Permit �,, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT14
Permit#: MEC2019 00812
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2019
Parcel: 1 S135AD01801
Jurisdiction: Tigard
Site address: 8840 SW SPRUCE ST
Project: VOTAVA Subdivision: GRAHAM ACRES Lot: 3
Project Description: Adding free standing wood stove and chimney vent.
Contractor: OWNER Owner: VOTAVA, KEVIN &SARA L S
8840 SW SPRUCE STREET 8840 SW SPRUCE ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 541-399-6499 PHONE: 541-399-6499
FAX:
FEES
Specifics: Description Date Amount
Wood/Pellet Stove 11/18/2019 $33.39
Type of Use: SF Chimney/Liner/FlueNent 11/18/2019 $23.32
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 11/18/2019 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 11/18/2019 $33.29
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 503.23 7 or 1.800.332.2344.
Issued By: Permittee Signature:
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
City of Tigard NOV 1 8 2019 Receive
DateB d jf iii 47 / P ,�" , 07l/S,'7%D1Z
13125 SW Hall Blvd.,Tigard,OR 97223
f"i�' a Plan Review
11 Phone: 503.718.2439 Fax: 503.598.1960 I'a' '' CsAr Other Permit:
f i r `x'SON Date Re
T I G A R D Inspection Line: 503.639.4175 i- G L„6j VIS`®N Date ReadyBy: Iuris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: I Supplemental Information
ta' ';TYPE OF WORK , 1. $ .:+ 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*
k `-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:
'''"` 'll: Air conditioning 46.75
Job site address: 6 10 S( /SPAi .5 T' Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: /7641/Di, 04 q7 g 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Vaal .cr01/6 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
CPI f7 4/6 f'J M - Residential boiler(radiator or
D O 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
pr j°l (/ Flue vent for water heater or gas
A yy���jyjDP / J I 5' I, , f r 6 timed fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove / 33.39 _33,3q
Wood fireplace/insert 23.32
Chimney/liner/flue/vent / 23.32 33.3„),.
ROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Jf gv/A/' I/Oes-��L/ Range hood/other kitchen
eq8 /® � 5/ 57 Clothes nt 33.39
Address: � ,� Clothes dryer exhaust 33.39
City/State/ZIP: -0644 Oa 17.3?3 Single-duct exhaust(bathrooms,
/ toilet compartments,utility rooms) 23.32
Phone:(54/I )),,,cr -6 y91 Fax:( ) Attic/crawlspace fans 23.32
. (APPLICANT El CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: grvi 1/ !l o-r4 VA Furnace,etc.
Address:
8 D .SW SMUG( 5 r Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: fi(6,A AD./ O A. ) -3 Water heater
Phone:(591)3 79 -6 yetei Fax: :( ) Fireplace
Range
E-mail: k-z.voYAv a P G/�t4IL CGaM Barbecue
i e ram`�Mt Clothes dryer(gas)
I/ /^ �r�/ Other:
Business name: N// ' MECHANICAL PERMIT FEES*
Address: `/ 4 Subtotal SG , IT-
City/State/ZIP: Minimum permit fee($90.00) 900 00
Plan review(25%of permit fee) .••••-
Phone:( ) Fax:( ) State surcharge(12%of permit fee) 0,
CCB lie.: TOTAL PERMIT FEE `e0r ifgig
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:44. '.1 * Fee methodology set by Tri-County Building Industry Service Board
Print name: k . l//4./ vo T,4i/4 Date: //-./5"/?
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I1/02/COM/WBB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
k 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