Permit CITY OF TIGARD MECHANICAL PERMIT
9
COMMUNITY DEVELOPMENT Permit#: MEC2016-00028
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/19/2016Parcel: 2S102ACO0800
Jurisdiction: Tigard
Site address: 12551 SW MAIN ST
Project: Kady Subdivision: BURNHAM TRACT Lot: 1
Project Description: Raise and replace gas piping.
Contractor: OWNER Owner: FINKE,ALEX &LOTTI
KADEY, GEORGE S JR
12551 SW MAIN ST
TIGARD, OR 97223
PHONE: PHONE:
FAX
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/19/2016 $75.20
Class of Work: ALT Type of Const: VB Plan Review 01/19/2016 $18.80
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/19/2016 $9.02
Info Process/Archiving-Sm$0.50(up to 01/19/2016 $0.50
Stories: 11x17)
Project Valuation: $700.00
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 chn
Gas Pressure. Units> 10000 cm:
Furnaces Boilers 8 Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces>= 100K BTU. 3-15 HP
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP.
Vents w/o Appliances. 50 or Greater HP'.
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $103.52
Hoods. Comm Incinerators:
Woodstoves: Gas Fireplaces. Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Lose
Duct Work
Fire/Smoke Dampers.
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 2.2344. J
Issued By: Permit gnature: 7 S
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. ^
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site al the time of each inspection.
Mechanical Permit Application
Received
City of Tigard Date/By. �( Pe mh No.:
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.71X.2439 Fax: 503.598.1960 nRe ' �� other Permit
rr 'By:
Inspection Line: 503.639.4175 C u� to Ready. p orris. ® See Page 2 for
IntemM: www.tigard-or.gov �E IIIJJJ NotiredMethod:� �'f /�j^ Supplemental Information
OR.WORK... kFSY_. .::,.. Or CONn3E.RCUL,FEE' ECICLiS
.SCREDULE - USE CNT
Mechanical permit fns'are based on the value of the work
❑New construction �Addition/alteration/replacement performed. Indicate the value(rrundod to the nearest dollar)ofall
E]Demolition El Other: L,II Y Ur ll�� mechanical materials,a ui menL labor,overhead,and profo.
- - Value:$ -�-
EES•❑ CATEGORY,OF CONSTR ..RE$IDENTIAL EQUIPMENTISYSTEMS FEES-
E] I-and
I-and 2-family dwelling gCommercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑ Master builder ❑Other: Description Qty. I Fa. Total
JOB SITE INFORMATION AND LOCATION Heatin coolin :
Air conditioning 46.75
Job site address: Furnace 100.000 BTU(duct,sent,) 4675
City'State ZIP: T r Furnace 100.000BTU(ducts cents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 1 I RE Duct work 23,32
Cross street/directions to job site: H dionic hot wales system 23.32
Residential boiler(radiator or
S C(Ll /f-c = hvdmnic) 23.32
Unit heaters(fuel-type,not electric).
in-wall,in-duct,suspended,etc. 46"75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fire lace/insen 33.39
Flue vent for water healer or gas
C ,T J fireplace 23.32
Log lighter((gas) 23.32
Woodspellet stove 33.39
Wood fir Iace/inscn 23.32
Chimney,lineir thick cat 23.32
❑ PROPERTY OWNER . ❑ TENANT Othn: 23.32
Environmental exhaust and ventilation:
Name: '4- �e Z Rangehood/other kitchen
l e ui ment 33.39
Address:
S 2(c.. Q Clothes dryer exhaust 33.39
City/State/ZIP: ��[= �p'7�'Z3 Single-duct exhaust(bathrooms.
� toilet compartments,utility rooms) 23.32
Phone:($o3i -3-30 — c?rC2V Fax:( 1 PkJ &--e Auiderawls ace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$13.15 for first four;$3.0;for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall susfndedunit healer
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Firc lace
Ran e
E-mail:
Barbecue
CONTRACTOR Clothes driver((gas)
Business name: Other:
e-f MECHANICAL PEEI1pTFEW
Address: Subtotal
City/Stale/ZIP: Minimum permit fee($90.00)
Plan reeiew(25%ofpermil fee)
Phone:( ) Fax:1 ) State surcharge(12%(if permit fee)
CCB lie.: TOTAL PERMIT FEE
Phis permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ,�6'y� S / ' Fee methodoin, act hr I i4 oumv Building Industp Scn ice Board
Print name: b-
I'..Bulldini,Pcmtilx MLC PenniNpp 040111 doe 440-0617[(11 02 COM W1 In
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-F mily 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.
IBuilding PannitsMEC-PennitApp_040113doc 2