Permit 1-:
CITY OF TIGARD MECHANICAL PERMIT
74,::. ,,:,a :.._ Permit#: MEC2015-00813
COMMUNITY DEVELOPMENT
Ali Date Issued: 12/03/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
:-I Parcel: 2S110CB11700
Jurisdiction: TIGARD
Site address: 15166 SW HARVEYS VIEW AVE
Project: Southview Heights Subdivision: SOUTH VIEW HEIGHTS Lot: 5
Project Description: Installation of a/c unit
Contractor: COMFORT ZONE HEATING&AIR COND Owner: STONE BRIDGE HOMES NW LLC
1032 NW CORPORATE DR 4230 GALEWOOD ST, STE 100
TROUTDALE, OR 97060 LAKE OSWEGO, OR 97035
PHONE: 503-667-5595 PHONE: 503-387-7577
FAX: 503-491-8252
FEES
Specifics: Description Date Amount
Air Conditioning 12/03/2015 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 12/03/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/03/2015 $43.25
Occupancy Grp: Investigation Fee 12/03/2015 $90.00
Stories: Investigation 12%State Surcharge 12/03/2015 $10.80
Fuel
Fuel Types:
Gas Pressure:
Total $201.60
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y• may obtain a copy of the rules
or direct ques • OUNC by calling 503.232.1987 or 1.800.332.2344.
/ . P -Issued By /',,, Permittee Signature: // / . - °.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Tigard t. 1� Received j��/�/ /�/�
City of 1 Igi11 U Date/By: �a Permit No.: H✓ego!5"q• /gt 3
Ill 14 13125 SW Hall Blvd.,Tigard,OR 97223
CPlan Review
/11.- Phone: 503.718.2439 Fax: 503.59814.14Other Permit: „
i Date/By: '-/- .-7.7-.:;,7. ..: i
Ins
Inspection Line: 503.639.4175
T I G A R U p 1- 1\G DateoReady/By:Metho See Page fnr
Internet: www.tigard-or.gov d Q J Notified/Method: Supplemental Information
,aCc�-
TYPE OF WORK i A S,tk;N. COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
New construction ❑ Addition/alteratid�b0 OW performed. Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other: eitI mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
461-
1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
bMulti-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
y_ /jA Air conditioning 46.75
+
Job site address: 1 J ( 1fro/V-4..-{1 V•( N) Ail''
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: I cf n(L 01722,1 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: sbOfhti;,' tvts Duct work 23.32
Cross street/directions to job site: 5J I,2, (4.tA 94Ree1 { / Hydronic hot water system 23.32
erre
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: 23.32
Subdivision: 5fi.'f'k yr bQ 1, 1ill t5 Lot no.: 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
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
[�PROPERTY OWNER ❑ TENANT -
1 Environmental exhaust and ventilation:
Name: c n.t 134(1' *mu; N W Range hood/other kitchen
J�
equipment 33.39
Address: (-12,2)0 (-lilts `ot..,d 91. j S v E k_ 00 Clothes dryer exhaust 33.39
City/State/ZIP: La/ 04-0a€10 /J bp_ q?0-5‘ Single-duct exhaust(bathrooms.
toilet compartments,utility rooms) 23.32
Phone:(5b7)) 3g 7. '157 Fax:( -;$2.2) '� ,.1(�1 ' Attic/crawlspace fans 23.32
, APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: C)(^ , C4S
G)►NV) $14.15 for first four;$4.03 for each additional
Contact name: D't.f vcJ F5 of Furnace.etc.
Address: Gas heat pump •
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) �{/� ' t '_, Fax: :( ) Fireplace •
)�✓�`1 -K/ �'i0"�- 00d?-141:11/611.5 ��f Barge
E-mail: �v�/r��� Barbecue
CONTRACTOR Clothes dryer(gas)
P„ [6 Other:
Business name: W 12,5i)"•<-' MECHANICAL PERMIT FEES*
Address: Subtotal
049
City/State/ZIP: Minimum permit fee($90.00) qQ.
Plan review(25%of permit fee) ----"-'
Phone:( ) Fax:( ) del,90
State surcharge(12%of permit fee)
CCB tic.: TOTAL PERMIT FEE Fe).60
This permit application expires if a permit is not obtained withinc180
�/ days after it has been accepted as complete./ett-O O
Authorized Signature e � * Fee methodology set by Tri-County Building Industry Service l3oag
i
Print name: 19�vl viA4 VdUf---- Date: 1/2/paii �i. eop
I:\Buildinu\Permits\MEC_I'ei mil App_401 I3.doc 440-4617T(I 02/COM/WBI3)
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.
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