECKLIST
'" "" ��_ ..' Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
- CATEGORY OF CONSTRUCTION ;
= = RESIDENITIAL EQUIPMENT/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
JOB SITE INFORMATION AND LOCATION !,!-,..-k Heating/cooling:
Air conditioning 46.75
Job site address:11950 SW Katherine Street Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Master Bath Fan Duct work 23.32
Cross street/directions to job site:SW 121st 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
DESCRIPTION OF.WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Install Ventilation Fan in bathroom fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNE [ y TENANT 4: TA
. Environmental exhaust and ventilation:
Name:Franki Baccellieri Range hood/other kitchen
equipment 33.39
Address:11950 SW Katherine Street Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms, f
toilet compartments,utility rooms) / 23.32
Phone:(503)476-4482 Fax:( ) Attic/crawlspace fans 23.32
� e
APPLICANT ,,,,i.: ®''CONTACTPERSON = Other:
23.32
Fuel piping:
Business name: $14.15 for first four;$4.03 for each additional
Contact name:Franki Baccellieri Furnace,etc.
Address:11950 SW Katherine Street Gas heat pump
Wall/suspended/unit heater
CitylStatealF:-TIgank-AIR-97223-- _. --
Water heater
Phone:(503)476-4482 Fax::( ) Fireplace
Range
E-mail:frankideane@gmail.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: e)-2-C)--PL--C.- -c__
i4IEHAIIIOAI P]RMIT FEES*
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.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: • irlib . * Fee methodology set by Tri-County Building Industry Service Board
40
Print name:Franki Baccellieri Date: '/b I /04
I.\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
cokiimercial & 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.
r _ ..
I.\Building\Permits\MEC_PermitApp_040113.doc 2