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Permit CITY OF TIGARD MECHANICAL PERMIT 11 q 1 COMMUNITY DEVELOPMENT 1 Permit #: MEC2013 -00650 Date Issued: 10/29/2013 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109DA13900 � � Jurisdiction: Tigard Site address: 12685 SW MOUNT VISTA CT Project: Armstrong Subdi • : ARLINGTON HEIGHTS NO.3 Lot: 58 Project Description: Replacing exhaust fan. 12/9/13, reprinted to add ductless split system. Placement of ground unit must comply with manufacturer's clearance requirements. Contractor: COPASETIC CONSTRUCTION INC Owner: ARMSTRONG, BRIAN P 3958 SE WAKE ST. 12685 SW MOUNT VISTA COURT MILWAUKIE, OR 97222 TIGARD, OR 97224 PHONE: 503 - 513 -9435 PHONE: 503 - 915 - 3777 FAX: FEES Specifics: Description Date Amount Heat Pump 10/29/2013 $61.06 Type of Use: SF Single Duct Exhaust (Bathrooms, Toilet, 10/29/2013 $23.32 Class of Work: ALT Type of Const: Utility Rooms) Occupancy Grp: Minimum Fee Adjustment - Mechanical 10/29/2013 $5.62 Stories: 12% State Surcharge - Mechanical 10/29/2013 $10.80 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 Util otification -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may obtain a copy of the rules direct questions to Ob C b ailing 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Cf� Cc 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. CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2013-00650 T IG ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2013 Parcel: 2S109DA13900 Jurisdiction: Tigard Site address: 12685 SW MOUNT VISTA CT Project: Armstrong Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 58 Project Description: Replacing exhaust fan. Contractor: COPASETIC CONSTRUCTION INC Owner: ARMSTRONG, BRIAN P 3958 SE WAKE ST. 12685 SW MOUNT VISTA COURT MILWAUKIE,OR 97222 TIGARD,OR 97224 PHONE: 503-513-9435 PHONE: 503-915-3777 FAX: FEES Specifics: Description Date Amount Single Duct Exhaust(Bathrooms,Toilet, 10/29/2013 $23.32 Type of Use: SF Utility Rooms) Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/29/2013 $10.80 Occupancy Grp: Minimum Fee Adjustment-Mechanical 10/29/2013 $66.68 Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application e roR OFFICE USE ONLY City of Tigard .,Ir�a't. \1 `d., " Received _ q ��'A �+ Date/By: 0 pliT J3 , Permit No.:13125 SW Hall Blvd.,Tigard, 97223A "'"., ' C g a *, y ` Plan Review .' Phone: 503.718.2439 Fax: 503.598. : 0' ch `L01 Other Permit Ms1 J Date/By: TI G A R D Inspection Line: 503.639.4175 ' G"\ g Date Ready/By: ® See Page 2 for Internet: www.tigard-or.gov O 0\ l�1 Notified/Method: Supplemental Information TYPE OF WOW,ic\A�'W.I' COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ' \ ;� �e. Mechanical permit fees'are based on the value of the work ❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF-CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES" *1-and 2-family dwelling ❑CommerciaUindustrial ❑Accessory building For special information use checklist. • ❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: �C _ � \ ' �� Air conditioning (ducts/vents)) 46.75 Job site address: '/ ` Furnace 100,000 BTU ducts/vents 46.75 City/State/ZIP: --"t ri.+VA b?:2, Furnace 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 �\C‘021)` ' 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 WO K Gas fireplace/insert 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 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: a. ` Range hood/other kitchen 11 equipment 33.39 Address: Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 - ❑ APPLICANT ❑.CONTACT PERSON Other: 23.32 Business name: Fuel piping: $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) Business name: Ck� � Other: �,� \ ,MECHANICAL PERMIT.FEES*. Address: L.-7 \ Subtotal 2 3. 5 City/State/ZIP: l\l�_ © Minimum permit fee($90.00) 40 , r Phone: -r$ ) ' �1 Fax:( ) Plan surcharge(25%1 %of permit fee) State surcharge(12/o of permit fee) 0 CCB lic.: 411' 4 ' —j/3 j it 5— TOTAL PERMIT FEE /00,,1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorize rR•• atur- • Fee methodology set by Tri-County Building Industry Service Board Print name: ., Id%\' \' . Date{ --pt-3 I:\Building\Permits\MEC PermitApp_0401 13.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_040113.doc 2