Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Permit#: MEC2020-00136
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/10/2020
TIC;;\R 1-) 9 Parcel: 25109AB03300
Jurisdiction: Tigard
Site address: 13424 SW MOUNTAIN RIDGE CT
Project: Cole Subdivision: THREE MOUNTAINS ESTATES Lot: 26
Project Description: Replacing(1)master bathroom bath exhaust fan.
Contractor: IN YOUR HOME Owner: COLE, FREDERIC J JR&ANN
16869 SW 65TH AVE#332 13424 SW MOUNTAIN RIDGE CT
LAKE OSWEGO, OR 97224 TIGARD, OR 97224
PHONE: 503-819-0245 PHONE: 971-708-5053
FAX: 503-598-7790
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 03/10/2020 $23.32
Type of Use: COM Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/10/2020 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 03/10/2020 $66.68
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth pp OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by Catlin 50 .232.1987 o b0.332.2344.
Issued By: Permittee Sig e:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Appli i`� FOR OFFICE LSE ONLY
CI Of Tl and ` E i V E D Received .0./ )
g Date/By: ,5 /�G/�►MIMi Zvi i,,. 1 -7:76-.61
• 13125 SW Hall Blvd.,Tigard,OR 9722,3 Plan Review
_ Phone: 503.718.2439 Fax: 503.598. 61R v 1 I ULU Date/By: Other Permit:
T I G ARD Inspection Line: 503.639.4175 Date Ready/By: 1mis: El See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
,wgi, `
;,", ( WORK x').. COMMERCIAL F SCHEDULE - USE CHECKLIST
f.
Mechanical permit fees'are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
value:$ 'j ��
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPM O '_SYSTEMS.FEES*
lil I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Aeating/caoling:
(� ,. Air conditioning 46.75
Job site address: \lj yZ LkSW �oovalrAtes tE+�Le_ or . Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 'N tc6e7t 0 1Lk Furnace 100,000+BTU(ducts/vents) 54.91
A� Q. g2.1- Heat pump 61.06
Suite/bldg./apt.no.: Project name: C.o\, _ Duct work 23.32
Cross street/directions to job site: \33 r S L✓.,s ST 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
�et SW `(ca�YNr0o- . 'sRoW�ir LrWr• fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name: Q h s. �o\1- Range hood/other kitchen
equipment 33.39
Address: ti•y,6LLN S W Vi.c�YA.-p{,yN, . CA, Clothes dryer exhaust 33.39
City/State/ZIP:Z4%vv-A4:5 O1') '�ZL-k J_, Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 1 23.32 2 3.3Z
Phone:(91 N) • 6 5 - S O S b Fax:( ) Attic/crawlspace fans 23.32
APPLICANT ❑ CONTACT PElO Other: 23.32
Fuel piping:
Business name: I.e. �\our th $14.15 for first four;$4.03 for each additional
Contact name: Mt V\tx,0•4\ \\ Furnace,etc.
Gas heat pump
Address: \t. b 5 t,k3 10 5 6 Wall/suspended unit heater
City/State/ZIP: 1...0\t.o. O5 w,e4s b'Q- C%1 D b s Water heater
(503) %Ls. i$Z�
Phone: Fax::( ) Fireplace
Range
E-mail: VAN 40.�0.r Q D r�, • '1 t-k o f70, . co VY\ Barbecue
v CONTRACTOR Clothes dryer(gas)
Business name: O-
ther.
S O,M tL ix-, li-6ev-53- 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 lie.: 1 S 7 7 37 l` ( l j72/ TOTAL PERMIT FEE
This permit aon expires Ira permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: Fee methodologypplicati set by Tri-Coon y Building Industry Service Boa d
Print name:��NSrq,Q,, Date: z �o`?.b=.O
I:\BoildingW ermits\MEC_PermitApp_040113.dnc 440.4617E(I1/a2/COM/W EB)