Permit CITY OF TIGARD MECHANICAL PERMIT
_
II V
1 ' COMMUNITY DEVELOPMENT Permit#: MEC2015-00320
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/01/2015
Parcel: 2S103DB05900
Jurisdiction: Tigard
Site address: 13355 SW GENESIS LP
Project: Dynack Subdivision: GENESIS NO.2 Lot: 27
Project Description: Installation of duct work for range hood
Contractor: KLN RENOVATIONS LLC Owner: DYNAK,ALAN
2411 SE ELLIOTT AVE 13355 SW GENESIS LOOP
PORTLAND, OR 97214 TIGARD,OR 97223
PHONE: 503-869-4417 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 06/01/2015 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 06/01/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 06/01/2015 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U otification -• -r. os= rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OU 0: •y cal" . 503.232.1987 or 1.800.332.2344. 7 1 i/ /
Issued By: / �� Permittee Signature:
f- Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr•"c//
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOIL Ot l l( 1 I tit. O\1.1
City of Tigard Received
J Permit No.: kg. . S (1 ,.
11111 I • 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review '�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I'I t n It I� Inspection Line: 503.639.4175 Date Read B y' Drys:
See Page for
Internet: www.tigard-or.gov Notified/Method: Supplemental Info
rmation
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction 'Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
pmt-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: /3 3 5``� . 5 GO 6 eh e 575' buy Furnace 100,000 BTU(ducts/vents) , 46.75
City/State/ZIP: /Copp-yet n of 72, 23 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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
APO Da c7-1:17 biz- Liy� 1i6�Lr/ fireplace 23.32
/ J Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
?ELPROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name: 1 Y4/� Ran a hood/other kitchen
� ! ange / 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
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
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
` Other:
Business name: K 1` f ,,Q H O vA,/ ,��J
f MECHANICAL PERMIT FEES*
Address: '1 1_
Subtotal Q
City/State/ZIP: Minimum permit fee($90.00) / .t id
Phone: Plan review(25%of permit fee)
�'��j.!�!!�7 Fax:(' ) State surcharge(12%of permit fee) /O. $Gl-
CCB lic.: 17 N 631 TOTAL PERMIT FEE ja9• ssa
I 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: e1R L G, LA"Aie f J Date: (0 / Z DI 5
t1/ �
t:l Building\PrnnitsV�C_PermitApp_0401 doc 7T(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
13355 SW GENESIS LP, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00320
George Heimos
adynak@gmail.com
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
13355 SW GENESIS LP, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00320
George Heimos
adynak@gmail.com
Violation Summary:
Inspector Contractor