Permit CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2014-00465
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/26/2014
Parcel: 2S 111 AD07900
Jurisdiction: Tigard
Site address: 8860 SW SCHECKLA DR
Project: Loverso Subdivision: SCHECKLA PARK ESTATES Lot: 12
Project Description: Gas fireplace installation with venting.
Contractor: R& D INSTALLATIONS Owner: TORRES,VICTOR AND
5246 SE 62ND LOVERSO, DIANA
PORTLAND, OR 97206 8860 SW SCHECKLA DR
TIGARD, OR 97224
PHONE: 503-774-7142 PHONE:
FAX: 503-774-7142
FEES
Specifics: Description Date Amount
Gas Fireplace 08/26/2014 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 08/26/2014 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: 12%State Surcharge-Mechanical 08/26/2014 $10.80
Stories: Minimum Fee Adjustment-Mechanical 08/26/2014 $33.29
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adop -d by th Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain copy of he u or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1 �
Issued By: •-•• ittee Signature: „A.2 =� 1 ki
/Li rte- - _
Call 503.639.4175 by 7:00 a.m.for the next available inspe 'on •,te.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application I'UR ul'I1 I I sl ()NI 1
Received
City of Tigard Permit No.: -• . —
13125 SW Hall Blvd.,Tigard, 97223 DateBy: I ' �7i y �4 �p�j
-Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
Inspection Line: 503.639.4175 r_ r
I I c.;\I:l> p Date ReadyBy: B See 'age 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
RiociiiNi.0 4
0\
TYPE OF WORK nt�Cj 4L6 Z COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
W Mechanical permit fees*are based on the value of the work
❑New construction PS Addition/alteration/r;
algi
tt _,* performed.Indicate the value(rounded to the nearest dollar)of all
ID Demolition Other: j �� mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONST i1"� ■_ ~ Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Al-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INF RMATION AND LOCATION Ileating/cooling:
Job site address: S e SGN I G k l di Air conditioning 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: j-i rA J A/'d Q,A \O1 '7 ILL' Furnace 100,000+BTU(ducts/vents) • 54.91 _
/ Heat pump 61.06
Suite/bldg./apt.no.: Project name: LOoC.rS. Duct work 23.32
Cross street/directions 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 F WORK Gas fireplace/insert . 33.39 33.3.1
J'1/1r Flue vent for water heater or gas
5 1 c tie( pf a c'e fireplace 23.32 .
V �T I PL, O k S Log lighter(gas) 23.32
S Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: M f-. i (,5 Lo 1 J f J/`5 Range hood/other kitchen
V equipment 33.39
Address: 6 66 O 51)0 A 56 II e_ cK (4 Clothes dryer exhaust 33.39
City/State/ZIP: +16,4 V a g* \ Single-duct exhaust(bathrooms,
((�� toilet compartments,utility rooms) 23.32
Phone:(51)7) 72_,t) )3 )I Fax:( ) Attic/crawlspace fans 23.32
iej APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: 9--0 S IVA+ow S ��„y ,- Fuel piping:
��� $14.15 for first four;$4.03 for each additional
Contact name: flCA r10 6 . Furnace,etc.
Address: Z,�b J& ,2_,4 Gas heat pump
` J �4 j�� Wall/suspended/unit heater •
City/State/ZIP: d t'T a Fes, al Z— T� Water heater •
Phone: `7I yZ Fax::( ) Fireplace •
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: L, Other:
A'1/1 MECHANICAL PERMIT FEES*
Address:
Subtotal 5-6,-7
City/State/ZIP: Minimum permit fee($90.00) 7o-GC,
Plan review(25%of permit fee) —
Phone:( ) Fax:( ) State surcharge(12%of permit fee) 10,ire)(
CCB lie.: 5 1 TOTAL PERMIT FEE /tk).$'c,
A..)bOL 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: n ` I ` D t) Date:€ -L 6 - i
\
I:\BuildingPermitsMEC_PennitApp_040113.doc 440-4617T(11/02/COM/WE
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$1 00.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
L\Building\Permits\MEC PennitApp 040113.doc 2