Permit IR
II CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00455
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/24/2007
PARCEL: 2S104DA -01900
SITE ADDRESS: 13344 SW 128TH PL ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - WEST LOT: 005 JURISDICTION: TIG
PROJECT: RIVANO
Project Description: Add an a/c unit.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ANTHONY RIVANO Description Date Amount
13344 SW 128TH PL
TIGARD, OR 97223 [MECH] Permit Fee 7/24/20W $72.50
[TAX] 8% State Surcha 7/24/20W $5.80
Total $78.30
Phone: 503- 747 -0779
Contractor:
HARDY PLUMBING + HEATING
14689 NE COUNTRYSIDE
AURORA, OR 97002 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 222 -9654
FAX 503- 678 -4498
Reg #: LIC 60947
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
(----)Thr.N I
Issued Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections 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.
anical Permit Application
e n FOR OFFICE USE ONLY
City of Tigard Received
g � Permit No.: •�
• LI 13125 SW Hall Blvd., Tigard, OR � + ' .Received
0 z . �� •�
Phone: 503.639.4171 Fax: 503. ' 8 I r . ; other Permit:
TIGARD Inspection Line: 503.639.417 4 Date Ready/By: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: 0711 Supplemental Information
jUL 2 ''- 2007
TYPE COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
��� �` ` Mechanical permit fees* are based on the value of the work
❑ New construction Wil Addi ' ..
A performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: v mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
gg..1- 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
Job site address: / Air conditioning or heat pump
1 S W ��� �� (requires site plan showing placement) } 14.00
City/State /ZIP: '7-7 6, )fr Y / 401e 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
/'- D fJ A- 1 ( Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
q PROPERTY OWNER ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: I2 1 Ni F)---' D Environmental exhaust and ventilation
Address: 13 3 r f S w } , R v p
Range other kitchen
7 l equipment 10.00
City /State /ZIP: 17 4' . t PI( Clothes dryer exhaust 10.00
p Single -duct exhaust (bathrooms,
Phone: (" 1 ) 9) D"� � 1 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawispace fans 10.00
Other: 10.00
Business name:
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
CONTRACTOR Barbecue
Business name: My `/ P 2 i g e., / 1 � 7 7 J 1 Clothes dryer (gas)
Other:
Address: ) q 1,?-1 / 1 �I`� fl (PVC 7 -Ay S / o n pie MECHANICAL PERMIT FEES*
A
City/State /ZIP: v , Q q "'1) h2 Subtotal
so
Phone: ( 2 ) / ). ")., C I L, S F a x: ( 3 ) t 'i
) . ') -! Minimum permit fee ($72.50) 7-2 .
� � _ Y Plan review (25% of permit fee)
CCB lic.: ie Q ') State surcharge (8% of permit fee) S . y n
TOTAL PERMIT FEE . " ---- S" - .3 D
This permit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete.
Print name: \ I Date: ) . ', y - 5) * Fee methodology set by Tri County Building Industry Service Board
I:\ Building \PermitsVMEC- PermitApp.doc 01/19/07 440-4617T ( I 1/02/COM/WEB)
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.
I:1Building\Permits\MEC- PermitApp.doe 01/19/07 2
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