Permit (14) 11111 CITY OF TIGARD MECHANICAL PERMIT
le ' COMMUNITY DEVELOPMENT Permit#: MEC2016-00151
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/07/2016
Parcel: 2S 102CA00245
Jurisdiction: Tigard
Site address: 9735 SW FREWING ST
Project: FAY Subdivision: FREWING'S ORCHARD TRACTS Lot: 22
Project Description: Furnace conversion,electric to gas.
Contractor: AIR COMFORT INC Owner: HAMPTON PLACE LLC
16055 SW 74TH AVE SUITE B BY FAY, JERRY
TIGARD, OR 97224 PO BOX 6027
PORTLAND, OR 97228
PHONE: 503-309-2525 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 03/07/2016 $46.75
Type of Use: SF Fuel Piping 03/07/2016 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/07/2016 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 03/07/2016 $29.10
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
issuanc- • i is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit Notification Cent- Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or'-irect questions to OUN •y :fling 503.232.1987 or 1.800.332.2344.
Is ued By: // /AI 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.
r
`Mechanical Permit A IVEP FOR OFFICE USE ONLY
Cityof Tigard Received / (� i �/6 d0/6I
g Date/By: 5 7 �t0 Permit No.: ��
13125 SW Hall Blvd.,Tigard,OR 97 ��yy3 r� Plan Review
• Phone: 503.718.2439 Fax: 503.5Bi60 /
Date/By: Other Permit:
I I GARD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov I `f[ 1 J 1�I f s 17t1i R Notified/Method: Supplemental Information
t t I I
II ,
411,.44- L COMMERCIAL FEE* SCHEDULIE IUSE t:TECICLIST
Mechanical permit fees*are based on the value of the work
❑ 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:S
Er
CATEGORY RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
I-and 2-fancily dwelling ❑ Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
N Heating/cooling:
IIIIIIIIIInIIIIIIJob site address: 1`)
Air conditioning 46.75
/ 33 - K/ �/1-G41 c,07, Furnace 100,000 BTU(ducts/vents) t 46.75
City/State/ZiP: ! 0'11
',� Furnace 100,000+BTU(ducts/vents) 54.91
v 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
;>"� *x `' Gas fire lace/insert 33.39
DESCRIPTION OF WORK P
.-".tet. �r�r ..
` Flue vent for water heater or gas
fireplace 23.32
j 4 `.?4 1% r"—t" Log lighter(gas) 33.39
L.�r � Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
. 0 PROPERTY OWNER 0 TENANT Other: 23.32
F — Environmental exhaust and ventilation:
Name: - ----re02.f1,Jc A TY Range hood/other kitchen
equipment 33.39
Address: ON)
' Clothes diyer exhaust 33.39
City/State/ZIP: . ' w Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(' )__.,'"2)S\_. ' 0 , <-' Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: 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
x0
� otRA �' ? 4s Clothes dryer(gas)
Other:
Business name: A 0 C 61 MECHANICAL PERMIT FEES*
Address: / b0srr a4J ?�.4Y Subtotal
_
City/State/ZIP: 1/a e ) 04( 7 7 7 Z l/ Minimum permit fee($90.00) 90.0
' Fax:( ) Plan review(25%of permit tee)
Phone:( 1,3 70, R3-1,5-
State surcharge(12%of permit fee) /D.i‘D
CCB lic.: C ji 3 / Vi/ TOTAL PERMIT FEE /j , go
(` This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: re f�R� i I Date: 3 - ') f
I:Building Permits'MEC_PermitApp 040113.doc , l 440-4617T(I 102COM WEB)
p
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