Permit II CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00251
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2013
Parcel: 2S110BA06900
Jurisdiction: Tigard
Site address: 12000 SW WILDWOOD ST
Project: Olin Subdivision: SHADOW HILLS NO.2 Lot: 52
Project Description: (1) gas log lighter
Contractor: VENNE PLUMBING LLC Owner: OLIN, GARY L & SHIRLEY J
15145 SW DIVISION ST 12000 SW WILDWOOD ST
SHERWOOD, OR 97140 TIGARD, OR 97224
PHONE: 503 - 624 -9309 PHONE:
FAX: 503 - 684 -0940
FEES
Specifics: Description Date Amount
Log Lighter (Gas) 05/13/2013 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 05/13/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/13/2013 $66.68
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 95 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / I /� p /n i /J Permittee Signature:
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 Applicat 1' it E ��// CEIVED FOR OFFICE USE. ONLY
Received Pe rmit No
- City of Tigard Date/By' {' i 3 kik, a3 _s
q 13125 SW Hall Blvd., Tigard, OR 97223 MAY 1 3 2013 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit
Inspection Line: 503.639.4175
TIGARD CITY OF TIGARD Date Read /B tun. 0 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: • � Supplemental Information
BUILDING 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
El Demolition El Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $513.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use check list.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total
JOR SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 12000 sw wildwood Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: tigard, or 97224 Furnace 100,000+ BTU (ducts /vents) 54.91
Heat pump 61.06 ki
Suite/bldg. /apt. no.: Project name: °% t 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
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
outdoor log lighter fireplace 23.32
Log lighter (gas) I 23.32 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
ID PROPERTY OWNER El TENANT Other: 23.32
� /may Environmental exhaust and ventilation:
Name: c. p4,,p ‘4 ter\ N Range hood /other kitchen
equipment 33.39
Address: \ )--0 0 0
•i,,,J kj, )l, � AO 11Jc-1)( - Clothes dryer exhaust 33.39
City /State /ZIP: ---- C�a�2� l J`l . t � - 121 Li Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: ( ) Attic /crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
S14.15 for first four; S4.03 for each additional
Contact name: Furnace, etc.
Address:
Gas heat pump
Wall /suspended/unit heater
City /State /ZIP: Water heater
Fireplace Phone: ( ) Fax: : ( ) Firep 1,
Range
E -mail: Barbecue
CONTRACTOR Clothes dryer (gas)
Other:
Business name: Venue Plumbing, LLC MECHANICAL PERMIT FEES*
Address: 15145 SW Divison St Subtotal
City /State /ZIP: Sherwood, OR 97140 Minimum permit fee ($90.00) 90
Plan review (25% of permit fee)
Phone: (503) 6249309 Fax: (503) 6840940
State surcharge (12% of permit fee) 10.8
CCB tic.: 192494 TOTAL PERMIT FEE 100.8
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatur • • Fee methodology set by Tri- County Building Industry Service Board I
Print name: lindsay venne Date: 5 /13/2013
I \ Building\Permits'MEC_PermitApp_ 040 113 -doc 440 -4617T (I I/02 /COM/WEB) I
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12000 SW WILDWOOD ST, TIGARD, OR, 97224
Residential - Mechanical
610 Gas Line
05/15/2013 00:00
MEC2013-00251
PASS
Gas pressure. 10psi. For 15min pass
Violation Summary:
Inspector Contractor