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Permit CITY OF TIGARD MECHANICAL PERMIT III s COMMUNITY DEVELOPMENT Permit#: MEC2014-00213 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/06/2014 Parcel: 2S111 CC12400 Jurisdiction: Tigard Site address: 10385 SW HIGHLAND DR Project: TREICK Subdivision: SUMMERFIELD NO.4 Lot: 175 Project Description: Fuel piping for gas stove. Contractor: J&M CONTRACTOR SERVICES INC Owner: TREICK,TOM EUGENE 15604 NE RUID RD 10385 SW HIGHLAND DR AMBOY,WA 98601 TIGARD, OR 97224 PHONE: PHONE: FAX: FEES Specifics: Description Date Amount Fuel Piping 05/06/2014 $14.15 Type of Use: SF 12%State Surcharge-Mechanical 05/06/2014 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/06/2014 $75.85 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: -.••••• d7tiL -- - II Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY Received City of Tigard `N� Date/By: `�-- Permit No G �/ t IMI ill • 13125 SW Hall Blvd.,Tigard.s� '' 3� Phone: 503.7182439 Fax: 5 Plan Review Other Permit: Date/By: T 1 G A R D Inspection Line: 503.639.4175 rto1� Date Ready/By: ® See Page 2 for Internet: www.tigard-or.gov �� 6 lr A O Notified/Method: FlASupplemental Information TYPE OF *�`�lv� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST �1 x,' NV Mechanical permit fees*are based on the value of the work ❑New constructionAddition/ajrltd151aement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: Al mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ,114 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: f� t t� Air conditioning 46.75 Job site address: (0 3 &S S IA i l y 1 a.�s`+ 1J ,c Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: i�c,..4._ ® e_ ci 4 2..__ -- y Furnace 100,000+BTU(ducts/vents) 54.91 l l Heat pump 61.06 Suite/bldg./apt.no.: Project name: Trot,+J( Duct work 23.32 Cross street/diredions 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 g 4 S S T©0 Q �n l C c-G...9-Q- fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: ® Z EA.' (---C". Range hood/other kitchen equipment 33.39 Address: (0 3 8 S S,--0 4 1&- 0 V Clothes dryer exhaust . 33.39 City/State/ZIP: "c i Cl Single-duct exhaust(bathrooms, `Y e`- biz a 1 ,/ toilet compartments,utility rooms) 23.32 Phone:(503) 3c,L. -- g a s? Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 1 Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater _ Fireplace ` Phone:( ) Fax::( ) Firep �([`' Range _ E-mail: Barbecue CONTRACTOR Clothes dryer(gas) _ ,n Other: Business name: Iv l S-e✓v L MECHANICAL PERMIT FEES* Address: S 6,-p t lU E , y �- j I Subtotal 74. City/State/ZIP: A,Nt- W>� `g(ob I Minimum permit fee($90.00) `j0,d". r Plan review(25%of permit fee) / Phone:(3 h 0) )-to s a to b 01 Fax:( ) State surcharge(12%of permit fee) !a-8.,) CCB lic.: 410, l 0 0 S l S TOTAL PERMIT FEE ?l 1,1d This permit application expires if a permit is not obtai ed within 180 L days after it has been accepted as complete. Authorized signatur W * Fee methodology set by Tri-County Building Industry Service Board Print name: 'Fr) `iZ E_k�`` I Date: s-k , l 1 1:\Building\Permits\MEC_PermitApp_040113.doc 4404617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. o9S �Z 1:\Building\Permits\MEC_PermitApp_040113.doc 2 0 Q�� Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 10385 SW HIGHLAND DR, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical ﬁnal PASS - No C of O MEC2014-00213 George Heimos Gas pressure: 10psi/15min pass Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 10385 SW HIGHLAND DR, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical ﬁnal PASS - No C of O MEC2014-00213 George Heimos Gas pressure: 10psi/15min pass Violation Summary: Inspector Contractor