Permit 1NCITY OF TIGARD MECHANICAL PERMIT
3 . COMMUNITY DEVELOPMENT Permit#: MEC2022-00701
Date Issued: 8/8/2022
Tf:ARI3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S125DB04800
Jurisdiction: Tigard
Site address: 7185 SW SHADY CT
Project: LAWRENCE Subdivision: SHADY DELL NO.2 Lot: 22
Project Description: Range hood,gas water heater replacement,and fireplace fuel piping replacement for remodel.
Contractor: OWNER Owner: LAWRENCE, BRIAN J REVOCABLE TRUST
7185 SW SHADY CT
PORTLAND, OR 97223
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Water Heater 08/03/2022 $23.32
Type of Use: SF Range Hood/Other Kitchen 08/03/2022 $33.39
Class of Work: ALT Type of Const: Fuel Piping 08/03/2022 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 08/03/2022 $10.80
Stories: Minimum Fee Adjustment-Mechanical 08/03/2022 $19.14
Fuel
Fuel Types:
Gas Pressure:
Tota I $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: _/„ —� ' Permittee Signature: s �/ fy�__
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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.
Prope caner tate ent
e• ardin Construction esponsi iiities
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 701.326(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:
own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
7 I will be performing work on property I own, a residence that I reside in, or a residence that 1 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.
ar‘ LaWrCrlce.
Print Name of Permit Applicant
a) 7 D.0 a3,
Signature of Permit Applicant Data
Permit#:
Address:
22/
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\ii ;el
Issued by: / • Date: ,rf4 f iA l r }`
This Copy for Permit Offices
Mechanical Permit Application FOR ovl►c'E I sE Ov I v
City of Tigard Received
DateBDateB Permit No.:
,� Y I w it/ % L� i A.
13125 SW Hall Blvd.,Tigard,OR M: II
97223
Plan Review '
Phone: 503.718.2439 Fax: 503.598.1 r .w Other Permit:
Inspection Line: 503.639.4175 V L�D y:
TIGARD Date Ready/By: IM H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
AUG 3 2022
TYPE OF WOW-NI OFTIGARD COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
t
�(� 15I O N Mechanical permit fees*are based on the value of the work
❑New construction ElAddition/alte LC performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
_`' ® 1-and 2-family dwelling ElCommercial/industrial ❑Accessory building For special information use checklist
p 0 Multi-family El Master builder El Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heatiog/cooling:
k'` Air conditioning 46.75
Job site address: 7185 SW Shady Ct. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Portland, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
�,J�Suite/bldg./apt.no.: Project name: Additon Lawrence Duct work 23.32
rTTA__Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unitheaters heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Tax I D:R231305 Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: 1 S 125B04800 Water heater 1 23.32
i
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Adding 50 sq ft and repositioning the kitchen fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
1 Wood fireplace/insert
4 Chimney/liner/flue/vent 23.32
)(] PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Brian Lawrence Range hood/other kitchen 7185 SW Shad equipment 1 33.39
5 Address: Y Ct. Clothes dryer exhaust 33.39
► City/State/ZIP: Portland OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 5033098868 Fax:( ) Attic/crawlspace fans 23.32
t APPLICANT 0 CONTACT PERSON Other: 23.32
�
Fuel piping:
, Business name: Ryone LLC $14.15 for first four;$4.03 for each additional
Contact name: Raul Onescu Furnace,etc.
(Address: 5321 Lakeview Blvd.Lake Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Oswego OR 97035 Water heater
w Phone:( ) 9713229416 Fax::( ) Fireplace l
4 E-mail: raulone28@grnail.coml 7z, Range 1r'� ) ri _ LA,JreA/o_ Barbecue
CONTRACTOR Clothes dryer(gas)
,tr.,,,
Other:
Business name: by owner MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.: 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: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Brian Lawrence Date: 7/28/2022
1:1Buildmg\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)