Permit CITY OF TIGARD MECHANICAL PERMIT
'` :� COMMUNITY DEVELOPMENT Permit#: MEC2020-00124
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.719.2439 Date Issued: 02/27/2020
Parcel: 2S110DC90021
Jurisdiction: Tigard
Site address: 15695 SW 114TH CT 2
Project: Fountains at Summerfield Subdivision:TAINS AT SUMMERFIELD CONDO-PH. Lot: 2
Project Description: Replacing(1)clothes,washer
Contractor: RKC LLC Owner: BROCK, PAUL W
PO BOX 1270 15695 SW 114TH CT#2
SHERWOOD,or 97140 TIGARD, OR 97224
PHONE: 503-330-3771 PHONE: 503-332-5169
FAX:
FEES
Specifics: Description Date Amount
Type of Use: MF Range Hood/Other Kitchen 02/27/2020 $33.39
Class of Work: ALT Type of Const: Single Duct Exhaust(Bathrooms,Toilet, 02/27/2020 $46.64
Utility Rooms)
Occupancy Grp: Occupancy Load: Minimum Fee Adjustment-Mechanical 02/27/2020 $9.97
Stories: 12%State Surcharge-Mechanical 02/27/2020 $10.80
Project Valuation: $0.00
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces < 100K BTU: 0-3 HP:
Furnaces>= 100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $100.80
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
s
Call 503.639.4175 by 7:00 a.m.for the next available inspection e.
This permit card shall be kept in a conspicuous place on the job site until co letio f the project.
Approved plans are required on the job site at the time of each inspe ion.
Mechanical Permit Application FOIt OFFICE USE ONLY
City of Tigard 1E�i�.IVE$ Received• )] P
Date/By: r/�/prl 'PlT 0 �,2 )"l!Kii -/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review s✓�
a Phone: 503.718.2439 Fax: 503.598.1960 FEB 2 7 2020 Other Permit:
Dale By:
T I G K I) Inspection Line: 503.639.4175 Date ReadyBy: Iuria: Id See Page 2 for
Internet: www.tigard-or.gov d 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/SYSTEMS FEES*
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: /S_lC 7 S .- ' f/`7 i 2_,
"- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -�-r4 kb <i '7,7 7 c./- Furnace 100,000+BTU(ducts/vents) 54.91
/ C Heat pump 61.06
Suite/bldg./apt.no.: P ine: TL IL'.4 ay- GLU✓Yvtlk itct 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
Flue vent for water heater or gas
! ,4?!ct wins..1" Or- (.1)) h,-- ✓ rY1 9--.G1-1.QtiG,9" fireplace 23.32
c1 av4 0` K /, Log lighte Wood/pelletgas) 23.32
J �7r�( stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen g
equipment i 33.39 33.3ti
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) pZ 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
r Fuel piping:
Business name: ` j
V -(v
514.15 for first four;S4.03 for each additional
Contact name: t f I S 6'fl-1(s J }?��(, Ls�J Furnace,
Address: ?O . ?Ls).( P70 Gas heat pump
Wallsuspended/unit heater
City/State/ZIP: .S0- ,J 0C 6 e- 7 fqD Water heater
Phone:( ) 2)3. - / (p( Fax::( ) Fireplace
Range
E-mail: �/
- ' I' — Barbecue
CONTRAC(Y TOR Clothes dryer(gas)
Business name: Other:
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: ''.--2,, , --/// TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatu1 * Fee methodology set by Tri-County Building Industry Service Board
Print name: cf,!(,(2%S i iha, //fG GC r 7 )
I:\Building\Permits'MEC PemtitApp_040113.doc 440-4617r(I 1/O2/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\Pemvts\MEC_PermitApp_040113.doc 2