Permit Support Document (38) CITY OF TIGARD MECHANICAL PERMIT
I
COMMUNITY DEVELOPMENT Permit#: MEC2019 00446
>t' ` Date Issued: 06/26/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t
Parcel: 2S114BB10300
Jurisdiction: Tigard
Site address: 10387 SW PICKS WAY
Project: Radke Job#19068 Subdivision: SWANSON'S GLEN Lot: 44
Project Description: Replace Gas Furnace and Air Conditioner.9/19/2019:REPRINT to add(1)gas line for range.
Contractor: DR HVAC INC Owner: PADIA,JENNIFER R
PO BOX 1290 10387 SW PICK'S WAY
MCMINNIVILLE, OR 97128 TIGARD, OR 97224
PHONE: 503-474-9891 PHONE:
FAX: 503-474-9897
FEES
Specifics: Description Date Amount
Air Conditioning 06/26/2019 $46.75
Type of Use: SF Furnaces< 100K BTU 06/26/2019 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/26/2019 $11.22
Occupancy Grp: Fuel Piping 09/17/2019 $14.15
Stories: 12%State Surcharge-Mechanical 09/17/2019 $1.70
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $120.57
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: , \L\C.,'ATACC-
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application =-4 � Received 4 FOR OFFICE USE ONLY
City of Tigard ``f Date/By: t'c- I Permit No.:` \„r� q_ '�
a 13125 SW Hall Blvd.,Tigard,OR 97223 UPI
g plan Review
Phone: 503.718.2439 Fax: 503.598.1960 SEF 1 7 2019 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/13y. ® El See Page 2 for
Internet: www.tigard-or.gov CITY UF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement ,. performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition 0 Other: �
5mechanical materials,equipment,labor,overhead,and profit.
. "`
fr; .. a Value:$
CATEGORY OF CONSTRUCTIONRESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accesso IPMt - For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 10387 SW Pick's Way Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Padia Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydropic) 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:Swanson's Glen Lot no.:44 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S114BB10300 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Gas Piping to Stove fireplace 23.32
MEC2019-00446 was already issued.The above work needs to be added to this Log lighter(gas) 23.32
Wood/pellet stove 33.39
permit. Wood fireplace/insert 23.32 ,
Chimney/liner/flue/vent 23.32
eTENANT4 PROPERTY OWNER 0 Other: 23.32
Environmental exhaust and ventilation;
Name:Jennifer Padia Range hood/other kitchen
equipment 33.39
Address:10387 SW Pick's Way Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)267-9426 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Dr.HVAC,Inc.
$14.15 for first four;$4.03 for each additional
Contact name:Teresa Lingle Furnace,etc.
Address: 1788 NE 18th Street Gas heat pump
Wall/suspended/unit heater
k ,_etyl8tateftffit-MeNIFIttiretle, 97128. - _. - - , - Cirtcatct -- :.. - _. _ _. a
Phone:(503)474-9891 Fax::(503)474-9897 Fireplace
Range
E-mail:teresa@dr-hvac.com
dr-hvac.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Dr.HVAC,Inc. Other.
MECHANICAL PERMIT FEES*
Address:1788 NE 18th Street Subtotal
City/State/ZIP:McMinnville,OR 97128
Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)474-9891 Fax:(503)474-9897 State surcharge(12%of permit fee)
CCB lie.: 162531 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: `��`-`-t-`g-_!`._ C'} * Fee methodology set by Tri-County Building Industry Service Board
Print name:Teresa Lingle t Date:9.16.2019
I:\Buildisg\Permits\MEC PennitApp_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.
1:Building\Permits\MEC_PennitApp_040113.doc 2