Permit (2) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2020-00023
Date Issued: 01/13/2020
T 1 G A It o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 151351)610SM
Jurisdiction: Tigard
Site address: 11090 SW 95TH AVE
Project: KASINGER Subdivision: ASHBROOK FARM Lot: 22
Project Description: Adding NC,replacing furnace,replacing range hood,replacing(2)fans,and adding(1)fan.
Contractor: THE HVAC TEAM Owner: KASINGER, STEVEN
PO BOX 854 11090 SW 95TH AVE
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 971-322-5013
PHONE: 503-268-7458
FAX: 503-352-9349
FEES
Specifics: Description Date Amount
Air Conditioning 01/13/2020 $46.75
Type of Use: SF Furnaces<100K BTU 01/13/2020 $46.75
Class of Work: ALT Type of Const: Range Hood/Other Kitchen 01/13/2020 $33.39
Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 01/13/2020 $69.96
Stories: Utility Rooms)
12%State Surcharge-Mechanical 01/13/2020 $23.62
Fuel
Fuel Types:
Gas Pressure:
Total $220.47
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Sp.. • Codes an. all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not s :rted within 80 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rule- adopted b the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may .btain a o• of the rules
or direct questions to OUNC by ling 503.232. 87 or 1.800. 2.2344.
� r
Issued By: Permittee Signature `ek..
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 • oject.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE I Sli ON I.,
/ 63 e'�OAp-tZ L3
City of Tigard Received •
Date/By: i w t
11111 ° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
_ Phone: 503.718.2439 Fax: 503.598.1960 DateBy: 'P 9"nrzk!//Cj --/Y(3G2
!.I t i A F U Inspection Line: 503.639.4175 Date Ready/By: Js'/- Hi 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 TgAddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
PT 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special iafrnrnation use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND L CATION Heating/cooling:� 1 Air conditioning I 46.75
Job site address: 1 1 CAD V v j CI Furnace 100,000 BTU(ducts/vents) I 46.75
City/State/ZIP." , ./]t.-_i,V �� '7"�'�_.!j Furnace 100,000+BTU(ducts/vents) 54.91
1C e ,r� J
Suite/bldg./apt.no.: Project name: Heat pump 61.06
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
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
n Flue vent for water heater or gas
- 1 Y2'12 pye p� -F tom fireplace 23.32
�� �e/f rf/.�ic/ "' - ✓aa t`G LogWood/pellet
23.32
q! Wood/pellet stove 33.39
k ati,,/ /4ta// X e [�lacr.6,- 62) (Gt ptc Wood fireplace/insert 23.32
a
� f �4 �` r/ f /� t1 ��G Other: /liner/flue/vent 23.32
l/f/Ul PROPER WNER✓) dhoJ ❑ TENSE 23.32
Environmental exhaust and ventilation:
Name: -1} �� \ �_-p Range hood/other kitchen
'� equipment 1 33.39
Address: S�f �1 �
Clothes j� dryer exhaust 33.39
City/State/Z : er j �^- Single-duct exhaust(bathrooms,
t� toilet compartments,utility rooms) _ 5 23.32
Phone:(' ) Fax:( ) Attic/crawispace fans 23.32
I APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Cj41,7,\ C)D.,ive.,--,it__ $l4.15 for first four;$4.03 for each additional
Contact name: t/Grit Furnace,etc.
Address O, v cpLg 4 Gas heat pump
7" Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: V 1— A Other:
MECHANICAL PERMIT FEES*
Address. 0. op..l` 5[ �/ /�'� Minimum permit fee Subtotal
City/State/ZIP: �r� en Il 1 /. /"`� ($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( State surcharge(12%of permit fee)
CCB lie.: t� 1 GI v TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within l80
days after it has been accepted as complete.
Authorized si tur i * Fee methodology set by Tri-County Building Industry Service Board
Print name: Date: a4b 4v62.4
Vaunding\Permits\ C_Fermi[App_a401 I Ids, 1 TiT (II/t2/COM/WEB)