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Permit 74 q CITY OF TIGARD MECHANICAL PERMIT s: ° . COMMUNITY DEVELOPMENT Permit #: MEC2009-00646 T I G XR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/03/2009 Parcel: 1 S 135ACO3700 Jurisdiction: Tigard Site address: 9330 SW OAK ST Subdivision: Lot: 0 Project: Davis Project Description: Permit existing furnace under crawl space. Owner: FEES FOREIGN MISSION FOUNDATION INC Description Date Amount 10875 SW 89TH AVE Furnaces < 100K BTU 12/03/2009 $46.75 TIGARD, OR 97223 12% State Surcharge - Mechanical 12/03/2009 $10.80 PHONE: 503 - 246 -5862 Minimum Fee Adjustment - Mechanical 12/03/2009 $43.25 Contractor: UNIVERSAL PLUMBING 8811 SW SPRUCE ST TIGARD, OR 97223 PHONE: 503 - 452 -7480 FAX: Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressue: 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 Notific • teter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct estions to OUN.0 by calling 503.246.6699 or 1.800.332.2344. Issued f ` 1 • A e - Permitte Signatu�: ,` `irr Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. Mech Permit Applicat' FOR OFFICE USE ONLY CI of Ti and C EIVED Received /��� � N,/ ,i A / �J g Date /By: r 7 Permit No.: Er 13125 SW Hall Blvd., Tigard, OR 97 2 Plan Review Phone: 503.639.4171 Fax: 503.598.19 Other Permit: SE C 0 3 20 D a te/B y TIGARD Inspection Line: 503.639 Date Ready /By ridir See Page 2 for Internet: www.tigard or.gov Notified /Method: pplemental Information CITY OF TIGARD TYPE OFRINN(U DIVISION . COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑New construction ddition /alteration /replacement Mechanical permit fees* are based on the value of the work 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* l.. 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling � ��� s � � ©A4z C Air conditioning Job site address: I (requires uires site plan showing placement) 46.75 City /State /ZIP: •-j t' 6 4y ©a 4 223 Furnace 100,000 BTU (ducts /vents) 1 46.75 x `75 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Q e ' Hydronic hot water system 23.32 (04 ,h Q�iW 4 / cl ,4 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 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 P A,64 „ II exs jst 1 Fix-i1/4/ d-e-� Flue vent for water heater or gas Q /� / p fireplace 23.32 U A-dv"� ev,u,) � S1,"v�— Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /I finer /flue /vent 23.32 liii PROPERTY, OWNER '� 1-� Name: 19 e 0 d ❑ TENANT Other: 23.32 , Environmental exhaust and ventilation p Range hood /other kitchen Address: / (g • 3 j R E1-. equipment 33.39 City /State /ZIP: . 'Co Aye( © e k c 7-22y Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (.5-o3) Z 5 Z. Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: ()N t u e,S41 - wyt� ( ;') Fuel piping Contact name: Au " d j� - 0/41Z191 $14.15 for first four; $4.03 for each additional Address: y` per, Furnace, etc. �S. I t w .S P Ot S4 Gas heat pump City /State /ZIP: - 0 (L 9722S Wall /suspended/unit heater Phone: (5 03) 452 7 Fax: : ( ) 0614 er., Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: A-30 () Other: Address: la 5,401 P / js MECHANICAL PERMIT FEE$k City/State /ZIP: I Subtotal Minimum permit fee ($90.00) - 10 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lic.: /g 5 , Z/ Z State surcharge (12% of permit fee) /a, go TOTAL PERMIT FEE / 7 , DO This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: AA (Z. o, Date: `' - 2-c y ' Fee methodology set by Tri- County Building Industry Service Board I. \Building \Permits \MEC- PermitApp doc 10/01/09 440 -4617T (I I /02 /COWWEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation. „r, 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. 1:\Building \Permits \MEC- PermitApp.doc 10/01/09 2