Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT '® / 494' Permit#: MEC2021-00603
Date Issued: 8/5/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134DC00500
Jurisdiction: Tigard
Site address: 11476 SW TWIN PARK PL
Project: Kurahara-Ductless Subdivision: None Lot: None
Project Description: Install ductless mini split heat pump. 8/25/2021: REPRINT permit to add(1)bathroom exhaust vent fan.
Contractor: BULL MOUNTAIN MECHANICAL Owner: KURAHARA, JORDAN
13580 SW RHETT CT 11476 SW TWIN PARK PL
TIGARD, OR 97224 PORTLAND, OR 97223
PHONE: 503-612-6677 PHONE:
FAX: 503-692-3084
FEES
Specifics: Description Date Amount
Heat Pump 08/05/2021 $61.06
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 08/05/2021 $23.32
Class of Work: ADD Type of Const: Utility Rooms)
Occupancy Grp: Minimum Fee Adjustment-Mechanical 08/05/2021 $5.62
Stories: 12%State Surcharge-Mechanical 08/05/2021 $10.80
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: ,<---I(J‘le . Permittee Signature: e/.fl !` /q--/C7 Dti,/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FORoattr,F:USEOr:"I. y/
'' s r ) r, of
llCatla , t geceived Penrtit t3o.', (
. „ �. 1 '
Mechanical Permit ApU_._. Da,erf3y:
Plan Review Other Permit:
City of Tigard v7zz3 ® See Page 2 for
Tigard,OR DateBy: kris __
r 73125 SW Hall Blvd., Supplementat Information
■ Phone, 503 718.2439' Date Ready BY /' 1
DaeiBy: etlm / Alf
Inspection Line: 503 63g.4175 a _
TI ARD Internet: s���w.itgar t n,�ov f ' r l
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ical permit fees"are based on the value ,t r� '.'��
and .roftt.
„ performed.Indicate the value(rounded to the nearest dollar)o a
+1� mechanical tnateriais a ui.mcnt labor,overhead,
New constr.,,,,,,, wr.---•_-- Value:$
Demolition -. '+IT'IAL k .�..____.
r /1S ; +rt r f1` y'tt<rir�til)'1 ,. .. ,. ,.� 7C'(,�IJfP >�P3Y/bu't�r4'R.
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6iEES*
tlnn u checklist.
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r . _ a . , },a , ,�,-*/ Forsperlallefo Total
Access+. Qty
l_and 2 tasrnly dwelling ❑Coinnten:ial/industrial Description
�"}Other _ti00 ---
[J Master builder .,.
Murto-ttsnrtv ...._. r �1.",r+ Hearin; coolin_t 46.75
d-;"i3 SiltINFORMATION 1s 1J I air T Air conditionin
all 46.75 alllL.I Lill
aim IOW
Furnace 1 OQ,QQQ BTU ductsivents) 56 75
Job site address --"- ctSiV vents
— 41.9061 �
_ — Furnace IQQQ�+BTU 6
ISIMIllglita
ittylStat 'LIP• `_____—_� --• — — Heat um
Project name: Duct work ��
_uitelbldg,apt :; Y ________�_____...—.-- ----
--- H drank hot waters stem .®
{ +:'rasa stree tldtrecttons to job site: — Residential boiler(radiator or
I h dronic
Unit heaters(fuel-type,not electric), III
46.15
,.. mein-wall,in-duct,sus.ended,etc. ��
i _
+__...-.. Flue/vent for an of above �
.__ Lot no.: Other:
Subdivision: Other ®�
_„- fuel a, liances•
; rh map/parcel no. Water heater
._ -• 33 39
{ DESC'dt1P1 tON OF 3+ ORR Gas fire.lace/insert
__ _ . _„ ,-."._......:. --•---- •-•---- Flue vent for water heater or gas
-- t/f" C`� T l T'+b �` q% f. r tk--'— fire lace ___ —__ 23.32
Log lighter(gas)
'` _ `- Wood/.ellet stove 33.39
I _ - Wood fireplace/insert 2332
ChimneyRiner(fluelvent 23.32
% Other:
23 32
t ! ar'R£IPT17 U4PtEit
_1,---�--�-- Environmental exhaust and ventilation:
Name: Range hood/other kitchen 1 33.39
____.-.._._.�.�..._.-.-.•-.,_^..`._�..� ,��/ a ui mont
Address: 7V03 S V �s.), *_ __ _ ,!*. .._.__ ._..,. Clothes dryer exhaust 33,39
City/State/ZIP: r ry Single-duct exhaust(bathrooms, l
t toilet cons tartments,brit rooms) ` 23.32
Inn c" 6 j`10 )(,)1 i I 11 7.._ __,._._ l a..c ( } h€etc+mast isTace fans
t._ O CO_NTACT PF,,R.54) i 0th4r 23.32
t :hPi#II4hs1 _
IIIMIB
41- l / Ebel ptptttrt
........ ....... . ._ rld t g far first four,yS 73 far_each additional
, , ..tire nasraxa, _._._
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,, ar+ r ; i (1:11 tsar{ulnt
, Wallfsuspertdedltinit beater
v
I.
' 1 Fireplace
Ranl,e
ti ot,er uji; ik1 d Barbt`,tie
_._' : .- IA t"S�' f 1 r{ ..� Clothes dryer(gas)
,..,7u'•. Sit 119) W.. _ 2..- ,...-_, " ) rl ,,...,._; Other .,.___--....-..h'iF4:Yt ^tkk eki PRR.mik F4�F4,
_w Subtokal ,_�
(/jar/ �J,AI(�M'§� _.. ..._
II !It 1!147 ,dl,�./H. Y 1 fi ! 1rM ...._.
F
__ _w 4 i Minimum permit¢ec($9Q.i10'1
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.........: ........... ., ( °� pLilnll fee}
t,E:,, t a, _ i SLdtC Sun hai e l2 oaf
� T ...:... , ._ 1tJ'fAL P'EFLMIT FEE
/ i •rr r' i -.lids p,,rtnit Application expires it a perruit Is nos obtained within t80
ttthot to t signature Anue / p , 7 L. days after it tax baem accepted as complete.
ri run-i- l ,1 t},t tc 1J to , ' ,._ aoa u ry Budding Industry erv,cc Board
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