Permit CITY OF TIGARD MECHANICAL PERMIT
III ■. COMMUNITY DEVELOPMENT Permit#: MEC2020-00053
T t C A,R o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/28/2020
Parcel: 2S 114AC00300
Jurisdiction: Tigard
Site address: 16590 SW 93RD AVE
Project: Hook Subdivision: CAFFALL'S CORNER Lot: 3
Project Description: Adding(1)gas line for new gas fireplace.
Contractor: LIONHEART FIRE&HEARTH LLC Owner: HOOK, DONALD J&
5717 BONITA RD DELATORRE, SHERILYN TRUST
LAKE OSWEGO, OR 97035 16590 SW 93RD AVE
TIGARD,OR 97224
PHONE: 503-443-1376 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 01/28/2020 $33.39
Type of Use: SF Fuel Piping 01/28/2020 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 01/28/2020 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 01/28/2020 $42.46
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR -001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 5 .232.1987 or 1.800.332.2344. /
Issued By: Permittee Signatu
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Folz OFFICE I'SI oNL)
Received 'C/ _ ,
City of Tigard Date/By: i ,/ 6 /
al 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review '
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: to See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction OE:r ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition L—N/Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
and 2-family dwelling ❑Commercial/industrial ❑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: i/�
C.F-'5-q d �(L) 9 3 tZi::, A�,..e_ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: //"'7/y3TLJ� /Z Ct-7 a z Furnace 100,000+BTU(ducts/vents) 54.91
j 7 Heat pump 61.06
Suite/bldg./apt.no.: Project name: e5/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
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 3Z. 57
Flue vent for water heater or gas
/</i/0 I/O'S ii/'0-e.. e' 1/( 4-// A1,P t� q J'ci fJ ,,fee fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
• Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: )/,.1 4i b r//_ ,y� Range hood other kitchen
��� equipment 33.39
Address: 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
p APPLICANT 0 CONTACT PERSON Other: 23.32
'' Fuel piping:
Business name: "R� lio 4f 3,�"-,,e,e. ,_cpf��1` 5 $14.15 for first four;$4.03 for each additional
Contact name: / ic A.a f l Z2O6,6 / Furnace,etc.
2 t ll`� Gas heat pump
Address:
/ c2- tie) 136 T /// / Wall/suspended/unit heater
City/State/ZIP: zy fg-)kb O� C 3 '7 Z, 3 Water heater
Phone:(SI 3) ' / 3-/3747 Fax: :( ) Fireplace I
j� Range
E-mail: O ' ss2 — Q'FC/V'.U1 5 tl lZ-C Se/V11/6.aS e 0,--1374- Barbecue
CONTRACTOR Clothes dryer(gas)
�� 9 Other:
Business name:
`g° '.0` � r �YQ f'" (-A& MECHANICAL PERMIT FEES*
Address: / 3 7/2 o`. ) j '0 ,(o/ Subtotal
Ci (State/ZIP: �� 9 / Minimum permit fee($90.00)
ty '/"`' •'` �� 2 7 �� 3 Plan review(25%of permit fee)
Phone:6'63) i/G 3Fax:( )
j State surcharge(12%of permit fee)
CCB lie.: 07- /j i i TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
/f ' ��\ days after it has been accepted as complete.
Authorized slgnat i e: " J * Fee methodology set by Tri-County Building Industry Service Board
Print name: //¢12,1 / RC/ 7 Date: /2,1/..2.61,2s
I:\Building\Permits\MEC_PermitApp_040 3.doc 440-461TT( OM/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_0401 I3.doc 2