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Permit CITY OF TIGARD MECHANICAL PERMIT "! t ; COMMUNITY DEVELOPMEN Permit #: MEC2013 00365 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/02/2013 Parcel: 2S102BA04700 Jurisdiction: Tigard Site address: 9865 SW JOHNSON ST Project: Pearce Subdivision: 2006 -010 PARTITION PLAT Lot: 1 Project Description: Install (3) vent fans in bathrooms. Contractor: OWNER Owner: HAWKINS, SARAH C PEARCE, MATTHEW PEARCE, MATTHEW S 9865 SW JOHNSON ST 9865 SW JOHNSON ST TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 - 747 -9863 PHONE: 503 - 747 -9863 FAX: FEES Specifics: Description Date Amount Single Duct Exhaust (Bathrooms, Toilet, 07/02/2013 $69.96 Type of Use: SF Utility Rooms) Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/02/2013 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 07/02/2013 $20.04 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 Not enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dire questions to Oh C by calling 503.232.1987 or 1.800.332.2344. Issu = d By: Permittee Signature: ■ IL, 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 Appli ,r FoR OFFICE USG 0i�1 :Y II q City g E IV ED D a teiv ed Q A P ermit No.: _ 1`�6e,�d3 —a� 34 of Ti and / 13125 SW Hall Blvd., Tigard,OR 9 y 7 Pl Phone: 503.718.2439 Fax: 503.598.13gpg3� 2 2013 D Dan Review ate Other Permit: Inspection Line: 503.639.4175 JUL T I G A K D p Date Re Ready /By: hid s: ® See Page 2 for Internet: www.tigard - or.gov an C , «,' /y�{yy��p „� Notified/Method: Supplemental Information ± DIVISION FEE* TYPE . ' 1 WIG COMMERCIAL FEE SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction (I 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* Ml- 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 Heating/cooling: 786,--- Air conditioning 46.75 Job site address: s W . 3 tlyxso',, s i--, Furnace 100,000 BTU (ducts/vents) 46.75 City /State /ZIP: 7%:yoeeit 0 2 X17 7.2 3 Fumace 100,000+ BTU (ducts/vents) 54.91 Heat pump 61.06 Suite/bldg. /apt. no.: Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 /± Residential boiler (radiator or nsVn S C7 0 . K • } - / � V hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Flue /vent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map /parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas �4 w 13‘4.-NA. hS fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 0 PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: NSA 4. Few..., e, equipment od/other kitchen 33.39 Address: 4' d 6 5 S w TiAet al S 0 A S = Clothes dryer exhaust 33.39 City /State /ZIP: Tj /el D 2 q 7223 Single -duct exhaust (bathrooms, toilet compartments, utility rooms) 3 23.32 / ' 9 Y Phone: (503) 79-7, erg .j3 Fax: ( ) Attic /crawlspace fans 23.32 APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: O .JV Mr' $14.15 for first four; $4,03 for each additional Contact name: 0' i c4 ii-- ' eciy' c e. Furnace, etc. Address: 7 g6 s - 5 t ,,, 0- ns 6v, S} Gas heat pump Wall /suspended/unit heater City /State /ZIP: •7 c � G � J ( 223 Water heater Phone: (5)) 71' _ q $ 63 Fax: ( ) Fireplace ry � ��/'� Range E -mail: S f 0 7o�c y I.tc. 1 G ✓` » . 0 '1 Barbecue r CON RACTOR Clothes dryer (gas) t , \ E(� Other: Business name: ( ` J MECHANICAL PERMIT FEES* Address: Subtotal City /State /ZIP: Minimum permit fee ($90.00) (...1 . mt5 Plan review (25% of permit fee) Phone: ( ) Fax: ( ) State surcharge (12% of permit fee) /0 . ErC) CCB lie.: TOTAL PERMIT FEE 700. f((, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: / • Fee methodology set by Tri- County Building Industry Service Board Print name: Date: I:\ Building\ Permits \MEC_PermitApp_040113.doc 440 -4617T (I I /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. I:\Building\Permits MEC_PermitApp_040I 13.doc 2