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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00292 - "' Date Issued: 06/17/2009 TI 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S104CA09700 Jurisdiction: Tigard Site address: 1.3728 -SW TAMAWAY_L•N Subdivision: Lot: 0 Project: Doan Project Description: Move gas piping for bbq. Owner: FEES DOAN, JASON & KARA Description Date Amount 13728 SW TAMAWAY LN TIGARD, OR 97223 Fuel Piping 06/17/2009 $5.40 12% State Surcharge - Mechanical 06/17/2009 $8.70 PHONE. Minimum Fee Adjustment - Mechanical 06/17/2009 $67.10 Contractor: FLANDERS JR 33535 NW VADIS RD CORNELIUS, OR 97005 PHONE: 503 - 647 -9320 FAX: Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressue: Total $81.20 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 Center. 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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Nip to . Permittee Signature: , Cv " ` 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. ..1VI,et Mechanical Permit Application � ' .FOR OFFICE U ON LY h a` ,r " ` 1121 Cl of Tigard ' i i "1 1 l i s Received c7�(� 0 �, City g �^v 1 � r 1 T.� ■ } Date/By: Permit No: i C V ..1. l l Y </ 13125 SW Hall Blvd., Tigard, OR 97223 .� -.: \ �' . Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date /By. Other Permit: T.t G, Inspection Line: 503.639.4175 JUN 17 2009 Date Ready/By: H See Page 2 for . - Internet: www.tigard - or.gov Notified/Method: ,Supplemental Information CITY OF TIGARD TYPE OF WORK DdVISIOW COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work 0 New construction VAddition/alteration/replacement 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* X1 and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Ileating/cooling Job site address: C (� Lin) Air conditioning or heat pump r 7� { ✓._ /�� (requires site plan showing placement) 14.00 City /State /ZIP: \ n Q� � D 0 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 t • p Gas fireplace 10.00 -9e�, i*t `J J i 1 4 C p tip NIA rov 4k. Flue vent for water heater or gas C c U 'K fireplace 10.00 )) �L Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: i q ' 0 .... 3 97/ j -0 A Environmental exhaust and ventilation ( 26 S� I ^ , A / L _ I Range hood /other kitchen Address: (� J 1l-� Z/yvth) , W fv equipment 10.00 City /State /ZIP: 1 ,,,,,,, v e■Y`e-' Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone .) sq '` / 7Oc 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 X Business name: L ( C_.� so- Clothes dryer (gas) Other: Address: 7 ?S f N� V \S"' ` l� MECHANICAL PERMIT FEES* City /State /ZIP:: C3 i, ( ( S � 0 !� ( 7 ,'l j Subtotal Phone: )) 2)0 7 7l' 1 5 Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: ( O 2 l i--- 3 State surcharge (12% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: o? ^ days after it has been accepted as complete. A Ft Print name: ( 1) (',L Date: GA 7/0 5 * Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitAppd 01 /19/07 440- 617T( COM/vEB) 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: \Building\Pennits\MEC- PermitApp.doc 01/19/07 2