Permit • CITY OF TIGARD MECHANICAL PERMIT mg
114 _ COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00493
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/8/2007
PARCEL: 1 S 133DD -16500
SITE ADDRESS: 11994 SW 129TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT: 201 JURISDICTION: TIG
PROJECT: CHIN
Project Description: Gas line to range.
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP WOODSTO
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
LARRY & ELAINE CHIN Description Date Amount
11994 SW 129TH
TIGARD, OR 97223 [MECH] Permit Fee 8/8/2007 $72.50
[TAX] 8% State Surcha 8/8/2007 $5.80
Phone: 503 -579 -1994 Total $78.30
Contractor:
HOME COMFORT
15185 SW CHRISBEN CT.
BEAVERTON, OR 97007 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 644 -9468
Reg #: LIC 161706
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.
Issued By :
A c e Permittee Signature: / `�� C ( - \
Call 503.639.4175 by 7:00 a.m. for inspections that busi99/ess 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.
Mechanical Permit Application ECEI VE 9 FOR OFFICE USE ONLY
Mill City of Tigard Date/By: 3 � Permit No,: �b 3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 AUG Receiv . 2001 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: lur 0 See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ❑ Addition/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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 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: I ‘. 4- S t / i 29,- F1•,� e. Air conditioning or heat pump
' � p (requires site plan showing placement) 14.00
City/State/ZIP: �l A`D 0 K ..-2-3 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
"
y— 5 Flue vent for water heater or gas
fireplace 10.00
(=;(« 1 '� e - —t—e) R Log lighter (gas) 10.00
UU Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: LAW 2 ca C-4- Environmental exhaust and ventila tion
Address: t \ C 4 Sw 12q R_ertg. Range equipment ood/other kitchen 10.00
City/State /ZIP: �l 6, Z3 CJ c'7 2243 Clothes dryer exhaust 10.00
l Single -duct exhaust (bathrooms,
Phone: ( 93) S 1' — [ j'Q Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace 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: Clothes dryer (gas)
Other:
Address: / G ?" C g, l S 564 MECHANICAL PERMIT FEES*
City/ State/ZIP: ' 1 e IOC I Subtotal
Phone: 903 )6_ 94/ 4 Fax: ( ) Minimum permit fee ($72.50)
/ /,,,, Plan review (25% of permit fee)
CCB lic.: 1 17 O. , /0/7)0 a V State surcharge (8% of permit fee)
/�` �� TOTAL PERMIT FEE �j �
p
Authorized signa This permit application expires if a permit is not obtained within 180
CA
. days after it has been accepted as complete.
Print name: * ` ' 1 t / Date: a 1 13 7 " Fee methodology set by Tri- County Building Industry Service Board
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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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