Permit a p CITY OF TIGARD MECHANICAL PERMIT
;�'� COMMUNITY DEVELOPMENT Permit#: MEC2016-00210
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016
Parcel: 2S102AC00800
Jurisdiction: Tigard
Site address: 12555 SW MAIN ST
Project: Barber Shop Subdivision: None Lot: None
Project Description: Replacing 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 03/28/2016 $69.06
Class of Work: ALT Type of Const: Plan Review 03/28/2016 $17.27
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 03/28/2016 $8.29
Stories: Info Process/Archiving-Sm$0.50(up to 03/28/2016 $0.50
11x17)
Project Valuation: $500.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&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 $95.12
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
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 1.800.332.2344.
Issued By: Permittee Signature:
l
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 . e project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE I SF: O\l.l
'''CReceived �
City of Tigard
Date/By: 3e'km 41, Pennit No.: = _11 . Ia..
,
111 13125 SW Hall Blvd.,Tigard,OR 97
Plan Review
Phone: 503.718.2439 Fax: 503.598.III
�� Other Permit:
�� Date/By:
I 1 G A R 1) Inspection Line: 503.639.4175 %� � Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov . J, itiied/Method: pilASupplemental Information
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tt
' ' Ma a ".� :� ' .*— ''—' . mom.- 4F.. ,� . ; - — = v ' — ..,..
Mechanical permit fees*are based on the value of the work
❑New construction 'ji Addition/alteration/{�,.. ent performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: '17' mechanical materials,equipment,labor,overhead,and profit.
5 ° :y c l y , Value $ 5 v oe
1 r ,. �:. .'�". i *t ,j="�dr� ,:,uh'rt � k, j ',:, ,. ..... ,. .,..,. r ,
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
> ' � t, Heating/cooling:
oem fiwu,3, x '. ..,r Air conditioning 46.75
Job site address: 12555 S r c4) IM/ - ,1) S r Furnace 100,000 BTU(ducts vents) 46.75
City/State/ZIP: 77-6 .z) C>12G ot,U Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: i Project name: Gtfc / b.- j' c 4i&)l ' Duct work 23.32
Cross street/directions to job site: IvOo kr J`o�p f( Hydronic hot water system 23.32
LK F 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: I Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
(3AT OF WORK Gas fireplace/insert 33.39
' ' _ " ' Flue vent for water heater or gas
L1144 l tt/A jZ 2u-S(Z-i CZ-C-7-Si/)L= p
G S pi- fireplace 23.32
P-11-1
S�/f et 1c` Log lighter(gas) 23.32
1 S L.L- GSC - ) A{3 dV C P--6 an'>' . Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
., Other: 23.32
'' '.' —: ,. r, - 0 : Environmental exhaust and ventilation:
Name: 5, ,,,11...),_...„ Range hood/other kitchen
�7����C� `IS ` equipment 33.39
Address: 1-256-/ u. , ?41A,„ti c7--, Clothes dryer exhaust 33.39
City/State/ZIP: 76 � C �'' Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( c)3) 336 v6-2_0 Fax:( ) Attic/crawlspace fans 23.32
? AIT r a C0NTAer PERSON Other: 23.32
Fuel piping:
Business name: 7/. ��0
S� $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
: t x�'4 _r =a 't "k5r;m5, +, 1,1TItAIt . . , , ,atxrt; ,. , ,., Clothes dryer(gas)
Other:
Business name: CyjimiC 4, ) , rf ,yyam, ,
Address: Subtotal / ,vit
Minimum permit fee($90.00)
City/State/ZIP:
Plan review(25%of permit fee) 2
Phone:( - ) Fax:( ) State surcharge(12%of permit fee) ,;,,Q
CCB lis.: TOTAL PERMIT FEE -1 S p%
This permit application expires if a permit is not obtained within 180
days after it
s
en
as
plete.
Authorized signature: �'/2?„,„z„,
a _,..•
21(E- * Fee methodology set by Tri CountycB Building Industry Service Board
Print name: CL7j,e6c Si Kif =�,, `2 Date: ..-2- f
1:Building=Permits MEC_PermitApp_040113.doc �"��% 440-4617T(11 02 WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & MultiFamily Fee Schedule:
T ' altatibn:
$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\M EC_PennitApp_040I 13.doc 2