Permit (27) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00391
TIG A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/31/2016
Parcel: 2S102DB00203
Jurisdiction: Tigard
Site address: 9303 SW HILL ST
Project: Neubo Subdivision: BURNHAM TRACT Lot: 7
Project Description: Kitchen hood installation.
Contractor: OWNER Owner: NEUBO, CRAIG&KRISTY
CRAIG&KRISTY NEUBO 18418 OLD RIVER LANDING
9303 SW HILL ST LAKE OSWEGO, 04 97034
TIGARD, OR 97223
PHONE: 503-577-6883 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 05/31/2016 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 05/31/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/31/2016 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /� -ermittee Signature: , A
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application vii441tick [oR multi:.1( 1/ t SE 011.1
Received � Q
City of Tigard Date/By � j(o /�{ Permit No.: M�( j(/'C�39/
;� 13125 SW Hall Blvd.,Tigard,OR Plan Review v` '
111 Phone: 503.718.2439 Fax: 503.59 60 '� ' Other Permit:
1 1, Date/By:
l I( ,R I) Inspection Line: 503.6394175 `A J q 1 w q Date Read /B turfs: C ���7
Internet: www.tigard-or.gov p `� S1 Ready/By: S See Page 2 Informationnr
�1$�'Is Notified/Method: 6 Suppleroental
•
h,.;, �`w r 3 � "4 l°+ x 0"14--t1:41,'—.. U.. y .ass a a
iikrit
vta
Mechanical permit fees*are based on the value of the work
0 New construction Doc Addition/alte acement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
' ". CONS W N
- ti�..,, �� CTiU , . . RIFSIIl ;j1 !►I.' QT4Oart041
IN 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
i��{�(y�p��A^"y qy'.�/��� �/f J�1�y{� Heating/cooling:
1.,,.,S Y°f , , —4A �i�:shit 1�ll l,liii L j°X14'
' Air conditioning 46.75
Job site address: Q I tA.- f.51'
1 . Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: I t�"l" Q `�'Cr �'kr J 1 f 7 `3 Furnace 100,000+BTU(ducts/vents) 54.91
"l Heat pump 61.06
Suite/bldg./apt.no.: 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
� 1 Flue vent for water heater or gas
trC fi t4 cx) j 1 u l(.T.\ 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
PROPER`IV U1!IER— 0 TENANT Environmental exhaust and ventilation:
Name: AN67 A 1 - Range hood/other kitchen
111���iii equipment .1", 33.39
Address:Li2,50/ A1411 j-3 (�(L Clothes dryer exhaust 33.39
City/State/ZIP: AriLl e"--, _ Y .'� 2-5 Single-duct exhaust(bathrooms,
-no-1.� _ toilet compartments,utility rooms) 23.32
Phone: �) , S Fax:, 'Zvt - �`� Attic/cmwlspace fans 23.32
..a APLICANT ' , 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:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other
Business name: 62,..
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) o
State surcharge(12%of permit fee)
CCB lie.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
` � days after it has been accepted as complete.
Authorized signafplt (_____,42,,,A.��� K.( `020` l� * Fee methodology set by Tri-County Building Industry Service Board
Print name: : V I' ,,- Date:q s( 02 I
I:Building Pe 'its MEC Pe it •p 0401 d lc 440- 6I7T 11 1CONI WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: = Perntit Pale;.
$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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