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Permit (9) CITY OF TIGARD MECHANICAL PERMIT ' COMMUNITY DEVELOPMENT Permit#: MEC2020-00084 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2020 Parcel: 1 S134DB00600 Jurisdiction: Tigard Site address: 11319 SW ELLSON LN Project: Brightwood, Lot 2 Subdivision: BRIGHTWOOD SUBDIVISION Lot: Project Description: A/C installation. Placement of A/C unit must comply with the manufacturer's installation requirements. Contractor: COMFORT ZONE HEATING &AIR COND Owner: VENTURE PROPERTIES INC 1032 NW CORPORATE DR 4230 SW GALEWOOD STE 100 TROUTDALE, OR 97060 LAKE OSWEGO, OR 97035 PHONE: 503-667-5595 PHONE: 503-387-7577 FAX: 503-491-8252 FEES Specifics: Description Date Amount Air Conditioning 02/06/2020 $46.75 Type of Use: SF 12%State Surcharge-Mechanical 02/06/2020 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/06/2020 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: _.Permittee Signature: ,e+e- Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE.ONLY Cl of Tigard _ Received g �.. DRateB /X,72 Z"- Permit No.: Mj III 13125 SW Hall Blvd.,Tigard,OR 97223 Ii E E y ��r•' ! i S Plan Review M Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: ‘ /� dY 3-2 K 1 I G A i,I, Inspection Line: 503.639.4175 r / ��' I Date Ready/By: Juris: Internet: www.tigard-or.gov �'LB 6 LD�u Notified/Method: See Page 2 nr T'T� Supplemental nformation TYPE OF WORK . ""° ti -/i , .:a �.Y� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: / t,} ii Air conditioning 46.75 �g 7s Job site address: i i 3717 5 In/ b 1141 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: T i yarJ i 0 12, Furnace 100,000+BTU(ducts/vents) 54.91 Duct 61.06 Suite/bldg./apt.no.: me: I9� Lct 2_ work 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 Other: Subdivision: Lot no.: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 _ DESCRIPTION OF WORK t ,.`i, Gas fireplace/insert 33.39 tax_.. Flue vent for water heater or gas ./4�t= 4/tl il-7.1//et 25 r fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: LL -- __ . a 4, 9 Range hood/other kitchen V't.J�TTY�- 1•=�'y tat`= ��f�u. _ Address: equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: : Fuel ti $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name: CcvncsYik 2.cvie Other: MECHANICAL PERMIT FEES* Address: 10 3 Z NIA/ Ccr c,vetbe Dr Subtotal =a;t<.- , City/State/ZIP: rrotifjale or., q 7o(go Minimum permit fee($90.00) C.lt) ( Plan review(25%of permit fee) Phone:(ca 3) y(p1 —S I.,f i Fax: ( ) State surcharge(12%of permit fee) 14-`p CCB lic.: -1 1009 I TOTAL PERMIT FEE Ed)- Re This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: //� #6,- * Fee methodology set by Tri-County Building Industry Service Board Print name: y I) 6e4-y te: /'740/,/24/ B \P \ME I:\ uildingermitsC_PermitApp_040113.doc 440-4617T(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. 1:\Building\Permits\MEC_PennitApp_040113.doc 2