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Permit CITY OF TIGARD MECHANICAL PERMIT 3/11 COMMUNITY DEVELOPMENT Permit#: MEC2015-00203 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2015 Parcel: 2S114BA03500 Jurisdiction: Tigard Site address: 9685 SW SERENA WAY Project: Cook Subdivision: PICK'S LANDING NO.2 Lot: 105 Project Description: Add gas line for new tankless water heater,venting for water heater and reconnect gas range at new location. Contractor: GRIDLINE PLUMBING Owner: COOK, GARY R&SUSAN E 14844 SW 109TH AVE 10582 SW KENT ST TIGARD, OR 97224 TIGARD, OR 97224 PHONE: 971-275-6167 PHONE: FAX: FEES Specifics: Description Date Amount Water Heater 04/13/2015 $23.32 Type of Use: SF Flue Vent for Water Heater or Gas 04/13/2015 $23.32 Class of Work: ALT Type of Const: Fireplace Occupancy Grp: Fuel Piping 04/13/2015 $14.15 Stories: 12%State Surcharge-Mechanical 04/13/2015 $10.80 Minimum Fee Adjustment-Mechanical 04/13/2015 $29.21 Fuel Fuel Types: Natural Gas Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work i •• tarted within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foil. ' the rules -dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obt.in a copy of the rules or direct questi UNC by calling 503.232.1987 or 1.800.332.2344. Issued By ( Permittee Signature: *war! Call 503.639.4175 by 7:00 a.m.for the next available inspr d.1 This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY ErCity of Tigard KECEIVEP Received �A1j a DateBy: / Permit No.:N j�—6t� ' 3 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review Phone: 503.718.2439 Fax 503.598.1960 Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 APR P R 1 2015 Date Ready/By: luris ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF 1 01' 1 Mitt) COMMERCIAL FEE* SCHEDULE – USE CHECKLIST ��11[� �j �S')'>?;'T !.,' Mechanical permit fees*are based on the value of the work ❑New construction Addition/altt?rhtMtil><c'p c�meht` performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ 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. Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling: ��/�� J � , Air conditioning 46.75 C'1 . ��K�V e ` r Job site address: � � (�(/t� Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 75 6 0.4 ,63,---- Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: I Project name: Duct work 23.32 Cross street/directi ins to job site: Hydronic hot water system 23.32 Residential boiler(radiator or t AA !__4<< IP / iA / G hydronic) 23.32 Unit heaters(fuel-type,not electric), 7- 1. `P��t�� ! in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: I Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater X / 23.32 e 2 3,32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 !l Flue vent for water heater or gas 2 0, �-a / 6, 7r c/ 2e_ 7Q fireplace // 23.32 23 3z �" Log lighter(gas) 23.32 A �1/.- /� aQ / �� Wood/pellet stove 33.39 j t�I i / Wood fireplace/insert 23.32 C t 9 76) 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 Phone:( ) Fax::( ) Fireplace Range //1r/J E-mail: Barbecue nif CONTRTOR Clothes dryer(gas) _ �p/ v/file_ ACli-P %/?2 Other:Business name: 6 ( MECHANICAL PERMIT FEES* Address: /4 O /Or �2 Subtotal City/State/ZIP: 77":44,-- Q/` g7Z2i Minimum permit fee($90.00) �Q.LP �� Plan review(25%of permit fee) Phone:( r ? Z Z 7 I Fax:( ) — (12%State surcharge(12/0 ofpetmit fee) l p,g 4 CCB lic.: d / TOTAL PERMIT FEE /oQ.SO �4/O5 //WA" G Oar grow, 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: e // A, / 1a4'%-- Date: _ I:\Building\Permits 1MEEC__-PermitApp_040113.doc 440-46I7r(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. 1:\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 9685 SW SERENA WAY, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical ﬁnal PASS - No C of O MEC2015-00203 David Young Note: seal around water heater vent in masonry chase. Seal around gas line penetration in kitchen. Owner request to pass ﬁnal and be responsible for corrections. Violation Summary: Inspector Contractor