Permit CITY OF TIGARD MECHANICAL PERMIT
" 111
> COMMUNITY DEVELOPMENT Permit#: MEC2019-00771
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/04/2019
Parcel: 2S 102C D04200
Jurisdiction: Tigard
Site address: 13805 SW COWLES CT
Project: Del Rey Properties Subdivision: LYNZ COURT Lot: 3
Project Description: Replace furnace in attic,gas piping and add A/C.
Contractor: DONS AIR CARE INC Owner: DEL REY PROPERTIES LLC
PO BOX 6408 1831 NE 9TH PL
ALOHA, OR 97007 HILLSBORO, OR 97124
PHONE: 503-642-5844 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 11/04/2019 $46.75
Type of Use: SF Furnaces< 100K BTU 11/04/2019 $46.75
Class of Work: ALT Type of Const: Fuel Piping 11/04/2019 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 11/04/2019 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00 Y` u may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,c:V Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the'roject.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Ap licatio ECEIVE . IOIZ OFFICE USE ONLY
City of Tigard Received Date/By: or km y ji �� v f Permit N 47 .)/t, . 77/
Iii 0 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 4 2019 Plan Review
s Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: ei See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVIgION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
Et1-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:
CO
Job site address: Air conditioning 46.75
, C SIL IJ /(j S C Furnace 100,000 BTU(ducts/vents) T' 46.75
City/State/ZIP: ��;, f 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: Hydronic hot water system 23.32
/J Residential boiler(radiator or
ii/! 0errI i ' /0 0 4' 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
Gas fireplace/insert 33.39
f) l 2 CQ
'"'° "'`" , Flue vent for water heater or gas
�.e_ ark G c_o ,n QM' e_, fireplace 23.32
�,, n Log lighter(gas) 23.32
£2 4A C-(10�1 G C--_ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent _ 23.32
Oth
laPROPERTY OWNER ❑ TENANTS' 23.32
Environmental exhaust and ventilation:
Name: ), _ t 7 y' - ,i 1t<' Range hood/other kitchen
Address: ✓ �tJ 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
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: / --+`" Fuel piping:
c.:42L ��ll`e ,e- $14.15 for first four;$4.03 for each additional
Contact name: «Lck Furnace,etc.
Address: U y�/ Z f oo 2 Gas heat pump
/ ^'�7� Wall/suspended/unit heater
City/State/ZIP: �li t7c Water heater
Phone:(spy)6,1 --c tizi Fax::( ) Fireplace
n� age E-mail: •
mail (tc s /'.!( e/'t� ( ., ;/,e _ Barbecue
CONTRACT 4 Clothes dryer(gas)
Business name: 65i"..< Jv ( J^ p Other:'it MECHANICAL PERMIT FEES*
Address: + Subtotal 7 7, 4 5
City/State/ZIP: L Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee) /r, , 9 vL-
CCB lic.: &2/f.2r TOTAL PERMIT FEE /,w, 5'7'
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature• fd
„v,1 // * Fee methodology set by Tri-County Building Industry Service Board
Print name: �QUI t� LA ev,, Date: re/G//! 7
I:\Budding\Permits\MEC_Pe mitApp_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.
I:\Building\Pernuts\MEC_PermitApp_040113.doc 2