Permit (2) CITY OF TIGARD MECHANICAL PERMIT
1. •• COMMUNITY DEVELOPMENT Permit#: MEC2020-00115
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02l20/2020
TfG 1Rp g Parcel: 2S111CD04300
Jurisdiction: Tigard
Site address: 9520 SW BRENTWOOD PL
Project: SMARTER REDESIGN LLC Subdivision: SUMMERFIELD NO.9 Lot: 502
Project Description: Adding gas line for kitchen range.
Contractor: OWNER Owner: SMARTER REDESIGN LLC
15916 NE CLAREMONT DRIVE 15916 NW CLAREMONT DR
PORTLAND, OR 97229 PORTLAND, OR 97229
PHONE: 503-866-8729 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 02/20/2020 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 02/20/2020 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/20/2020 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by ca ' 503.232.1987 or 1.800.33 .2344.
c Issued By: ermittee Signature: ro
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard DateBy ^
41 11141 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
I . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175
T I A,A R 1) Ins P Date Ready/By: Jura: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
' Mechanical permit fees*are based on the value of the work
❑ New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family D Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
A�5 S� Furace1conditioning, 00 46.75 _
ress: (� .20 ,tgIQt7UTu/Ob,p r�� Furnace]00,000 BTU(ducts/vents) 46.75
Bate/ZIP: Ti! �� 6 A' 9 7 t/ Furnace 100,000+BTU(ducts/vents) 54.91
`� / Heat pump 61.06
Suite/bldg./apt.no.: Project name: S IYl //--y 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 _
Gas fireplace/insert 33.39
Flue vent for water heater or gas
q a$ /'/!e r'a✓19e/Ahli. 14 fireplace 23.32
r Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
tzl PROPERTY OWNER ,Liii ❑ TENANT Environmental exhaust and ventilation:
Name: ,)/7)Mi.Zra !t p COE S/6/1/ i_L C/ - 1 l k ir/ Range hood/other kitchen
equipment 33.39
Address:
/3--- //6, Am/C AA7b- eit/T Clothes dryer exhaust 33.39
City/StateZIP: 6��L , / �' �2 9 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone: (j', _,) j'(!4, -f,-77'j Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT W 0 CONTACT PERSON ' Other: 23.32
Business name: Fuel piping:
�/Y P eC*S a $14.15 for first four;S4.03 for each additional
Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range j 1t'1 t 15
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
6. MECHANICAL PERMIT FEES*
Address: Subtotal /-/,
City/State/ZIP: Minimum permit fee($90.00) q1i
Plan review(25%of permit fee) —
Phone:( ) Fax:( ) State surcharge(12%of permit fee) c
CCB lie.: TOTAL PERMIT FEE iW.�)
This permit application expires if a permit is not obtained within 180
/�'1, _�� days after It has been accepted as complete.
gnature: d ,(.L�,,_7 Lr---�. * Fee methodology set by Tri-County Building Industry Service Board
--A/1)17W d. 69,e)7- ,e 11 Date: ; /lf1ldv
I:\Building1Permea\MEC_PertuitApp_040113.doc 440-4617T(11/02/COMMrEB)
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 fast$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.
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