Permit CITY OF TIGARD MECHANICAL PERMIT
'°'! s COMMUNITY DEVELOPMENT Permit#: MEC2015-00159
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/24/2015
Parcel: 2S111CB01742
Jurisdiction: Tigard
Site address: 10425 SW HOODVIEW DR
Project: Dukelow/Koppes Subdivision: HOOD VIEW NO.2 Lot: 41
Project Description: Replacing bathroom exhaust fan.
Contractor: CORNERSTONE BUILDERS INC Owner: DUKELOW, OWEN
7849 SW CIRRUS DR KOPPES, LAURA
BEAVERTON, OR 97008 10425 SW HOODVIEW DR
TIGARD,OR 97224
PHONE: 503-671-9538 PHONE:
FAX: 503-671-9640
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 03/24/2015 $23.32
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/24/2015 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 03/24/2015 $66.68
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow •_ . -_ ... ed by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo may • ain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
L
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard 8.'I �S— Permit No.: � _
13125 SW Hall Blvd.,Tigard,OR 97223 r■
Plan Review
Phone: 503.718.2439 Fax: 503.598 �/ Received
By: Other Permit
T I G A R n l nspection Line: 503.639.4175 �j E I V ED Date Ready/By: Juris r. See page 2 for �, t
Internet: www.tigard-or.gov Notified/Method: lro Supplemental Information
MAR 2 4 2015
E OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑Nev, construction Addition/
�'I�It��eD}11�1Si� performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
m l-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: /0 y Zs— SLA/ 1001, '1£ V✓ /t- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: T'4 '"y I "�'� Furnace 100,000+BTU(ducts/vents) 54.91
J 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
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
n ,�� Flue vent for water heater or gas
U ��t-.14— &1,111/ r ■/ fireplace . 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) j 23.32 .3- --
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: r_ fir, Us 9e//��
J° y 514.15 for first four;54.03 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 AA_
Clothes dryer(gas)
Business name: C 12�' hfrv�»,s , Other:
MECHANICAL PERMIT FEES*
Address: 7179 ,S w CItr J. 7)j ,27.'3,;.,
f�!'--' Subtotal
City/State/ZIP: /1 s - p� )7 go 8 Minimum permit fee($90.00) .�
Phone: t�/ Plan review(25%of permit fee)
�3) ci 7/ - 9 S3 Y Fax:( ) State surcharge(12%of permit fee) /v,py
CCB lic.: i 7 0(e 5Y TOTAL PERMIT FEE if/O.V
V 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:
: � /0/■/ L SIA--/ Date: 3 44 /,,-
,
1\Building\Permits MECC_PermitApp_040113.doc
440-46171(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 Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10425 SW HOODVIEW DR, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00159
David Young
Violation Summary:
Inspector Contractor