Permit " CITY OF TIGARD ' MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit fl: MEC2014-00230
T I .;A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/15/2014
Parcel: 2S 110DD123o0
Jurisdiction: Tigard
Site address: 10720 SW HIGHLAND DR
Project: Lehman Subdivision: SUMMERFIELD NO.13 Lot: 693
Project Description: Gas piping for range.5/20/14,reprinted to add(1)gas outlet for water heater.
Contractor: LEHMAN, CARL Owner: LEHMAN,CARL
10720 SW HIGHLAND DR 10720 SW HIGHLAND DR
TIGARD, OR 97224 TIGARD,OR 97224
PHONE: PHONE: 503-502-6037
FAX:
FEES
Specifics: Description Date Amount
Mechanical Permit-RES 05/15/2014 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 05/15/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/15/2014 $75.85
Occupancy Grp:
Stones:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct q tions to •UNC by calling 503.232.1987 or 1.800.332.2344. /,
Issued By / Permittee Signal e: e4-!c Q�Gs-c.c�J
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. a
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
MilCity of Tigard Received a 5 C) �� PermitNo.: tie � -OC J
• 13125 SW Hall Blvd., Fax: OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 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:
Air conditioning 46.75
Job site address: /07 9,U , t„ I Co 1-f L.,q 1,57' ,),Q. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
" Heat pump 61.06
Suite/bldg./apt.no.: Project name: k-I,,H.l-i.-(vot 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
Alr.:5-r e, P-5r ct,e�LE.T r 2 Ln3j-ThL- fireplace 23.32
t.1 - Ex, ST/t..s(b P e,QNI'r Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent _ 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
-- Environmental exhaust and ventilation:
Name: C i4--.Q L 1.___,£If N ti0 Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) . 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$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 /
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other:name: nuV� t n v
MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00) i`, t ij
Phone:( ) Fax:( ) Plan review(25%of permit fee) 1„1
State surcharge(12%of permit fee) _elect
CCB lic.: TOTAL PERMIT FEE �G _
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: Date:
1:'Building\Pennits\MEC_PermitApp_040113.doc 440-46177(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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2014-00230
T t
G D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/15/2014
Parcel: 2S110DD12300
Jurisdiction: Tigard
Site address: 10720 SW HIGHLAND DR
Project: Lehman Subdivision: SUMMERFIELD NO.13 Lot: 693
Project Description: Gas piping for range.
Contractor: LEHMAN, CARL Owner: LEHMAN, CARL
10720 SW HIGHLAND DR 10720 SW HIGHLAND DR
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: PHONE: 503-502-6037
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 05/15/2014 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 05/15/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/15/2014 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,d ,()`+'e_ Permittee Signature: C 4116 A v-7
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application RECEIV I O12 O I 1 (l I ,1 (,\I.1
City of Tigard Received
13125 SW Hall lvd.,Tigard,OR 97223
Date/By: /.S / „A Permit NyWero2ey .,0i , So
•1111111 II Phone: 503.718.2439 Fax: 503.598.1960 MAY 15 201' Plan Review Date/By: Other Permit:
1 ,i;\I,I 1 Inspection Line: 503.639.4175 Date Read/B HI See Page 2 for
Ready/By: Judi'
Internet: www.tigard-or.gov CITY OF TIGA i fttifled/Method: 76" Supplemental Information
BUILDING DIVISION OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Err-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:/� Air conditioning 46.75
Job site address: / 0- 1D a)1! (9�/n �ei Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: /. 7 T ' - A l Furnace 100,000+BTU(ducts/vents) 54.91
bb''�� �, TT ! Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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
Other: 23.32
Subdivision: 45; ,40.7 6:o It /r o/ Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
PFlue vent for water heater or gas
/s SAY(/ p�r 7/ h 4a jc sec vio f-/L„Ye fireplace 23.32
T Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER I ❑ TENANT Other:
Environmental exhaust and ventilation: 23.32
Name: a r / 1._. 4 Range hood/other kitchen
L� `'
equipment
33.39
Address: ` O 7 Ti O �i 9.16 l O r. Clothes dryer exhaust 33.39
•Cit /State/ZIP:` ' " 7 Z Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(103) 7 j1 7 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 _
Fuel piping:
Business name: $14.15 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
Phone:( ) Fax: :( ) Fireplace /
Range r
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:
Other:
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00) ,910 ,et
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) , /0 ,8
CCB lic.: TOTAL PERMIT FEE _/a4 ,g
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
) Authorized signature: L° w • Fee methodology set by Tri County Building Industry Service Board
Print name: ad 1,1 149 /�E7 y,t C(f1 Date: (95/$— ) or
I:\Building\PermitsMEC_PermitApp_040113.doc 440-4617T(I1/09JCOM/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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
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
10720 SW HIGHLAND DR, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00230
George Heimos
Violation Summary:
Inspector Contractor