Permit q CITY OF TIGARD MECHANICAL PERMIT
`f"! COMMUNITY DEVELOPMENT r Permit#: MEC2015-00167
Date Issued: 03/26/2015
T t CiARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.24 /MOH
Parcel: 2S112CD01300
Jurisdiction: Tigard
Site address: 15905 SW 79TH AVE
Project: Buchanan Subdivision: DURHAM ACRES Lot: 4
Project Description: Replace a/c,placement of a/c unit must comply with manufacturer's clearance requirements. 4/6/15,reprinted to
correct address from 15915 to 15905 SW 79th Ave.
Contractor: DONS AIR CARE INC Owner: BUCHANAN, MICHAEL R&SHEILA
PO BOX 6408 15905-15915 SW 79TH AVE
ALOHA, OR 97007 TUALATIN, OR 97062
PHONE: 503-642-5844 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 03/26/2015 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 03/26/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/26/2015 $43.25
Occupancy Grp: Misc Administration Fee 04/06/2015 $45.00
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $145.80
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 Notific- - . 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 q -stions to OUN .y callin. 03.232.1987 or 1.800.332.2344. .______.
..6
Issued B : V ' / ,/ I' Permittee ignature: ), ��! /
- L'
Call 503.639.4175 by 7:00 a.m.for the next available ins• tion date.
This permit card shall be kept in a conspicuous place on the job si e 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#: MEC2015-00167
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2015
Parcel: 2S112CD01300
Jurisdiction: Tigard
Site address: 15915 SW 79TH AVE
Project: Buchanan Subdivision: DURHAM ACRES Lot: 4
Project Description: Replace a/c,placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: DONS AIR CARE INC Owner: BUCHANAN, MICHAEL R&SHEILA
PO BOX 6408 15905-15915 SW 79TH AVE
ALOHA, OR 97007 TUALATIN,OR 97062
PHONE: 503-642-5844 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 03/26/2015 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 03/26/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/26/2015 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
iss or • , is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
ility Notification Cen Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0091 ou may obtain a copy of the rules
or direct questions to OUN • g 503.232.1987 or 1.800.332.2344.
4pi de'
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard E C E I V E D B _. ' Permit N �, —�S
Er I
ii 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
a Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD
Inspection Line: 503.639.4175 MAR 2 6 2015 Date Ready/By: Juri s la See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE OF kkitiliKDING DIVISION COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
e–'-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 INFORMATION AND LOCATION Heating/cooling:
Q �+'- r 72 ../k Air conditioning 1 46.75
Job site address:
/ /- t�/ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: —1 4(3n e c7ZLd 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
n Residential boiler(radiator or
�r///`i�,`L`I/ v 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
�Weft , (J j fireplace 23.32
` Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
At–PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
gi t e, pName: r -�' rte' Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: .-,.� f�-, Single-duct exhaust(bathrooms,
�l���9- �br' f 77i 2.9 toilet compartments,utility rooms) 23.32
Phone:( ) " Fax:( ) Attic/crawlspace fans 23.32
Ia APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:
�r�
rf Fuel piping:
S ✓ $14.15 for first four;$4.03 for each additional
Contact name: sp a.ti'c /Ct _N v Furnace,etc. ,
Address: 6 `�11/0.i Gas heat pump
pot Wall/suspended/unit heater •
City/State/ZIP: A �-4_ eel-- ?7o,7' Water heater
�N )�Z �/�`1/4 ( ) Fireplace
Phone: d Fax:: - •
Range _ •
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas) - •
Business name: Other:
36144■2•2 MECHAN ICAL PERMIT FEES*
Address: Subtotal
p
Minimum ermit fee($90.00) 9t 7 s
City/State/ZIP:
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) /O.0r) _
CCB lie.: CziY4' 43/6- TOTAL PERMIT FEE /00.ire,
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: , ~ L� • Fee methodology set by Tri-County Building Industry Service Board
Print name: Du t 4 l..d Date: ?/2)/rr
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617f(I1/02/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