Permit IL CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2020-00397
TfGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/30/2020
Parcel: 2S112BB00200
Jurisdiction: Tigard
Site address: 14010 SW HALL BLVD
Project: Gurin Subdivision: WILSON ACRES Lot: 1
Project Description: Installing(1)bathroom fan.
Contractor: OWNER Owner: GURIN, CHRISTINA J&TED A
TED GURIN 14010 SW HALL BLVD
14010 SW HALL BLVD TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 971-409-2838 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 06/24/2020 $23.32
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/24/2020 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 06/24/2020 $66.68
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: t22
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application +` I FOR OFFICE.lisE ONI.1
City of Tigard ��']1ECEt V ED ‘/ J�� /'�w y ,6 1� " /
iiiq 13125 SW Hall Blvd.,Tigard,OR 9722Plan 3 DII y' l- )0 /��I A C%f/DjY�/��/� (
C Phone: 503,718.2439 Fax 503.598.1960 1 DaterBeview f)(iie / i��/
TIGARD inspection Line: 503.639.4175 �uN 1 1 2�•. Crate
Internet' www.ti and-or, ov Dace Ready/By: is See;'age 2 for
g B r',1TY O1-' 116AHD Notifted/Method: Supplemental Information
TIPS OF WORK COMMERCIAL FEE* SCHEDULE -USE CHECKLIST
Mechanical permit foes*are based on the value of the work
❑New construction p Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
— Value:$
CATEGORY OF CONSIRUCI lO\ RESIDENTIAL EQUIPMENT/SYSTEMS FEES"
® I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building Far special information use checklist
❑Multi-family 0 Master builder 0 Other: flsrription I Qty. Ea. Total
JOB SITE 1NFORDfn4
` , kaVD LOCATION
Heating/fooling:
�+` Air conditioning 46.75
Job site address: /trot° 44r 13ly4 • Furnace 100,000 BTU(ductslvems) 46.75
City/State/ZIP: 77,54 v ot 1 012... 17 p.� Furnace 100,O00+BTU(ducts/vents) 54.91
Suite/bldgJapt•no.: Project name: PIaS4etr BA D 61.06
Duet work
23.32
Cross street/directions to job site: r-let1.t J,4 c n')c1d« llydronic hot water system _ 23.32
4'� �' p Residential boiler(radiator or
�I�L"t. 7� Aot,A .S 4-• 'ct..l tL I h1 U n Yive..:,47"E hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75 •
Fluelvent for any of above 23.32
Subdivision: Lot no.: Other. 23.32
Other fuel appliances:
Tax map/parcel no.: 12,0 61 I. 6(s7s Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
--------- - Flue vent for water heater or gas
`nS-1- . I 13 01- 1/i vc,a v'n fit{ci•, fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove , 33.39 ,
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
{II PROPERTYOWNER ❑ rENAN1 Other. 23.32
Environmental exhaust and ventilation:
Name: -I4\ Range hood/other kitchen
1� C 4 . ,
`` '' � 1- equipment 33.39
Address:
t4-0 ( 0 $w t"'fAt 31 Vd ' Clothes dryer exhaust 33.39 ,
City/State/ZIP: �(E9CR ( 0Iz .1??•2-� Single duct exhaust(bathrooms
7 toilet compartments,utility rooms) j 23.32 ,'j)-
Phone:(771 ) tiff 0 of- -.5.-.8' Fax: ( ) Attic/crawispacefans 23.32
0 APPLICANT i ❑ CONTACT PERSON °liter: _ 23.32
Business name:
Fuel piping:
$14.15 for first four;S4.O3 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater e i 14.15
City/State/ZIP: Water heater
Fireplace
Phone:( ) Fax::(
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: t'�l J yf r-/ O her:
4fECHA\1CALY'ER 417T FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee(S9O.0O) ektiTh
Plan review(25%et permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit.fee)
CCB lic.: TOTAL PERMIT FEE /0•o`"
This permit application expires if a permit Is not obtained within 180
�n days after it has been accepted as complete.
.Authorized signature: 6 —_ . Fee methodology set by 7ri-County Building Industry Service Board
Print name: i lei 6tktrIin Date: C9/11/20 24D
1:1Buildinefermaa MEC_PemiiApp 040113.doc 440.4617r(1 t/03/COMAVEa)