Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2014-00239
T IGAAO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/19/2014
Parcel: 1S126DB05100
Jurisdiction: Tigard
Site address: 9483 SW 92ND AVE
Project: Steiner Subdivision: MONTAGE Lot: 22
Project Description: Installation of a/c unit. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: BULL MOUNTAIN MECHANICAL Owner: STEINER, KENNETH L&DANIEL R
6520 ROSEMONT ST 9483 SW 92ND AVE
LAKE OSWEGO, OR 97035 TIGARD, OR 97223
PHONE: 503-612-6677 PHONE:
FAX: 503-692-3084
FEES
Specifics: Description Date Amount
Air Conditioning 05/19/2014 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 05/19/2014 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 05/19/2014 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility I'cation .= ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or di ct questions to O C • a g 503.232.1987 or 1.800,332.2344.
Iss ed By: ,/ / // Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFI( 1. 1 SE 0\1.1
City of Tigard Received permit No.:
11111 II • 13125 SW Hall Blvd.,Tigard,OR 97223 DaeRe 5 �L��� �C��3�
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
l'I G A R D Inspection Line: 503.639.4175 Date Ready/By: furls. ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
and 2-family dwelling ❑Commercial/industrial ❑Accessory building
F
Multi-family 0 Master builder ❑Other: Description For special information use checklist.
I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75
Job site address: 9 14.s,3 560 ci a-KJ +A-C._ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Po{ �1 fr,,,11 l.J� 9 .- a 3 3 Furnace 100,000+BTU(ducts/vents) 54.91
1 r Heat pump 61.06
Suite/bldg./apt.no.: Project name: 54_.e...) ,may _ A—C Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
‘'CO Residential boiler(radiator or
W mAr, s4 1 -' 9. --':-.21A-v.,, / 1vwc 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
(A� Flue vent for water heater or gas
V‘S}� 1T
1 I -C-- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 _
Chimney/liner/flue/vent 23.32
Other: 23.32
I C PROPERTY OWNER ❑ TENANT
/ Environmental exhaust and ventilation:
Name: Ke s ,, rt e r Range hood/other kitchen
.9 equipment 33.39
Address: s,3 5 W cy r--1. _ Clothes dryer exhaust 33.39
City/State/ZIP: o,(-{—SAY—c4 g D_ 3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( )$.e h L.5k r fr'o bxth r_r_,) Attic/crawlspace fans 23.32 _
VI aa APPLICANT ❑ CONTACT PERSON Other: _ 23.32
Business name:fJ Fuel piping:
t 1 t r I �k h�A to + ea 1'�S f iC- '1 -r%sc,.-la. $14.15 for first four;$4.03 for each additional_
Contact name: Vv,y.t. N a,,se n p r LAA.urc, }-f ri c c r--. Furnace,etc.
Address: (5 ZO $to IZvSe_yY.vri- S� 1 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: L A_fie`, OSW e_sp, 621L„ el -3--05 Water heater
Phone:(5-0 3 ) (Q la__(,Co 3:9... Fax::(50 ) 61. -— 308 Fireplace
Range
E-mail: 1--)e-1(r) ( b t.,k 11 1-r-__a,k r 1,,.\ ✓V\e,L. 60 r--- Barbecue _
CONTRACTOR Clothes dryer(gas)
Other:
Business name: ‘C Q� ip i,L 1' MECHANICAL PERMIT FEES*
Address: Subtotal 4-tri-5-
City/State/ZIP: Minimum permit fee($90.00) ?o.''
Phone:( ) Fax:( Plan review(25%of permit fee)
) IV State surcharge(12%of permit fee) 7O•ff0
CCB lic.: 1 5-3 g 14 TOTAL PERMIT FEE loo. 96
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: 4,,a„....,..._. hi, arts-e-L1 • Fee methodology set by Tri-County Building Industry Service Board
Print name: Day(.Q ,.‘L H a-vt 5 e. -, I Date: G _ 1 -I
I:\Building\Pennits\MEC_PmnitApp_040113.dac 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.
1:\Building\Permits\MEC_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9483 SW 92ND AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
May 27, 2014 at 8:29:23 AM
MEC2014-00239
Jeff Grove
Violation Summary:
Inspector Contractor