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Permit 111 CITY OF TIGARD MECHANICAL PERMIT i r COMMUNITY DEVELOPMENT , Permit#: MEC2015-00125 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/11/2015 Parcel: 1 S134CB03100 Jurisdiction: Tigard Site address: 12330 SW SUMMER CREST DR Project: Sampson Consulting Subdivision: SUMMER HILLS PARK Lot: 30 Project Description: Replace furnace,add a/c,(3)exhaust fans&dryer ducting.6/1/15,Reprinted to add range hood. Contractor: PHILEO CONSTRUCTION Owner: SAMSON CONSULTING LLC 13155 SW WORCHESTER PL ATTN:JENNIFER ORNELAS TIGARD,OR 97223 12705 SW KATHERINE ST TIGARD, OR 97223 PHONE: 503-830-5827 PHONE: FAX: FEES Specifics: Description Date Amount Air Conditioning 03/11/2015 $46.75 Type of Use: SF Furnaces<100K BTU 03/11/2015 $46.75 Class of Work: ALT Type of Const: Clothes Dryer Exhaust 03/11/2015 $33.39 Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 03/11/2015 $69.96 Stories: Utility Rooms) 12%State Surcharge-Mechanical 03/11/2015 $23.62 Range Hood/Other Kitchen 06/01/2015 $33.39 12%State Surcharge-Mechanical 06/01/2015 $4.01 Fuel Fuel Types: Gas Pressure: Total $257.87 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 N. • _. _-iter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or.• -ct questions to OU . by ca g 503.232.1987 or 1.800.332.2344. Hued By: Permitte Signature: Call 503.639.4175 by 7:00 a.m.for the next availab : nspection 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. CITY OF TIGARD MECHANICAL PERMIT 1111 s COMMUNITY DEVELOPMENT Permit#: MEC2015 00125 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/11/2015 Parcel: 1 S134CB03100 Jurisdiction: Tigard Site address: 12330 SW SUMMER CREST DR Project: Sampson Consulting Subdivision: SUMMER HILLS PARK Lot: 30 Project Description: Replace furnace,add a/c,(3)exhaust fans&dryer ducting. Contractor: PHILEO CONSTRUCTION Owner: SAMSON CONSULTING LLC 13155 SW WORCHESTER PL ATTN: JENNIFER ORNELAS TIGARD, OR 97223 12705 SW KATHERINE ST TIGARD, OR 97223 PHONE: 503-830-5827 PHONE: FAX: FEES Specifics: Description Date Amount Air Conditioning 03/11/2015 $46.75 Type of Use: SF Furnaces< 100K BTU 03/11/2015 $46.75 Class of Work: ALT Type of Const: Clothes Dryer Exhaust 03/11/2015 $33.39 Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 03/11/2015 $69.96 Stories: Utility Rooms) 12%State Surcharge-Mechanical 03/11/2015 $23.62 Fuel Fuel Types: Gas Pressure: Total $220.47 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow t e rules adopted by the Oregon Utility Notifica• Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo may o• copy of the rules or dir uestions to •- C b • 1g 503.232.1987 or 1.800.332.2344. ued By: . / J Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application !!�� FOR OFFICE 11SE ONLY City of Tigard IIF CEIVED Daattee/By� pJ��'/�►T' Permit No.: M 5"--e6105 - • 13125 SW Hall Blvd.,Tigard,0 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 MAR 11 2015 Date Ready/By: ]aria la Internet: www.tigard-or.gov Notified/Method: Supplemental m Information _ CITY OF TIGARD TYPE COMMERCIAL FEE° SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 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 i 46.75 f -7S Job site address: D //- t 2,3 0 5 w Svc ME� (-t��°r 1J 2,. Furnace 100,000 BTU(ducts/vents) 1 46.75 i v,76 City/State/ZIP: en G HJ) OIL i'-] 22 Furnace 100,000+BTU(ducts/vents) 54.91 1 , Heat pump 61.06 Suite/bldg./apt.no.: Project name: H i lis.; ez1, , C TJ Duct work 23.32 Cross street/directions to job site: ''ZI S 1 c umm C A.F- Hydronic hot water system 23.32 / 1 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 A�., rr Flue vent for water heater or gas bG2 A F-ui-N ca Ao0 ,A.I C ` add fireplace 23.32 eN IAIA 1 ( Log lighter(gas) 23.32 GouS� �7J NJ(A;1nit--1 / Dal Ovt:.,r)hCJ 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 LE5 49 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 3 23.32 .7•9l0 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) 1nn /� ^ 1- Other: Business name: phi KO [ O'sCr1�i of MECHANICAL PERMIT FEES* Address: 13 Is C S W OIL h,i-e2 'PIA C.e Subtotal /9.'47,TS City/State/ZIP: °x'12 2'7 Minimum permit fee($90.00) I 1 Plan review(25%of permit fee) Phone:(5b3) i&3 0 58,2-7 Fax:( ) State surcharge(12%of permit fee) 3.ep . CCB tic.: ( 13J (p TOTAL PERMIT FEE _a 9.6.7 / S 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: I:\Buil ding\Permits\MEC_PermitApp_040113.doe 440-4617T(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. l:\Building\Permits\MEC_PermitApp_040113.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 12330 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Mechanical 699 Mechanical ﬁnal FAIL MEC2015-00125 David Young Provide access for inspection, lock box on front door. 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 12330 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Mechanical 699 Mechanical ﬁnal FAIL MEC2015-00125 David Young Seal line set, condensate and furnace vent penetrations in exterior wall. 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 12330 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Mechanical 699 Mechanical ﬁnal PASS - No C of O MEC2015-00125 David Young Corrections done. Violation Summary: Inspector Contractor