Permit (39) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00509
Date Issued: 07/16/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S111 DB08700
Jurisdiction: Tigard
Site address: 15430 SW OAKTREE LN
Project: THORNE Subdivision: SUMMERFIELD NO.10 Lot: 548
Project Description: (1)gas fireplace, (1)range hood,and gas piping for fireplace,range,and barbecue.
Contractor: AIRMAXX HEATING &COOLING LLC Owner: THORNE, CLIFFORD D JR
6924 SW PINE ST THORNE, STEPHANIE E
TIGARD, OR 97223 15430 SW OAKTREE LN
TIGARD, OR 97224
PHONE: 503-840-7925 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 07/16/2019 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 07/16/2019 $23.32
Class of Work: ALT Type of Const: Fireplace
Range Hood/Other Kitchen 07/16/2019 $33.39
Occupancy Grp:
Fuel Piping 07/16/2019 $14.15
Stories: 12%State Surcharge-Mechanical 07/16/2019 $12.51
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $116.76
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00.0. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: •#-Signature: // !4
i1
Call 503.639.4175 by 7:00 a.m.for the next available inspec da e.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR orrlcF. l si:oy1.1
City of Tigard t.. I t�`• ' Received
d `2 cr i7 Permit No.: _
r 13125 S W Hall Blvd.,Tigard,OR 9722 r Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: r-^ '
4 g yya ,/n t Date/By: / �/i
II G A k D Inspection Line: 503.639.4175 J l i 1_ A i3 '.- '- Date Ready/By: Jung: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
VIS/t
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�'¢"` '` �' s ° -"` " '`'"" " ` � Mechanical permit fees*are based on the value of the work
❑New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY 01F CONSTRUCTION
RESIDENTIAL EQUIPMENT/,SYSTEMSSEES*
A J 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
r:. -' Heating/cooling:
JOB S.. INFORMATION AND LOrAtiON
.,,. ..r. Air conditioning 46.75
Job site address: f/5 L{30 G U) Oc k \.cee Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ' Furnace 100,000+BTU(ducts/vents) 54.91
1 U'! d Heat pump 61.06
Suite/bldg./apt.no.: U Project name: 7A64i 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
# et y Gas fireplace/insert t 33.39 33, $°1
.. ,.-e=a RiErnoN OF WO u 47:
i „. a - . (� !dry Flue vent for water heater or gas
CLtj '\n�- C ti' Y6 lZ V(�t' / fireplace 1 23.32 el) j3+
f I Log lighter(gas) 23.32
T- C f Q l 0 C? Wood/pellet stove 33.39
( G(., r -t d C tk Wood fireplace/insert 23.32
c ` Chimney/liner/flue/vent 23.32
Ni Other: 23.32
5 ROP1iyRTY C WNEIt 1 , . - . Environmental exhaust and ventilation;
/jj- v
Name: -? •IIA / i, Range hood/other kitchen /kl
v ` equipment 33.39 aj 3 -31
Address: Clothes dryer exhaust 33.39 ,
City/State/ZIP: Single-duct exhaust(bathrooms,
ty toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
23.32
'` i000NTACT •PERSON
Other:
� ` Fuel piping:
Business name: 54/ne ,i S 7v". J $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Fireplace I
Fax::
Phone:( ) ( )
Range I I i1,l 5
E-mail: Barbecue I
CONTRACTOR Clothes dryer(gas)
w j pp Other:
Business name: p I f yvi t x,t 1 P_,,,-\_i n 3 i#2 ti,10,4 Ll(.. MEGH►LAICAL 'ERMITF S* `
Address: Cq ail cw 'vi `J ; k ; d ; Subtotal �Q�,e2�
City/State/ZIP:` ,{► Minimum permit fee($90.00)
A� Z ' a 1- Plan review(25%of permit fee)
Phone:( ) ?t.� Fax:( ) State surcharge(12%of permit fee) �' „5 1
X01 � t � �'Z�
CCB lit..: b TOTAL PERMIT FEE
�� ZS dry
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signa •
�a, * Fee methodology set by Tri-County Building Industry Service Board
Print name:
Date: 7 -/G i
61
I:\Budding\Permits\MEC 'A 040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: >PertFee
$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 s $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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