Permit CITY OF TIGARD MECHANICAL PERMIT
III 1 COMMUNITY DEVELOPMENT Permit#: MEC2019-00113
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/26/2019
T I i;;�I<.D g Parcel: 2S101 BC00301
Jurisdiction: Tigard
Site address: 12360 SW KNOLL DR
Project: Reed Subdivision: None Lot: None
Project Description: Gas piping for new water heater,stove,and dryer.
Contractor: RANDY ROGERS PLUMBING LLC Owner: WILLIAM REED
PO BOX 358 12360 SW KNOLL DRIVE
SANDY, OR 97055 TIGARD, OR 97223
PHONE: 503-668-0846 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Water Heater 02/26/2019 $23.32
Type of Use: SF Range Hood/Other Kitchen 02/26/2019 $33.39
Class of Work: ALT Type of Const: Clothes Dryer Exhaust 02/26/2019 $33.39
Occupancy Grp: 12%State Surcharge-Mechanical 02/26/2019 $10.81
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.91
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
: :: :Ttohls
r dict ito OU iy ca g 503. 31987 or' .800.332. 44.
rPermittee Signature: L\6-11 ^
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
City of Tigard Received
II Ill Date/By: a �1�1/�g .:4 �.. i ��
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
i Phone: 503.718.2439 Fax: 503.598.1960 -
Date/By: --
T 1 G n R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ee Page 2 or
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK " COM04ERCIAL EEE* SC)IEDJJLE — USE CI ECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction al Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
$
CATS_ RY" F CO STRCI : ION. , QQUlue:
x,
1-and 2-familydwellingt�,� �'RESID�1\f7C .E 1►IENT1"SYSTEVIS FEE5*'
D Commercial/industrial � ..
0Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
." ,v=:" JOB SITE"INFORIlr TIO LAND ' ;CATION ''F. ,_ Heating/cooling:
Il g
Air conditionin46.75
Job site address: L Se 0 t I' UV Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ; A5 ( Furnace 100,000+BTU(ducts/vents) 54.91
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
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
w: -` Gas fireplace/insert
1 ESTI IPTIO 'OF vRKiiiit eP 33.39
1 h n,_� Flue vent for water heater or gas
1 0 li r - t Ny Q^ fireplace 23.32
1 Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
ii A �,}sl E O R v "":rb ' N ,... Other: 23.32
_. " ' 4 ' : Environmental exhaust and ventilation:
Name: il Range hood/other kitchen
equipment 33.39
Address:
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
If . I'M *-4.'1...4'") `.} `,. n~ ;. . 0 .,ACT PERSo W ':a 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
E-mail: , Barbecue
Range 1
�NT ".."OR {..
„' �� - �u :; i',...,:.: �" - Clothes dryer(gas)
Business name:LI
pi j/ Other _
�� 489
�(/\\ •• ... 11 ECHA CAL TEES*. ., •
Address: pA1
Subtotal
City/State/ZIP: ��n(� � 9i S Minimum permit fee($90.00) 90---'
A,
! Plan review(25%of permit fee)
Phone:(9'1)1) Sb Fax:(S ) �jf
r ��!O State surcharge(12%of permit fee)
CCB lic.: 1 cs 6 8 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: (I, Illi , ) t r f "'I * Fee methodology set by Tri-County Building Industry Service Board
Print name: l ate:fT"a6--)q
I:\Building\Permits\MEC_Permit pp_040113Ilc 440466117TT(11/02/COM/WEB)
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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2