Permit (7) CITY OF TIGARD MECHANICAL PERMIT
II COMMUNITY DEVELOPMENT Permit#: MEC2019-00720
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2019
Parcel: 25111 CC15500
Jurisdiction: Tigard
Site address: 10045 SW HIGHLAND DR
Project: Keefe Subdivision: SUMMERFIELD NO.4 Lot: 206
Project Description: Replacing furnace and vent.
Contractor: AIR MASTERS HEATING&AIR CONDITIONING INC Owner: KEEFE, R BARRY& FRANKI
2858 LIVINGSTON ST NE 10045 SW HIGHLAND DR
SALEM, OR 97301 TIGARD, OR 97224
PHONE: 503-244-8880 PHONE: 503-913-7176
FAX:
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 10/09/2019 $46.75
Type of Use: SF Flue/Vent For Any of Above 10/09/2019 $23.32
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/09/2019 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 10/09/2019 $19.93
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow t - les a opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y, ma'y n a copy of the rules
or direct questions to OU " b calling ..i3•23 987 or 1.':'x.332.2344.
Issued By: I, Permittee Signatu •. ;.% /
Call 503.639.4175 by 7:00 a.m.for the next available inspection d•te.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application { , r� FOR OFFICE ( Sly:ON1.'
9 4^��^',»� 3
"I�' Received
City of Tigard Date/By: / 1 A�i�=gaMilliEffl
IIIII • 13125 SW Hall Blvd.,Tigard,OR 97223 9 2019 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 O T J Date/By: Other Permit:
T I GA R D Inspection Line: 503.639.4175 ,Date Ready/By:
(a r Juris ® See Page 2 for
Internet: www.tigard-or.gov �4 t , `Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction E Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
ir-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: '
0014 51,E LTl t../4-&i� 'Da s Furnace 100,000 BTU(ducts/vents) ( 46.75
City/State/ZIP: `"fl O x_ Cf 7 ze l Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: ��" , Duct work 23.32
Cross street/directions to job site: -0 t.=-- �Sr'rt_o".")S .i,,y.,l Hydronic hot water system 23.32
7 Residential boiler(radiator or
S u tit&iki-e/L-t ..L 17 hydropic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 1 23.32
Other: 23.32
Subdivision: Lot no.:
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
F-�-l)^(J'Kk f j(CJ,4-ct fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
9 PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: FiL f„Kj IC( (__p Fe Range hood/other kitchen
equipment 33.39
Address: J �- "e
l 0U Cl S cut) t4-ar7,4LAAJD D Z Clothes dryer exhaust 33.39
City/State/ZIP: -/ (s.- 61(... 9?Z Z`t Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( . ) 9 1 - --..7 176, Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: „LH K _ .as-rc,ZS G._®f..A.C._ MECHANICAL PERMIT FEES*
Address: 4 71 L( F'/4-. 7('( I 4 S-7--- Ai,G-, Subtotal
City/State/ZIP: S ,1,✓1 O/ t c/ 7-305--- Minimum permit fee($90.00)
1 Plan review(25%of permit fee)
Phone:(.5)3) 044-R--E -.0 Fax:( .--4.— —
State surcharge(12%of permit fee)
CCB lic.: ( `7 (d G 1TOTAL PERMIT FEE
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: Z i 04.4(0) fi{.vvi ewL er,..i Date: (C.)// /2.-01 9
\ \ \I:BuildingPermitsMEC_PermitApp_040t13.doc 440-416I7T(I 1/02/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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