Permit CITY OF TIGARD MECHANICAL PERMIT
1111 2 - _, COMMUNITY DEVELOPMENT Permit #: MEC2011 -00145
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2011
Parcel: 1 S 136AD01901
Jurisdiction: Tigard
Site address: 6910 SW OAK ST
Project: Batteron Subdivision: Lot: 0
Project Description: Installation of gas line for new range.
Contractor: HOLMES INSTALLATION SERVICE Owner: BATTERON, CONNIE
33535 NW VADIS RD 6910 SW OAK ST
CORNELIUS, OR 97005 TIGARD, OR 97223
PHONE: 503 - 647 -9320
PHONE: 503 - 245 -8330
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 04/06/2011 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 04 /06/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/06/2011 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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
iss ce, or if we is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
tility Notification Cent- The e 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 OUN • p • ^13.232.1987 or 1.800.332.2344.
Issued By: / / Permittee Signature: 0. 4A/J4----
•
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 FOR OFFICE USE ONLY
City of and
Ti Recetvea DateBy: ��� Permit No.:
1 ,.off �l�/ g
M I
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639 Date Ready/By: Julia. RI 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 Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. I
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
let and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
s: �^� Air conditioning or heat pump
Job site addres
5'� (i 4r ` 5 .1 (requires site plan showing placement) 14.00
City/State /ZIP: ' ( qua, i a e_. y 72 z3 Furnace 100,000 BTU ( ducts/vents) 14.00
// Furnace 100,000+ BTU (ducts/vents) 17,90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
.-• / Gas fireplace 10.00
-i% G 4 S fro, o, f ate 4 6 �-5 k, c_._ Flue vent for water heater or gas
✓ f / fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
X PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 10.00
111 Other: 10.00
Name: Co" e... 6 `„,. (.,/ Environmental exhaust and ventilation
o�/ Range hood/other kitchen
Address:
61 S ® p i_ s y - equipment 10.00
City/State/ZIP: j r Gir 0 one. 7 2 2 3 Clothes dryer exhaust 10.00
) 21
Single-duct compartments, exhaust (bathrooms,
Phone: � 3 3'0 Fax ( ) toilet t compartmrtments, utility lity rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range . X
CONTRACTOR Barbecue
Clothes dryer (gas)
Business n t eV ... 5A / Other:
Address: / i S / y ( S �*' MECHANICAL PERMIT FEES*
City /State/ZIP: C stn G,f OS O i t f 7// 3 j Subtotal
7 Minimum permit fee ( . t di r
Phone: ( 9332__ ( 9332_ ( 9332__1.7 -7 Lit Fax: ( )
Plan review (25% of permit fee) ..--------'
CCB lic.: i ti Z % f 7 3 State surcharge (8% of permit fee) /Q ,$C)
L� � TOTAL PERMIT FEE �' f)
Authorized signature: _�( G /V This permit application expires if a permit is not obtained within 180
// "" / l / days after it has been accepted as complete.
Print name: g A Q I,N5 Date' L l L l/O2/COMB)
* Fee methodology set by Tr-County Building Industry Service Board
I:uilding\PermitsC- P!1'mit APP .doc 01/19/07
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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