Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013-00529
T t GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718 2439 Date Issued: 09/19/2013
Parcel: 1 S135DA00400
Jurisdiction: Tigard
Site address: 11180 SW HALL BLVD
Project: Bergmann Subdivision: METZGER ACRE TRACTS Lot: 13
Project Description: Ductless heat pump installation. Unit must comply with manufacturer's clearance requirements.
Contractor: DAMAR HEATING INC Owner: BERGMANN FAMILY TRUST
P.O. BOX 56327 BY BERGMANN, KENNETH L&DONNA J
PORTLAND,OR 97238 TR
10726 SW 63RD PL
PORTLAND,OR 97219
PHONE: 503-236-6344 PHONE
FAX. 503-236-6552
FEES
Specifics: Description Date Amount
Heat Pump 09/19/2013 $61.06
Type of Use: SF 12%State Surcharge-Mechanical 09/19/2013 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/19/2013 $28 94
Occupancy Grp:
Stories:
•
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503 232 1987 or 1 :11 .32.2344.
Issued By: % Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Folz OFFICE: USE ONLY
City of Tigard Received 4 .4 ,..,/ Permit No. — d } -
13125 SW Hall Blvd,Tigard,OR 97223
1 Plan Review As -
C. Phone: 503 718 2439 Fax: 503.5':,,i1 1�+�O Date/By. Other Permit re 15—
Inspection Line 503.639.4175 ;, Date Read /B -. See Page 2 for •
rlcnliD 2� Ready/By g
Internet www tigard-or.gov 1 9 13 Notified/Method Supplemental Information
SEP 1 0.�
TYPE OF W ��+116 COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
I� 1St Mechanical permit fees*are based on the value of the work
ID New construction A Addition alt ¢(tt>�lent performed.Indicate the value(rounded to the nearest dollar)of all
12 Demolition ID Other: �SU1 mechanical materials,equipment,labor,overhead,and profit.
Value.$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Z1.1-and 2-family dwelling ❑CommerciaUindustrial ❑Accessory building For special information use check list.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: I t -(D c Li) ,'c 1 l /(I ` Furnace 100,000 BTU(ducts/vents) 46 75
City/State/ZIP: �% 6,� ci v2 ' Ja Z., Furnace 100,000+BTU(ducts/vents) 54.91
c Heat pump / 61.06 G/,d�
Suite/btdg./apt.no.: ) Project name: P w r^ .,r1 Duct work 23.32
Cross street/diredions to job site: 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
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
/) Ac-fie-)S 4,261-p&, ,. . fireplace 23.32
Log lighter(gas) 23 32
Wood/pellet stove 33.39
Wood fireplace/msert 23.32
Chimney/liner/Flue/vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other 23.32
Environmental exhaust and ventilation:
Name: /< Q Range hood/other kitchen
Q ✓' e✓ Gr.Gn,'--
Address: equipment 33.39
h l,_I G 3~��/ Clothes dryer exhaust 33 39
City/State/ZIP: U i �C c Z Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:60--. ) ' , cc 1 _oZ/9 -3 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other 23.32
Fuel piping:
Business name:
w. 0 r„ S e,l-,.. P $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
1 Other.
Business name: /J �� I e c.._ / 'i n MECHANICAL PERMIT FEES*
Address: 9 u R a , S (. 30 v Subtotal 6/,(J(,
City/State/ZIP: YI).,_. -1_,,, U Q s -,, _ (3a Minimum permit fee($90.00) ljd-00
Plan review(25%of permit fee)
Phone:(S',, -?„) , ,.1(,'L 3y q Fax:( ) State surcharge(12%of permit fee) la 87 _
CCB tic.: as- ii I(0/I? TOTAL PERMIT FEE ion, Fr•
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: l<'Q •, !�G /J • Fee methodology set by Tn-County Building Industry Service Board PI
Print name: '�5 "^' ' (�h-�S l Date: C{ -is_L3
1 lBuddmgTermits\MEC PermitApp_040113 d 4404617r(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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