Permit (128) CITY OF TIGARD MECHANICAL PERMIT
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'I COMMUNITY DEVELOPMENT Permit#: MEC2019-00685
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2019
Parcel: 1 S 134CA00505
Jurisdiction: Tigard
Site address: 11175 SW 119TH AVE
Project: Weaver Subdivision: PANORAMA NO.2 Lot: 16
Project Description: Duct work for master bedroom and(1)bathroom exhaust fan.
Contractor: PRO COM HOME SERVICES Owner: WEAVER,WARREN A&TONI A
2033 6TH AVENUE STE 236 11175 SW 119TH AVE
SEATTLE,WA 98121 PORTLAND, OR 97223
PHONE: 206-429-8327 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 09/25/2019 $23.32
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 09/25/2019 $23.32
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: 12%State Surcharge-Mechanical 09/25/2019 $10.80
Stories: Minimum Fee Adjustment Mechanical 09/25/2019 $43.36
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not s -■-d within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fol the • es ad,pted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009•7Yo may obt-'' a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.86 i.332,23Alc
Issued By: -�
..fte"7..- :.c. -ti _� --
.410."
ite Sjdnature:
#0074--
Call 503.639.4175 by 7:00 a.m.for the next available inspecti'n da -.
This permit card shall be kept in a conspicuous place on the job site until .m%etion of the project.
Approved plans are required on the job site at the time of eac• nspection.
Mechanical Permit Application FOR OFFICE. t SI Om.)
City of Ti and Received i Permit No.: t
g Date/By: / .. S J • 1• -.c-' ! - y5---
q 13125 SW Hall Blvd.,Tigard,OR 97223 EN ED Plan Review
Other Permit:
Phone: 503.718.2439 Fax: 503.598. 0 Date/By: ��
II(.�A R 17 Inspection Line: 503.639.4175 G Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov
SEP
2 5O19
Notified Method: T _ Supplemental Information
_ , TYPE OF Y F TIGARI.) COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
' "� IO ' W ` . Mechanical permit fees*are based on the value of the work
"❑New construction M �dition/altttplacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
_VI--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:
2
"( v c� yt,� Air conditioning 46.75
Job site address: 1'( SLID t r Pr\e, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 9t Jc-l C'l1L. --Z2 3 Furnace 100,000+BTU(ducts/vents) 54.91
1 � Heat pump 61.06
`
Suite/bldg./apt.no.: Project name: N 4:Za� Duct work ! 23.32 27,:',1.3),
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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION Old WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
(1\ o, Q, j.,4 f" A �_1) '� fireplace 23.32
�
l J}� 1 '� Log lighter(gas) 23.32
t\ I(• Ci Z.\.NINC.) ' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
PROPERTY`OWNER, [, TENANT` Environmental exhaust and ventilation:
Name: N Q .).szsf` Range hood/other kitchen
t\,4
+ equipment 33.39
Address: 1' S- SW (.\Q t\,4—. Clothes dryer exhaust 33.39
City/State/ZIP: (3c.:::,,,e-,Ns-\ ...s.14--,6 U 1--- il_ZZ_3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) f 23.32 )73; �,
;
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
G4 LICANT `' Q CONTACT,PERSON Other: 23.32
=. Fuel piping:
Business name: 42f t,, L,,V� $14.15 for first four;$4.03 for each additional
Contact name: S\.` sL 'U,R'.xr V.VFurnace,etc.
Gas heat pump
Address: 2c� 3 3 Wall/suspended/unit heater
''. Ci 1st tr' J�rA-\ w - ) 1,i iteafier
Phone:(5-(3 .-1--‘(6 13 t6k, Fax::( ) 1 Fireplace
Range
E-mail. 1� +��+��,\�, q.„(-c,. C � Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: MECHANICAL PERMIT FEES*
Address:
Subtotal 'l-1(y',L,l.�j
City/State/ZIP: Minimum permit fee($90.00) 071;7. >;)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) _ State surcharge(12%of permit fee) cup
CCB lic.: .2.:Z-y'`LSs
TOTAL PERMIT FEE A 5,
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
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Print name: h).sk, .�,3Date: s--ii\P1:\Buildin ermits\MEC_PermitApp_040113.doc 440-4617T(11/02/CO B
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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2