Permit Support Document CITY OF TIGARD I 4 ' MECHANICAL PERMIT
COMMUNITY DEVELOPMENT 4.Pa Permit#: MEC2022-00219
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/21/2022
T I[;,gA.Tf 9 Parcel: 2S114BB17000
Jurisdiction: Tigard
Site address: 10227 SW STUART CT
Project: Johnson Subdivision: RIVERVIEW ESTATES Lot: 16
Project Description: Hood vent. REPRINTED 4/6/22:Add dryer vent and gas line
Contractor: COLUMBIA HEATING&COOLING LLC Owner: JOHNSON REVOCABLE TRUST
16756 SW 72ND AVE BY JOHNSON, RANDALL W& KRISTEN R
PORTLAND, OR 97224 TRS
10227 SW STUART CT
TIGARD, OR 97224
PHONE: 503-624-2704 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 03/21/2022 $33.39
Type of Use: SF Clothes Dryer Exhaust 03/21/2022 $33.39
Class of Work: ALT Type of Const: Fuel Piping 03/21/2022 $14.15
Occupancy Grp: Minimum Fee Adjustment-Mechanical 03/21/2022 $9.07
Stories: 12%State Surcharge-Mechanical 03/21/2022 $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: 1.40. y yam,De,Wege, Permittee Signature: �rL App,' ^^,t ti
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 Application I (Iii(id I I( 1 I -I t r,I 1
Raeived G l,r^,72_��}
City of Tigard etc 8 4Permit No.(Yle ,e - 1
13125 SW Hall Blvd.,Tigard,OR 97223 Plan review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I I , i, Inspection Line: 503.639.4175 Date Ready/B : tarts.
Internet: www.ti ardor. ov y S See Pent l for
g B Notified/Method: Supplemental Information
TYPE OF WORK • COMM ,.. ',_'USE CHECKLIST_
Mechanical permit fees'are based on the value of the work
❑New construction ❑Addition/alteration/replacement perforated.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building 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: / . 9 7 ST1 4. . t Cr Furnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP: "�Z /A rt l/'S I V ct 1 ZZ* Furnace 100,000+BTU(ducts/vents) 54.91
�•Y'���'e� 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 holler(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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Md f\A oioe. a j ex- uteri-A- 4 net fireplace 23.32
fnSJ`�� Log lighter(gas) 23.3
� Vine, ex�'�-1nq Wood/pelletstove 33.399
r J
�exm Wood fireplace/insen 23.32
Chimney/liner/flue/vent 23.32
•
❑ PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
Cite/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone.( I Fax ( ) Attic/crawlspace fans 23.32
0 APPLICANT 1 ❑ CONTACT PERSON Other: 23.32
Business name: Y _ fn Fuel piping:
( C t`�i 1! ' /1_J S14.15 for first four;S4.03 for each additional
Contact name: Furnace,etc.
Address: Gas hat pump
-- ------ WalEsuspended/unitheater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail.
Barbecue
CONTRACTOR • Clothes dryer(gas)
Business name: Other'.
MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: __ Minimum permit fee(590.00)
Phone:( ) Fax:( ) ---Plan review(25%of permit fee)
State surcharge(12%of permit fee) / NO
CCB lie.: TOTAL PERMIT FEE
This permit apptkatioa expires if a permit is not obtained within 180
'pq� �� days terser It hate been accepted n anmpkte.
Authorized sigma s/( /J/ ny • Fec methodology set by To-County Building Industry Service Hoard
.5 302dt
Print Date: r 222���CC�ff»I: ildmgl• edM . PermnApP_MaI 11duc NO-46 Tr(11,0 WWEB)