Permit CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2015-00390
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2015
Parcel: 1 S 136AA08700
Jurisdiction: Tigard
Site address: 10048 SW 70TH PL
Project: Bridges Subdivision: VENTURA ESTATES Lot: 9
Project Description: Installation of a/c unit. Placement of unit must comply with manufacturer's clearance requirements.
Contractor: DANNYS HEATING AND COOLING INC Owner: WEST COAST HOME SOLUTIONS LLC
16303 NE 36TH ST PO BOX 1969
VANCOUVER,WA 98682 LAKE OSWEGO, OR 97035
PHONE: 503-914-8058 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 06/17/2015 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 06/17/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 06/17/2015 $43.25
Occupancy Grp: Investigation Fee 06/17/2015 $90.00
Stories: Investigation Mechanical 12%State 06/17/2015 $10.80
Surcharge
Fuel
Fuel Types:
Gas Pressure:
Total $201.60
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notifi - •• enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire •uestions to O► C : c. ing 503.232.1987 or 1.800.332.2344.
Issucld By: k /i/iC Permittee Signature: y
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Appliccq *n 1.()R ()I, lc l: I tit Oil l
City of Tigard RDecatee/Biveyd: &A�eb71 Permit No.: 0 e,7 JS ei3 jc)
;� .1 13125 SW Hall Blvd.,Tigard,OR 9'�z�3,
S ►6p Plan Review
Phone: 503.718.2439 Fax: 503.598.1 1 7 2015 Date/By: Other Permit:
I WARD Inspection Line: 503.639.4175 Date Ready/By: mss: Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental S Information
�zI(Ill/OF l''IiGAIW
TYPE�O 'W 1 I' DIVISION COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
Al New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
Multi-family El Master builder El Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: /D 10(,I 5 W -D 1 L Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: +i 80-Ca, OR-- i 7 ),23 Furnace 100,000+BTU(ducts/vents) 54.91
!`v / 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
Other: _
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater .
DESCRIPTION OF WORK Gas fireplace/insert . 33.39
Flue vent for water heater or gas
iLr 1( Mc__ V n i ‘-- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
N.
Other: 23.32
PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: _\ct�+ �, B ,&o,p R Range hood/other kitchen
v "' ,�{, equipment 33.39
Address: to Q 141 J "7O it FL Clothes dryer exhaust 33.39
City/State/ZIP: `ot 04..d 0 g 7 7-2-3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(3a) Li. .2_,.... ciy`/to Fax:( ) Attic/crawlspace fans 23.32
R APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Da.A n b is 7�a{ L Ab q co D i t fUv
$14.15 for first four;$4.03 for each additional
Contact name: t1 i u 2, �ROV Furnace,etc.
Address: !J J Gas heat pump -
Wall/suspended/unit heater
City/State/Z1P: Water heater
Phone:(3 3) 71 i'— so 51 Fax: :( ) Fireplace ,
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
■Business name: f)/5411), S ��'C� f� 9 Zoo f: tl Other: MECHANICAL PERMIT FEES*
Address: /63 3 D 3 IV '�b� T L Subtotal
City/State/ZIP: V,9.4'\C O we 1ms q' O 6 O 7i Minimum permit fee($90.00) 9e 00
Phone:( j3) 71 4... Q 0 Fax:( ) Plan review(25%of permit fee) -`—
p s- State surcharge(12%of permit fee) /0.600
CCB lic.: ( t1 7'Stir l TOTAL PERMIT FEE 1M.g p
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: Z./ et jt,t.../.-- • Fee methodology set by Tri-County Building Industry Service Board
Print name: tJatl fvtA 2,4,60,n Date: 6 - I 7 - s /_ 1 /e sr;a4- j/� X --
I:\Building\Permits\MEC_Permit pp_040I13.doc 440-4617T(11/02/COM/WEB) N ^ , f'Q
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.
L\Building\Permits\MEC_PermitApp_040113.doc 2