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Permit Support Document (39) CITY OF TIGARD i AMECHANICAL PERMIT -s • ' COMMUNITY DEVELOPMENTIN Permit#: MEC2019-00676 T f t_;A F.0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/20/2019 Parcel: 2S103ACO2800 Jurisdiction: Tigard Site address: 11075 SW ERROL ST Project: 19-190r Subdivision: None Lot: None Project Description: installing one head ductless heat pump system. 9/23/19:REPRINT to add(1)bathroom exhaust fan. Contractor: SUN GLOW INC Owner: PIERCE, DARREN F REVOCABLE LIVIN 2428 SE 105TH PIERCE,AMY J REVOCABLE LIVING TRUS PORTLAND, OR 97216 11075 SW ERROL ST TIGARD, OR 97223 PHONE: 503-253-7789 PHONE: FAX: 503-253-7693 FEES Specifics: Description Date Amount Furnaces<100K BTU 09/20/2019 $46.75 Type of Use: SF Heat Pump 09/20/2019 $61.06 Class of Work: ADD Type of Const: 12%State Surcharge-Mechanical 09/20/2019 $12.94 Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 09/24/2019 $23.32 Stories: Utility Rooms) 12%State Surcharge-Mechanical 09/24/2019 $2.80 Fuel Fuel Types: Electricity Gas Pressure: Total $146.87 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 no Carted within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to -Ho e 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 ,stain a copy of the rules or direct questions to OUNC b, •fling 503.232.19 8 or 1.800. 32.2344. Issued By: ( •/' / ermittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available insp ction •:te. This permit card shall be kept in a conspicuous place on the job site u it co• pletion - the project. Approved plans are required on the job site at the time of =a inspection. Mechanical Permit Application ,, roa OFFICI. 1 S1:OnLv City of Tigard Date/By.Received . j , eG � rX11. 4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit: 1 I G rt R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information FEE* SCHEDULE — `:: : 'rw +�r-.- .i; ' - c i1�- ._ — "'.,.v., :�..� --""' w,, y i, fees* on value CHEMIST work IST itees are basedon the va ue ofthe wo ❑New construction ,Addition/alteration/replacement ,8, - ' w- i�r . l icate the value(rounded to the nearest dollar)of all ` $ / P(h!aterialsequipment,labor,overhead,and profit. ❑Demolition ❑Other: Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* _and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist ❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: (1 d`rt- k\�‘,l\ Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: \ , c .. 0 - vi--22 3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: 1 Project name: V\<Z� L.� Duct work 23.32 Cross street/directions to job site: v 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: I Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 '1*-•.-:- Gas fireplace/insert 33.39 DESCRIPTIGK OF WORD s ' I`-':-': /� � Q e Flue vent for water heater or gas T S�S( Q \rn 3 t. � C fireplace 23.32 Log lighter(gas) 23.32 ‘5 R. vY\A\N\---: Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 OPERTY OWNER ( TENANC= Environmental exhaust and ventilation: Name: t Ca f•CP-.1 A oni `Q Range hood/other kitchen t �— equipment 33.39 Address: c�.rS t Y't l Clothes dryer exhaust 33.39 City/State/ZIP: `\\��r„h ©c2—, C':?_ -2 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 1 23.32 x i Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 ' rAPPL1CANT 0 CONTACT PERSON. Other: 23.32 Fuel piping: Business name: V C G \" $14.15 for first four;$4.03 for each additional Contact name: -.-6\./. ...1„4„0,..... V)-real'V\�',, f Furnace,etc. Address: 2 `V3 3 f�.Je l Gas heat pump Wall/suspended/unit heater - C;rty/StateTLTP: S IZ, --t...., .-- "" w -A- - t 7.1 Water heater Phone:( - ,),I Ca, I'2)`t jb Fax :( ) Fireplace lie E-mail: ��>`� o 5Azsz,,t)tZ•• v. C c W\ Barbecue coNt6 TOR Clothes dryer(gas) Business name: Other: Su//� fl�� MECHANICAL PERMIT FEES* Address: A 5 /U c-- Subtotal City/State/ZIP: �U if ia(4 I C L/l„— l 721(o, Minimum permit fee($90.00) n t '�/� Y Plan review(25%of permit fee) Phone:(4i ) -• 72 Fax:( ) State surcharge(12%of permit fee) CCB lic.: t LC�(� 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: r * Fee methodology set by Tri-County Building Industry Service Board Print name: sylcx,,sz f .eZ • Date: -4617� 02/C� (d I:\Building\Permits\MEC_PermitApp_040113.doc 44 7T(11 OM/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