Permit CITY OF TIGARD MECHANICAL PERMIT
` a COMMUNITY DEVELOPMENT Permit#: MEC2022-00101
Date Issued: 2/22/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CD02805
Jurisdiction: Tigard
Site address: 9825 SW OMARA ST
Project: Murphy Subdivision: FREWING'S ORCHARD TRACTS Lot: 29
Project Description: Adding mini-split heat pump to basement
Contractor: OWNER Owner: MURPHY, ELIZABETH A
9825 SW O'MARA ST
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Heat Pump 02/22/2022 $61.06
Type of Use: SF 12%State Surcharge-Mechanical 02/22/2022 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/22/2022 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Edga.rdo-Ma.(44-r\.ad0- Permittee Signature: SQ-e
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applica y FOR OFFICE USE ONLY
Cityof Tigard
I vEr Received �f Permit No.. 'h
g Date/By: (rtq`Z+Z tiV� ookoN
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
a Phone: 503.718.2439 Fax: 503.598.196�AN 2 6 2022 Other Permit:
Date/By:
1 1 G A R D Inspection Line: 503.639.4175 Date Ready/By:fr i w tZ Z Juris: Id See Page 2 for
Internet: www.tigard-or.gov l�I fY OF I IIaHHt, eneNotified/Method: ;,�� 1`61 Supplemental Information
3UILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 16 00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
t1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
(� ( �7�- Air conditioning 46.75
Job site address: lg 9.5 5 ti� 0 VY1 O. - I,1 Qe-\ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: --\-- r A If& 0'p 4..C .. m Furnace 100,000+BTU(ducts/vents) 54.91
1� 0�4`+✓ Heat pump ' 61.06
Suite/bldg./apt.no.: Project name: pri N yU rj,,',-' Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
r i T , (� 1 Residential boiler(radiator or
0 v\ Gt - (C^(2 l b \ ac�' VL l t5 1v o `14 i Q^H (_ , hydronic) 23.32
rJ 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: o T P 1 n '� 0 C � Lot no.: Other fuel appliances:
Tax map/parcel no.: C`iuri c.. "�G (�5 Water heater 23.32
�7 DESCRIPTION OF WORKGas fireplace/insert 33.39
AA ii- Flue vent for water heater or gas
AdA ;v't o YY\k A.:( --5c 1 tk kca 0 I .-V-D fireplace 23.32
1,,� Log lighter(gas) 23.32
t")Sz'-4ki 41 Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
"PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name: I t'-za , \IJ�Q\n'/ Range hood/other kitchen
C equipment 33.39
Address:°(, S17 V) O► 12XCt Clothes dryer exhaust 33.39
City/State/ZIP: r1--'`t (-6, Q 9?-�2- Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(,) ) q4.1 — /32_c - Fax:( ) Attic/crawlspace fans 23.32
APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14__. additional
15 for first four;$4.03 for each
__ _
Contact name: Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
aa Range
E-mail: Q t r'Z &a beth z colt r'l¢, c ma 1 I . Corr) Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: ‘i\.11\t
Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 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: - "+"\ I /i y tl�(f1 * Fee methodology set by Tri-County Building Industry Service Board
Print name: .(i +�/\' J.-�JnViV\VV JJJ 1 11 J Date: 1 / '� /' oxp...
C\t3uilding\Permits\MEC_PermitApp_040113.doc f �tAN,/Nl�/ �J 440-4617T(11/02/COM/WE13)
RECEIVED
JAN 2 6 2022
Property Owner Statement CITY OF TIGARU
Regarding Construction Responsibilities 3UILDING DIVISION
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325 (2))
This statement is required for residential building,electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box.
_ I own. reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
I will be performing work on property I own a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors. I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
E , -%,c(--1-..)Q-kA,A 1- k.,-(01.y
Print Name of Permit Applicant
CCP . JA-A-,1 ii„(4,t.)-A-- 1
f
Signature f PermitApplicant Date
Permit#: 'm .CZ.AZZ" OUkOk , F.
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V��Address: q O�/Yla r� " , � ��"..
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Issued by: I1/23 Date: Z Cl\Z2 - 5 9