Permit (114) CITY OF TIGARD MECHANICAL PERMIT
`' ' COMMUNITY DEVELOPMENT Permit#: MEC2019-00643
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2019
TIGARD Parcel: 2S103CD09000
Jurisdiction: Tigard
Site address: 13571 SW PIPER TER
Project: Crook Subdivision: 2008-074 PARTITION PLAT Lot: 3
Project Description: Gas piping for barbeque,fireplace,and fire pit.
Contractor: JAVAZ HEATING AND COOLING Owner: CROOK, NATHANIEL
12009 REES ST NE CROOK, CHRISTY
DONALD, OR 97020 13571 SW PIPER TER
TIGARD, OR 97223
PHONE: 503-310-9416 PHONE: 503-481-5937
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 09/04/2019 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 09/04/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/04/2019 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if wo, is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foil th rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00.0. :'Yo ay obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ermi ignature: 149%
Call 503.639.4175 by 7:00 a.m.for the next available insp- tion date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
'' i.k 3 1 Received
City of Tigard i ' Date/By: 403,4111 Permit No.: . ,t E ... LA. j
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 r Date/By:an Review
Other Permit: _ c/
Inspection Line: 503.639.4175 `,C r' `: �-ll j u / v
T I G n R D Date Ready/By: II Supplemental
See Page 2 for
Internet: www.tigard-or.gov t 3 y , ' Notified/Method: Information
!» :77 a tb' t§ l-;J7, -" ,x?t r 'r„! s-. avr
a o),ll ''f.,',.... �,t,.. .Zi!!. -47,'&'
Mechanical permit fees*are based on the value of the work
❑New construction "Ntikddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
,err ` Value:$
h CATEGORY 4F S M . Yw .+" s -IDENIiIx I *
n a
1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. _
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
r f Heating/cooling:
X016 ��� d' ,� �iND` ��, � �:"
. .w ..' :,. .. ,.; ._ w4. Air conditioning 46.75
Job site address: 35 71 JAN e, fj {r Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: '�, f 3, GP 2 Z 3Furnace 100,000+BTU(ducts/vents) 54.91
t 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: 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
s" E RIpTI O , , Gas fireplace/insert 33.39
Flue vent for water heater or gas
1195[COI GIS " 1 ..n�r tS`'� rift, 0.LSC .. �.., fireplace 23.32
PP fl)
i �� Log lighter(gas) 23.32
— - Wood/pellet stove 33.39
C/cLj It v c6.-4 p t KA,t S I- el.I' S'v R Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
-4,4.I :, ,"" Other: 23.32
W 1'ROPEIEi `-*' '.- .- Pt). ° 1 4 �',,,, ..,TEI+TANT ;- ..
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
APPI.1c iT CONTACTi so,N'' Other: 23.32
Business name: Fuel piping:
C`•VC\ �AC{7 l try Ai, Gad,�t IYIf� L. $14.15 for first four;$4.03 for each additional
Contact name: SC:c UG Furnace,etc.
Gas heat pump
Address: ,2 54. NC Wall/suspended/unit heater
_ ._ +1:�_:_3 —t7� tater heater _ ---
bi'bA (
Fireplace
Phone:(S-D3) '3h it/l Fax::( ) p
Range
E-mail: tAyG -- f�G C/t c .) . hex ,(+I CP vv.) 'Barbecue I
r tl I -, t# Clothes der(gas)
1
j p f1 Other: KA. 'r I
Business name: `i G;t/Ct Z kGt ri rl5 pK., A,/ L 3 Aci I it+s'rt 1 Yl 2,1-L
Address: i'ao3 s, fV t Subtotal /l i
City/State/Z1P: 1)o�w1,A JTZ CI'7O Minimum permit fee($90.00) �)�,,c)
Plan review(25%of permit fee) —
Phone:(53)) i i4) qt I Fax:( ) State surcharge(12%of permit fee) /i) j�
CCB lic.: o 6 9 i/��3/ TOTAL PERMIT FEE (i)).`eV
�/ This permit application expires if a permit is not obtai d within 80
days after it has been accepted as complete.
Authorized signature: J ktG'Zh UCx.� t 'Z * Fee methodology set by Tri-County Building Industry Service Board
Print name: AvDate: 9'Iti( 9
I:ABuilding\Permits\MEC_P itApp_0401 .do 440-4617T(1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi Family Fee Schedule:
Totallalu E ' �_ 1tt
$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.
l:\Building\Permits\MEC_PennitApp_040113.doc 2