Permit (4) ,, CITY OF TIGARD MECHANICAL PERMIT
INCOMMUNITY DEVELOPMENT Permit#: MEC2019-00724
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2019
Parcel: 1S125DD09300
Jurisdiction: Tigard
Site address: 9660 SW VENTURA CT
Project: STEVENS Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 101
Project Description: Make up air and damper installation for exhaust fan.
Contractor: HARPER CONSTRUCTION & RENOVATION LLC Owner: STEVENS, JB TRUST
1285 SW 84TH AVE STEVENS, PE TRUST
PORTLAND, OR 97225 BY STEVENS, PATRICIA&JOEL TRS
9660 VENTURA CT
TIGARD, OR 97223
PHONE: 503-203-6804 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 10/10/2019 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 10/10/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/10/2019 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: Permittee Signature: //
Call 503.639.4175 by 7:00 a.m.for the next available inspection -.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLI"
City of Tigard (NEW . �" Date/By: i /$ c Cy PermitNo.:r . _
11 13125 SW Hall Blvd.,Tigard,OR 97223' Plan Review
_ Phone: 503.718.2439 Fax: 503.598.1960 0 2019Other Permit: 4_
Date/By: (�(��`�
TIGARD Inspection Line: 503.639.4175 OCT Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.govy �1/ Ty(ypprk' Notified/Method: AirSupplemental Information
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TYPE OF WOk COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
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 ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
ja.l-and 2-family dwelling ❑CommerciaUindustrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
/�� � Air conditioning 46.75
Job site address: l`dbO „Si- ,t) .. .- 74 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: QJ �! Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 0 Project name: g-1,6Ley k *I,,,,,� 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.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
f ` Flue vent for water heater or gas
(W)'jZ L-'l%u� 04- -C- `ovkA.s,.k - Y, U, who--ksf' 1/4.-r fireplace 23.32
ff t Log lighter(gas) 23.32
6C1$( m e LVIAIn`C alein i'Vt y�Z'►� Wood/pellet stove 33.39
/ Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
1:1PROPERTY OWNER 1:1TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: aiRange hood/other kitchen
l -h`tom` equipment ( 33.39 33 51
Address: t3(a(P U s,k.) \r'Y{ v.z.,„ Clothes dryer exhaust 33.39
City/State/ZIP: /, Single-duct exhaust(bathrooms,
M4.,)
` .cvut � , b 2 !r j toilet compartments,utility rooms) 23.32
Phone:(St% ) TG�ci_ ct(�CS ' Fax:( ) Attic/crawlspace fans t 23.32
❑ APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: { �� /
rC Ax {/ice l�s� L
I ITI '� &-
. � e-4 I(,,c 7 c t L(..t $14.15 for first four;$4.03 for each additional
Contact name:` I 1."I D�V Furnace,etc.
Address: ' s S vJ ' -1 .. Gas heat pump
1, Wall/suspended/unit heater
-�p
City/State/ZIP: T p`l--{ pt2_ q 7Z2;7
Water heater
Phone:(� )l) .�(>? �Q U� Fax::( )
Fireplace
Range
(.4 :: ::
ail .L..ir,-k2 r nA,.5 6.:, 444 ,. .:t(, C�,cvvi Barbecue
1 °CONTRACTOR Clothes dryer(gas)
name: Other:
MECHANICAL PERMIT FEES*
Address: Subtotal 3j w
City/State/ZIP: Minimum permit fee($90.00) err/.t/U
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) /0,
CCB lic.: 1413 3(-'L TOTAL PERMIT FEE /eiJ
This permit application expires if a permit is not obtained within 180
/ - / days after it has been accepted as complete.
Authorized signature: . I/—� * Fee methodology set by Tri-County Building Industry Service Board
Print name`Be t—k-i ^' Date: /0 l O ZUI 11:\Building\Permits\MEC 'tApp_040 13.doc 440-4617T(t1/02/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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2