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Permit (141) CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2019-00665 T[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2019 Parcel: 2S102CA00905 Jurisdiction: Tigard Site address: 13350 SW ASH AVE Project: HORTON Subdivision: VILLAGE GLENN Lot: 5 Project Description: Gas piping for range. Contractor: THE HEAT EXCHANGE Owner: HORTON, PETER R PO BOX 230566 EASTLUND-NORTON, SARAH K TIGARD, OR 97281 13350 SW ASH AVE TIGARD, OR 97223 PHONE: 503-524-8719 PHONE: FAX: FEES Specifics: Description Date Amount Fuel Piping 09/18/2019 $14.15 Type of Use: SF 12%State Surcharge-Mechanical 09/18/2019 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/18/2019 $75.85 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ado•te• b the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma • •in a copy the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: / `ermi ee ignatur=. ..11 A Call 503.639.4175 by 7:00 a.m.for the next availa< e inspection d, •. This permit card shall be kept in a conspicuous place on the jo site until < pletion of the project. Approved plans are required on the job site at the time o each inspection. Mechanical Permit Application• FOR OFFICE USE O\I.V IN ...`1 '"' Received �y City of Tigard '' DateBy: f -,' Permit No.: '_ ) f 4 13125 SW Hall Blvd.,Tigard,OR 1 plan Review II Phone: 503.718.2439 Fax: 503.59 .1 60 Other Permit: } Da[eBy: 1 1 U A K U Inspection Line: 503.639.4175 ,, . `"'� 111Date Ready/By: ® See Page 2 for Internet: www.tigard-or.gov ��t ID P AC2,\ Notified/Method: pirM Supplemental Information Mechanical permit fees*are based on the value of the work ❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory buildingNI For special information use checklist. Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total • JOB SITE INFORMATION AND LOCATION Heating cooling: Air conditioning 46.75 Job site address: 1'3:3'- ' t,y.\. A L Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: -'C` tir C tiq 2-2-s 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 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF OI Gas fireplace/insert 33.39 '' Flue vent for water heater or gas CV\.6,0115 \. -{T,( �'�`�v/I� fireplace 23.32 'v " `J Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 ° " OPERTY OWN 14' n.. .Fl,,. ..,©.' - "., 4 Environmental exhaust and ventilation: Name: R) t, " ow'vz �- �_ - Range hood/other kitchen equipment 33.39 Address: 13357) sc1.3 ( tO� Clothes dryer exhaust 33.39 City/State/ZIP: - dQ` 22 3 Single-duct exhaust(bathrooms, f toilet compartments,utility rooms) 23.32 Phone: t ) ("j3 lei t Fax:( ) Attic/crawlspace fans 23.32 O APPLICANT CQxrAC'T;PERSON': Other: 23.32 �f �� Fuel piping: Business name: z�CLti a )CA jt $14.15 for first four;$4.03 for each additional Contact name: "`"'"��� Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater , City/State/ZP: NIr _ _ . .. r r 4 Phone:( ) Fax::( ) Fireplace Range i /it l 3— E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Other: �xrr - ' Business name: MECHANICAL PERMIT FEES* Address: yid S 3�IC!„/', Subtotal Ay,,r City/State/ZIP: "c �1`nct ���Cco `L,�'i. Minimum permit fee($90.00) £WL.. Fax: Plan review(25%of permit fee) Phone: ( ) bZ� f3�-� ( ) State surcharge(12%of permit fee) ,0 6zi CCB lic.: 56 co 3 le 5y3 /� TOTAL PERMIT FEETJ(2) .4 /5'3/P-0' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signatur- - a L�/Vl / * Fee methodology set by Tri-County Building Industry Service Board Print nan74,,,r0, . .kli Date: i��J Ji q \B \ I: uilding: its _' 'tApp_040113.doc 6440-4C617T(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