Permit Support Document r Q CITY OF TIGARD F , ,. MECHANICAL PERMIT•
COMMUNITY DEVELOPMENT Permit#: MEC2014-00624
T fGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2014
Parcel: 2S 111 DC06700
Jurisdiction: Tigard
Site address: 9460 SW BRENTWOOD PL
Project: Nicholas Subdivision: SUMMERFIELD NO.9 Lot: 497
Project Description: install gas line for 4 hookups and 1 flue. 12/1/14:Reprinted permit to include gas piping for range.
Contractor: R&S HEATING INC Owner: SHIRLEY NICHOLAS/GARY SHARMAN
1123 MEADOWVIEW COURT 9460 SW BRENTWOOD PL
WEST LINN, OR 97068 TIGARD, OR 97224
PHONE: 503-657-4137 PHONE: 15419218665
FAX: 503-657-4137
FEES
Specifics: Description Date Amount
Mechanical Permit-RES 11/17/2014 $90.00
Type of Use: SF 12%State Surcharge-Mechanical 11/17/2014 $10.80
Class of Work: ADD Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.832 23 44.
Issued By: Permittee Signature: ~
Aop Call 503.6 •.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard �� / Permit No
1111 "
13125 SW Hall Blvd.,Tigard,OR 97223 Prik Date/By: ! /y �i� J L.✓`4/`1 1!/�
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
-1 I(i A R l)
Inspection Line: 503.639.4175 D I •ji 1 Date Ready/By: Adis: 0 See Page 2 for
Internet: www.tigard-or.gov D Y Notified/Method: 7-2:z Supplemental Information
OD
TYPE OF WORM 11( I tlif46 1� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
11!nfR�'r'F1°�qh� 1 Mechanical permit fees*are based on the value of the work
❑New construction t 1on/alteratiott/f lacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
_ RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
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: 'Y'lG r; C� /1rrN� k, / /9C Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: J �! Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Ni c-%dI j 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
r et y=am fireplace 23.32
teill,( ?Clef r _ 7V9` Log lighter(gas) 23.32
/9/3, 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: 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 _
Fireplace Phone:( ) Fax: :( ) Firep
Range / - _
E-mail: Barbecue _
CONTRACTOR Clothes dryer(gas) _
Business name: ��S ,L,Lr„x J/q Other: _
`f ` ... MECHANICAL PERMIT FEES*
Address: (/)3 /j-n_ _ 4��vr e� ‘E./2..14- Subtotal
City/State/ZIP: / �`'°� Minimum permit fee($90.00)
Gtkj- G Jv.J d/�_ 7d p'
f Plan review(25%of permit fee)
Phone:( ))) 6 57,by 3 2 Fax:( ) g ( ° permit fee) _
State surcharge 12/o of ermit fee
CCB lic.: 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: I Date:
1:\Building\Permits\MEC PermitApp_040113.doc 440-461Tr(I1/02/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_040I I 3.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9460 SW BRENTWOOD PL, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
FAIL
November 26, 2014 at
10:27:09 AM
MEC2014-00624
David Young
Gas line not holding pressure. Leaked 1lb in 15 min. PRESSURE TEST not holding.
Systems utilizing less than 14 inch water column shall hold min. 10 psi for 15 minutes
with no perceptible drop in pressure. Systems utilizing welded piping and systems in
excess of 14 inch water column shall hold min. 60 psi for 30 mins. G2417.4.1
C406.4.1Identify gas pipe at meter bank as to address served. C401.7
Provide permit and mechanical rough in inspection for gas fireplace. Flue not connected,
no shut off at appliance.
Add gas range to permit.
Seal gas line penetration to crawl area in garage.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9460 SW BRENTWOOD PL, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
December 2, 2014 at 11:36:56
AM
MEC2014-00624
David Young
30 psi, 15 min.
Protect gas line at fireplace penetration.
Violation Summary:
Inspector Contractor