Permit (156) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00612
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/19/2019
T r c.A I<.Dg Parcel: 2S110AB03500
Jurisdiction: Tigard
Site address: 14255 SW 114TH AVE
Project: Davis Subdivision: COLE'S ACRES Lot: 16
Project Description: Install gas line for kitchen range.
Contractor: PRECISION AIR LLC Owner: DAVIS, MICHELLE M
6004 EAST EVERGREEN BLVD 14255 SW 114TH AVE
VANCOUVER,WA 98661 TIGARD, OR 97224
PHONE: 503-970-4115 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 08/19/2019 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 08/19/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/19/2019 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' ' , Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date,
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application-,-4 ,'l nt.' V ,
City of Tigard Receivedar
Permit
IIIw 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 1 2019 Date/By: / q / .r- EC / -C(? /.L
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
• •DateBy�
Other Permit:
i'TIG RD Inspection Line: 503.639.4175
,Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov , Notified/Method: Supplemental Information
h a , .
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� ..�mm. '.- - Mechanical m� a
❑New construction 7.1 Addition/alteration/re lacement permit fees*are based on the value of the work
Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
OA IE O) -C ON U OI ' , . Value:$
15 1-and 2-familyR SW N” L V1PMEN ' t ' 1 ' #
dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
#b8 3i3'EpwoltwiioN AND," Heating/cooling:
p Air conditioning 46.75
Job site address: 11-1. 5 fjN \14-1- ,1 V U E Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: T t i '] / �j`'01-II vi Furnace 100,000+BTU(ducts/vents) 54.91
1 �, Heat pump 61.06
Suite/bldg./apt.no.: Project name:NAkbk Ci vW 7AJ\S
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
I CRIl IO 'OF*ORO'' Gas fireplace/insert 33.39
(1 rL I // II Flue vent for water heater or gas
G15 � N, tC"( - 1k6k `On 4ov e, (. Gtc i f 1/\c v(c S w,-Fes+�.,• 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
"' , *-63444* t!' 1'AN ,
Environmental exhaust and ventilation:
Name:
\(A4A c 'bp t S Range hood/other kitchen
equipment 33.39
Address: ��9 I ��k AVv E, Clothes dryer exhaust 33.39
City/State/ZIP:-r-r,,,,,,,., (� / OI '1.-J,I_' Single-duct exhaust(bathrooms,
l�!/ toilet compartments,utility rooms) 23.32
Phone:( 0%,)OG!`), ,.' ,1:1,---1 Fax:( ) Attic/crawlspace fans 23.32
Cli APPuc4$ . _ _. . U CONTACT,Pls� . ' . Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
CMyISS
Water heifer( ) Fes..( ) Fireplace
( Range
E marlI�����tGt V4 S LI 1 1 (�Vl(1 Barbecue 5 ����
v _ � Clothes dryer(gas)
Business name:71 S t U Ni .k R. Other:
Address: �/00Lir ,- ,t`t, Fi
, Yity Nv� 'Subtotal i-i.IG—j
City/State/ZIP: V> CD UVGf/ V V k ( Minimum permit fee($90.00) p (N
Plan review(25%of permit fee)
Phone: 0 3)ens Fax:( ) State surcharge(12%of permit fee) (0 ,
CCB lic.: u(plt,,.�.� TOTAL PERMIT FEE /00. ere)
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: a ^ IsA i,�)A Ce- Date: 5. 1 1
I:\Building\PermitsNEC`Pem.itApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi Famil Fee Schedule:
$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