Permit (148) CITY OF TIGARD MECHANICAL PERMIT
IN 3
8 ' COMMUNITY DEVELOPMENT Permit#: MEC2019-00678
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2019
TIGARDParcel: 2S112BD14100
Jurisdiction: Tigard
Site address: 7679 SW CORNUTT ST
Project: Riverside Homes Subdivision: ELDERBERRY RIDGE Lot: 37
Project Description: A/C installation. Placement of A/C unit must comply with manufacturer's installation requirements.
Contractor: PRO HEATING AND COOLING INC. Owner: RIVERSIDE HOMES LLC
2095 NW ALOCLEK DR, SUITE 1103 17933 NW EVERGREEN PL STE 370
HILLSBORO, OR 97124 BEAVERTON, OR 97006
PHONE: 503-443-5692 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 09/23/2019 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 09/23/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/23/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to f. low the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009► You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:i%' Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio •a -
This permit card shall be kept in a conspicuous place on the job site until c• pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFF IC I. list:O\l.l
City of Tigard RECE�� Received
Date/By: ...J. tJ Gia Permit No.: a fC A
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
a Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit:
I I C;A R D Inspection Line: 503.639.4175 SEP 2 3 2019 Date Ready/By: ® See Page 2 for -
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD ....M
' WILDING ON MMERCIAI.FEE* SCHEIfULE cliEClcl I$T.
TRIPE OF WO :. ._ ,. „n . . CLI „
Co
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 Gx , RESIDENTIAL EQUIPMENT/SYSTEMS FEES*`'
WI 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 Heating/cooling:
Air conditioning I 46.75
Job site address: 7679S, c (',.._)-',k- S4— Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: j */ V.-2.e
-‘-, 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.: 3Other: 23.32
?
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
S,rr-\k AC.— a— IrirNi�C]✓ L A4: G 1 eC 6,L.--k- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
= i Other: 23.32
TA PROPERTY:OWNER i' ,
�� "' - Environmental exhaust and ventilation:
Name: J. l2 j 5;� _ -\ - ,� L LC Range hood/other kitchen
\
Address: equipment 33.39
I 7?r3c5 /v /_'� CA"Q-.t-r y k /i v tiS+� ,,n' Clothes dryer exhaust 33.39
City/State/ZIP: LI ^ (3 ti 7?0 t Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) , 23.32
Phone:(50 ) 6ci5 (G s 4 Fax (5) ) ( YO 2c,y 2_ Attic/crawlspace fans 23.32
,: `�.
r LiCANT ❑` oNTACT p Other: 23.32
Fuel piping:
Business name:
'er 9,- , ' \.t r•--4-5 LL $14.15 for first four;$4.03 for each additional
Contact name: A,r,, Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
------ tyPKiturrKf__meCftl ter°°--:. ' ----_. r ___—
Phone:( ) Fax::( ) Fireplace
911 LuZo 3�1.s7s Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Pro `A •.�. Other:
r--1 e- �` \ MECHANICAL.PERMITFEES*r
W
Address: 7 c r .�� I"c rJ f� jc C )e_k Ds( # J,0 Subtotal
City/State/ZIP: `\`b„. 0`-- e -1 2 .5/ Minimum permit fee($90.00)
) � �� ���� ( ) Plan review(25%of permit fee)
(
Phone: 5 Fax: State surcharge(12%of permit fee)
CCB lic.: ao W\. // LI(K pco‘..E p )4-.1_( ( ., v TOTAL PERMIT FEE /eid.,dc'
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized si tare: c, * Fee methodology set by Tri-County Building Industry Service Board
Print name: t' io Date: l 13
I.\Budding\Permits\MEC_PermitApp_040113.doc 4 -461 (11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& 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.
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