Permit (173) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00290
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/09/2019
Parcel: 2S103CA00104
Jurisdiction: Tigard
Site address: 13125 SW 115TH AVE
Project: DAVIS Subdivision: None Lot: None
Project Description: (1)new bathroom exhaust fan in laundry room,replacing(1)bathroom exhaust fan in main bathroom,and rerouting
(1)existing clothers dryer vent.
Contractor: OWNER Owner: DAVIS,JAMES
JAMES DAVIS 13125 SW 115TH AVE
13125 SW 115TH AVE TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-949-9951 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Clothes Dryer Exhaust 05/09/2019 $33.39
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 05/09/2019 $46.64
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: 12%State Surcharge-Mechanical 05/09/2019 $10.80
Stories: Minimum Fee Adjustment-Mechanical 05/09/2019 $9.97
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued to the regulations contained in the Tigard Municipal Code, State of OR. SpecialtyCodes and all other
subject9 9 P
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 tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: R z& 'ttee Sy_ i :
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 01 F1(E USE ONLY
Cityof Tigard �°�` +� Received Permit No.:
- ° 131SW Hall Blvd.,Tigard,OR 9: v 0` Date/By: r j �� �J ,►.i
9 Plan Review Other Permit. /� C
Phone: 503.718.2439 Fax: 503.598, •I J eo Date/By: / r /7-i t
TIGARD Inspection Line: 503.639.4175 MP.` ,<\, \p Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov (*,._\)WCNotified/Method: Mil Supplemental Information
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:$
y 4
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
k�� ''---,,''‘' ''',','--'A tIktibN , '
. . yoV\ a ,. .a , . � swaw - Air conditioning 46.75
I lS.
Job site address:l3/. 'f�
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: - Furnace 100,000+BTU(ducts/vents) 54.91
�-7 Heat pump 61.06
Suite/bldg./apt.no.: ,� Project name:rf ifi 5 Duct work 23.32
Cross street/directions to job site: �� Hydronic hot water system 23.32
'LG) 0 or-}41 & hydronic)Residential boiler(radiator or
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
�� vvvvvvvv rvv y ® 'vv Gas fire lace/insert 33.39
\\�`atet�\��\��t'T� W . 'u Sao\\o\\\ 1"- ' ', N''°" \,M,\\ 6 ..,�"� p
�j ��\vv�,���s �.� ��) Flue vent for water heater or gas
J�,.d ' , none) . � 1 h 44-1A-retip
�d M fireplace 23.32
ovd 1 SUN /� �j� � n^/' Log lighter(gas) 23.32
�CG� 1 `��q / t K.i�� 41-A; Wood/pellet stove 33.39
1 ,.ems- Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
\ \ a y j . a; / , �\" Other: 23.32
ice: r t \ ,at gt � � -- a \'\\\ ,
�� _„ >,,,,. z _ �=�° �=- _ _ � Environmental exhaust and ventilation:
Name: > ' Range hood/other kitchen
�S tt `� �r J equipment 33.39
Address:(I'S I.16_1- f , Clothes dryer exhaust / 33.39
Single-duct exhaust(bathrooms, .
City/State/ZIP: ' 1 ' 61Z
toilet compartments,utility rooms) 23.32 14., 4i
Phone ) et C, 51 Fax ( ) Attic/crawlspace fans 23.32
Ilk��0��v�\tl rA ) a »a y a c 6 -. l � � ,av�a Other: 23.32
Fuel piping:
Business name: $14.15 for first four;54.03 for each additional
Contact name: r Furnace,etc.
Gas heat pump
Address: -
WalUsuspended/unit heater
City/State/ZIP: Water heater
Fireplace
Phone:( ) Fax::( ) Range
E-mail: Barbecue
vv 4 �e \ ,. 1 \ \\*,44,,,,,,,r��\l�� Clothes dryer(gas)
tb . ,.e; ,. , >,,,t2 ,i A \ ,, .
Other:
Business name: :4%\\VW,';':::7 Pi ` € : \ '' 4 . .i
Address: YGOh Subtotal -C,
City/State/ZIP: Minimum permit fee($90.00) q/().cO
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) (,f),
CCB lic.: TOTAL PERMIT FEE I i,Z;,
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: ZQ _ S 4 4/.:( Date:-9^//
Mechanical Permit Application - City of Tigard
Page 2 -Supplemental Information
Commercial & Multi-Family Fee Schedule:
t/ ha /7,1 944 d; y // j/0
$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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