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Permit (253)
CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2019-00621 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2019 Parcel: 2S 1038 D05900 Jurisdiction: Tigard Site address: 12720 SW 116TH AVE Project: NINNEMAN Subdivision: HUNTER'S GLEN Lot: 15 Project Description: Relocating and adding duct work for crawl space addition,and(1)new bathroom exhaust fan. Contractor: ABBOTT HEATING &COOLING Owner: FREY, JESSICA PO BOX 68977 NINNEMAN, MATTHEW MILWAUKIE, OR 97268 12720 SW 116TH AVE TIGARD, OR 97223 PHONE: 503-513-7774 PHONE: FAX: FEES Specifics: Description Date Amount Duct Work 08/22/2019 $23.32 Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 08/22/2019 $23.32 Class of Work: ALT Type of Const: Utility Rooms) Occupancy Grp: 12%State Surcharge-Mechanical 08/22/2019 $10.80 Stories: Minimum Fee Adjustment-Mechanical 08/22/2019 $43.36 Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 4. Issued By: Perms e- ature: 4 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received , Date/By: O „dr., " '4:. iiPjeles jog Permit No.: ,, ,„ e - q 13125 SW Hall Blvd.,Tigard,OR 97223 111 . Phone: 503.718.2439 Fax: 503.598.1'a ECENED Plan Review Date/By: Other Permit: 1 I GA R n Inspection Line: 503.639.4175 Date Ready/By: n See 'age 2 for Internet: www.tigard-or.gov UG 2 Z019 Notified/Method: -MI Supplemental Information ....... A 2 . '!-...-, ,..., - - Mechanical permit fees*are based on the value of the work '" U New construction ffej AdditiTAI u on/altera • rep acement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ Ilec,•"':'1*.e.,. cAtEO*19F770,i‘Is*V00-ii 12 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. 1 Total 11 „ ,,,,,L„•,:, , ,...i, -,..:'.i-„,,,Por,"•,ir,;,. --, Heating/cooling: ,10B SITE INEOEIVI Yi r 5 .,'A.,tt?":1,A)VATION -ej..' ,E.°:!* ''A.i.,,- "',. Air conditioning 46.75 Job site address: 1 2,7 Z C) ,... IA/ i 1 :.%.1C4 Ave- Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: ' ,syivaci 0 It_ 9'-7 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work i 23.32 27,3„).,_ Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or UJct I rx A.A 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: 1 Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DEscRipTIQ1'14jF ,0,,,,,f,„,:.„.,.,,. , , Gas fireplace/insert 33.39 Flue vent for water heater or gas ge.-to.k.4-44 e,i(tis-Li„,,., .p,,,„,,t. l'i.; ,ti,2„,,ti fireplace 23.32 Log lighter(gas) 23.32 bAsc--"Alit 44-44 I Add Y se ial 1-4P,71 S Wood/pellet stove 33.39 I IQ PetAl A1A- It biZif I bA1fl ri NI) Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 23.32 OWNER - -4... 1'.::-.:;1 ''' ,.13 TEbIANT 4.,,, -i, 7.;:,., . ,,..r.I,, ,, „,..•.•-.•, ,.. ,...„ , .,.. • ...,. ,, ,..., . • .;, - .-- '. - Environmental exhaust and ventilation: Name: (A evi.k.._ K) ;,.ay,.€04 ,44...., Range hood/other kitchen equipment 33.39 Address: / 2.7 20 L./ 1 I& tY1 Awl- Clothes dryer exhaust 33.39 City/State/ZIP: 7--(5 Ant/ Oft- Single-duct exhaust(bathrooms, Oft- toilet compartments,utility rooms) 1 23.32 )-3 .3,,. Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 4....ir'S,Att.".'n 7;0,Ai-,,j' *,.i..-4,-''..e .'•"'",, " ,' ''''0<:,-,'a..tr'10friA.TA ' it 141.k"-, ,-, Other: 23.32 , ,,f-v , Fuel piping: Business name: xhbo-K- ,ty f* C'ty $14.15 for first four;$4.03 for each additional Contact name: 54.4„,-1._ tit Le t.41.1 dear Furnace,etc. Gas heat pump Address: p 0 3 O y„ 6 t ell 7 Wall/suspended/unit heater City/S4tete/ZIP. re4,11„, (y_/ - q 12.6,6' -- Water heater Phone:(5c3 ) 1-13,...-0-7 1.4 Fax::( ) Fireplace Range E-mail: ee .,--i-c(4-; ,,,,, • °Auk,. e )y-'-•-•.- Barbecue ' - Clothes Clothes drYer(gas) Other: Ot Business name: 4b biro /4-1- e Q. ty -...7"Tfor--z-,Iv,.7..,,,,mi4-. , 1-,-, --•---,:c:--,;.,39fr,.....-,-tr4e-- Address: p r., 5-,,,, ( '-77Subtotal ilea- ci City/State/ZIP: 7-,‘. ,1,4) 0 A- q 2'2(or Minimum permit fee($90.00) el a,,r)., Plan review(25%of permit fee) Phone:(5.2 ) :,S.13 "7")747` Fax:( ) State surcharge(12%of permit fee) , if,;. p CCB lic.: /2 i-/6 3 TOTAL PERMIT FEEfi i,A; ,o1 This permit application expires if a permit is not obtained within 180 Authorized signature: 69.4 c/L------- t ...441( days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board Print name: (;4w-L- Al..e.y-All 4... -41{ Date: 42 /1 ? I:\Budding\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 Valaati©n», ''rm1t 'eye .. . . $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\Pennits\MEC PermitApp_040113.doc 2