Permit CITY OF TIGARD MECHANICAL PERMIT
E1 COMMUNITY DEVELOPMENT Permit#: MEC2015-00490
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2015
Parcel: 2S103BB06100
Jurisdiction: Tigard
Site address: 12600 SW 124TH AVE
Project: WESTWOOD HOMES LLC Subdivision: BROOKWAY Lot: 61
Project Description: Installing 6 ft.of gas line to move gas meter.
Contractor: CENTRAL AIR LLC Owner: WESTWOOD HOMES LLC
PO BOX 433 12700 NW CORNELL RD
CLACKAMAS, OR 97015 PORTLAND, OR 97229
PHONE: 503-656-1908 PHONE:
FAX: 503-650-3898
FEES
Specifics: Description Date Amount
Fuel Piping 07/21/2015 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 07/21/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 07/21/2015 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.801 - . ••
Issued By: ee signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE ( SE ONLY
Received
City of Tigard Permit No.:13125rSW HalBlvd.,Tigard,OR 9722taiN DateBy: �� i1I _/ .
7 Phone: 503.718.2439 Fax: 503.598.19 Plan Review Date/By: Other Permit:
!AGAR!) Inspection Line: 503.639.4175 1 ,tp1C3 Date Ready/By: ® ® See Page 2 for
Internet: www.tigard-or.gov ,u` 2 1 Notified/Method: ,— Supplemental Information
1, 7,r�
. Mechanical permit fees*are based on the value of the work
❑New construction OAddition/alterat. performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
•
1-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
Heating/cooling:
Air conditioning 46.75
Job site address: /2 COO 51A/ IZ`l fit . Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: l l CQ y,,, 0R q1.2.2 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.. I 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: I 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
S
,r i - il 7C1.1 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 PROPERTY OWNER
/ Environmental exhaust and ventilation:
Name: Wec 4/C.'()/ p S L( Range en`
equipment kitchen 33.39
Address: 12.4{C A)Vl (0/0-ell (2O
Clothes dryer exhaust 33.39
City/State/ZIP: Po l a r di O R (17.7 2 '7 Single-duct exhaust(bathrooms,
/ / toilet compartments,utility rooms) 23.32
Phone:(x;71 ) 6 ig- SG(g Fax:( ) Attic/crawlspace fans 23.32 ,
Other: 23.32
Business name: 4'4 44 1 t 5 ✓✓l Ov P Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) I Fax::( ) Fireplace
Range
E-mail: Barbecue
Clothes dryer(gas) _
/ _ 0 / Other: ii. ()
Business name: �(�l/t I t'r
Address: p c. �Gf,X- 933 Subtotal 01 ,1 5--
City/State/ZIP: G(oCe-6t P✓,ac/ OR q70/5 Minimum permit fee($90.00) q0.Qt.,
Phone:( )l� 6� — I 9n� Fax:( ) Plan review(25%of permit fee)
State surcharge(12/o of permit fee) Jo. j
CCB tic.: (q�/- 9 TOTAL PERMIT FEE $kV. 'it
v This permit application expires if a permit is not obaided within 180
days after it has been accepted as complete
Authorized signature: /1/ • Fee methodology set by Tn-County Building Industry Service Board
Print name: /2 ! to 1 Date: 2(/24/j
I:\Building\Permita\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil Fee Schedule:
$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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2