Permit CITY OF TIGARD MECHANICAL PERMIT
. "` ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00242
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/01/2011
Parcel: 1 S125DC06900
Jurisdiction: Tigard
Site address: 7169 SW ASH CREEK CT
Project: Joeger Subdivision: ASH CREEK ESTATES Lot: 2
Project Description: Install a/c unit. Unit must meet minimum 3 foot side and rear yard setbacks.
Contractor: WILFERT SHEETMETAL + HEATING Owner: JOEGER, JIM
430 NW 231ST AVE 7169 SW ASH CREEK CT
HILLSBORO, OR 97124 TIGARD, OR 97223
PHONE: 503 -648 -1561 PHONE:
FAX: 503 - 547 -0329
FEES
Specifics: Description Date Amount
Air Conditioning 06/01/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/01/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/01/2011 $43.25
Occupancy Grp:
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 - ■ -r. Those rules are set forth in OAR 952 -001 -0010 through OAR 952- 001 -0090. You ma • .tain a copy of the rules
or direct qu ins to OUN , g 50 32.1987 or 1.800.332.2344.
Issued : y: / Permittee Signature: l/ /
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 Tigard Received 6 'me � Permit No.: k- ga i y.-- o:4 2
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/Ry: Other Permit:
TI G A R D Inspection Line: 503.639 Date Read /B md5
Ready /By: ® 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.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
g)
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
Multi- family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning t ,
Job site address: '7(6 9 J' C e- c-7 Y
(requires site plan showing placement) / 46.75 o 7 C
City /State /ZIP: 7-�� C /
Furnace 100,000 BTU (ducts /vents) 46.75
1 / Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
WC-- OF WORK Water heater 23.32
d �� GTE C Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
[PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
( r Other: 23.32
Name: j / ■ 3 -' Environmental exhaust and ventilation:
Address: Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT CONTACT .PERSON Attic /crawlspace fans 23.32
/ Business name: Other: 23.32
�
Fuel piping:
Contact name: J�,t� J LC. i m.e /f/r /Le. $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: (5-03 799 — ? 03 Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: C j / /,,I- ,5 4 f 7�r l� Clothes dryer (gas)
Other:
Address: C /?J w l✓ 23 . f MECHANICAL PERMIT FEES*
City /State /ZIP: /7 ,2, d/Z 9 ?(Z V Subtotal W. if
Phone: ( _c o)) b / g.._ X ( Fax: (T ) ) X ' ? - 0)2_ 5 Minimum 25% fee r it fee
Plan review (25% of permit fee)
CCB lic.: 7 ie S 3 S tate surcharge (12% of permit fee) / , tJ
TOTAL PERMIT FEE /00. ft v
Authorized signature: /� / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 5 A., L. _4.0tx_ Date: e- /' I / / * Fee methodology set by Tri- County Building Industry Service Board
I.\ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -4617T (11 /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: 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.
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