Permit (51) ll, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PeCOMMUNITY MEC2019-00513
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/16/2019
T i c;A R F) g Parcel: 2S102AA02100
Jurisdiction: Tigard
Site address: 9065 SW CENTER ST
Project: AV Equity Inc Subdivision: KINGSTON Lot: 15
Project Description: Replacing(1)range hood,(1)bathroom exhaust fan,and(1)heat pump.
Contractor: PROUD BUILD CONSTRUCTION Owner: AV EQUITY INC
6306 NE 84TH PLACE 7505 NE 123RD CT
VANCOUVER,WA 98682 VANCOUVER,WA 98682
PHONE: 360-831-2306 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Heat Pump 07/16/2019 $61.06
Type of Use: SF Range Hood/Other Kitchen 07/16/2019 $33.39
Class of Work: ALT Type of Const: Single Duct Exhaust(Bathrooms,Toilet, 07/16/2019 $23.32
Occupancy Grp: Utility Rooms)
Stories: 12%State Surcharge-Mechanical 07/16/2019 $14.13
Fuel
Fuel Types:
Gas Pressure:
Total $131.90
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work i -•t started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio, the r les adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ou ma ob :in a copy of the rules
or direct questions to OUNC b calling 503.232.1987 or 1.800.332.2344.
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Issued By: Permittee Signature: , I
Call 503.639.4175 by 7:00 a.m.for the next available inspection d. ,.
on the'ob site until com lets• 11:project.
This permit card shall be kept in a conspicuous place p p l
Approved plans are required on the job site at the time of each inspection
Mechanical Permit ApplicataPn E G ()NENr
FOR OFFICE \LI
ri�.
City of Tigard Date/By: l_� '' _♦
13125 SW Hall Blvd.,Tigard,OR 9722I3 „
i Phone: 503.718.2439 Fax: 503.598.1960 l .i a Received jcp1Plan Review P S-G,J`/
Date/By: :�
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.ti and-or. ov Notified/Method: Supplemental Information
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Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF i STRUC l!<ON . u
C( RESIDENTIAL EQIIIPINT f SYSTEMS FEES*
AfN1-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
JQU ITE INFORMATION AND LOCATION Heating/cooling:
. Air conditioning 46.75
Job site address: �j � .7e#11,0'.(--
� •f Furnace 100,000 BTU(ducts/vents) ,
46.75
City/State/ZIP: / ] ,-,f i Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump r 61.06
Suite/bldg./apt.no.: Project name: Cv7 lest" 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
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
Gas fireplace/insert 33.39
� ��" ....
xtrtt,,. .- DESRiPTION Oi',r!WORK; eIJ
Flue vent for water heater or gas
is ) fireplace 23.32
lin(✓7 / G� Log lighter(gas) 23.32
era, V / Wood/pellet stove 33.39
v�t`i �� �� r G�� Wood fireplace/insert 23.32
i o fa/ e;ee Chimney/liner/flue/vent 23.32
/?( Jc S t Othet: 23.32
7
, > t illop ' ,,,,owNER 0 TENANT
. _. r _ .. ...... . ..._ _. .. _
Environmental exhaust and ventilation:
Name: /1 V/eq 4/4 fl2C l Range hood/other kitchen r
7 ��.3 �l equipment33.39
Address: tv/) //'% Clothes dryer exhaust 33.39
City/State/ZII': � Civ AGS Single-duct exhaust(bathrooms, `AE p•y ,a�� ,/ toilet compartments,utility rooms) I 23.32
Phone:
��) � 6)3 Fax:( ) Attic/crawlspace fans 23.32
. , , + 'LI , :. ;:;7".1 �,,c**• PE O)hl Other: 23.32
Business name: �l Fuel piping:
f U e9t4/f $14.15 for first four;$4.03 for each additional
Contact name: !�( l a� Furnace,etc. ,
Address: -r)^0j /1/ / 3 L'/ Gas heat pump
-- Wall/suspended/unit heater
,_ eity#Altezw -ivy t - fri ,,
Phone:(�0 ) :.--;-Z -WSJ(2 Fax::( )
Fireplace
Range
E-mail: ct e9(,i !4, ca a ,1 COM Barbecue —
CON" CrOR Clothes dryer(gas)
/ ,, Other:
Business name: p/Ot{C, u(`G GAJ'/S`T/ -c,.6-1:,:, q „MECHANICAL PERMIT FEES*
Address:
3 ✓lid eY2y f-)1 766`L __— Subtotal
City/State/ZIP: V r/CQ uvly/- ,f-in Minimum permit fee($90.00)
Phone:( )) 57 Z —a Fax:( ) Plan review( 2/0 of permit fee)
State surcharge(12%of permit fee)
CCB lie.: Zee '2?c-I I._/.ii I!1 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: ilk e/ * Fee methodology set by Tri-County Building Industry Service Board
r /
Print name: i %- 3 , Date: /// /y
I:\Building\Permits\MEC_PermitApp_040113.doc _ 440 617T(1/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuations 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