Permit CITY OF TIGARD MECHANICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit 4: MEC2015-00437
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2015
Parcel: 2S114BA03100
Jurisdiction: Tigard
Site address: 9640 SW SERENA WAY
Project: WHITE Subdivision: PICK'S LANDING NO.2 Lot: 108
Project Description: A/C installation. Placement of NC unit must comply with manufacturer's clearance requirements.
•
Contractor: ADVANCED HEATING&AIR CONDITIONING INC Owner: WHITE, DUSTIN J& ELIZABETH H
5825 SE FOSTER RD 9640 SW SERENA WAY
PORTLAND, OR 97206 TIGARD, OR 97224
PHONE: 503-774-0161 PHONE:
FAX: 503-774-4391
FEES
Specifics: Description Date Amount
Air Conditioning 07/09/2015 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 07/09/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 07/09/2015 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: •ermittee Signature: �'
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Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/By: 7 / }_
0257 r• Permit No.:m is�—�_A
3,7 SW Hall Blvd.,Tigard,OR
311 : Phone: 503.718.2439 Fax: 503.59
C E IV E C Plan Review
Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris HI See Page 2 for —
Internet: www.tigard-or.gov
JUL UL 2 2015 Notified/Method.
At Supplemental Information
TYPE OF CST4s�l�
0-.....---
j l- ,1',..-,‘, r,}2
,. n COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
RR�� � II���ll E, 1 f(fs i`ON Mechanical permit fees*are based on the value of the work
❑New construction ® Addition/R1ttY�M6fI/e> Pdc�rrient performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION
Value:$
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. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75 46.75
Job site address:9640 SW Serena Way Furnace 100,000 BTU(ducts vents) 46.75
City/State/ZIP:Tigard,Oregon 97224 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
_ fireplace 23.32
Installing a A/C system Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Dustin and Elizabeth White Range hood/other kitchen
equipment 33.39
Address:9640 SW Serena Way Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,Oregon 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)505-3478 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
_ $t4.15 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
E-mail:
Range
Barbecue
E,NTRACTOR Clothes dryer(gas)
Business name:Advanced Heating&Air Conditioning,Inc Other:
MECHANICAL PERMIT FEES*
Address:5825 SE Foster Rd. Subtotal
City/State/ZIP:Portland,Oregon 97206 Minimum pennit fee($90.00) 90.00
Plan review(25%of permit fee)
Phone:(503)774-0161 Fax:(503)774-4391 State surcharge(12%of permit fee) 18
CCB tic.:98573 TOTAL PERMIT FEE 108.00
This permit application expires if a permit is not obtained within I80
��� .���, , days after it has been accepted as complete.
Authorized signatu S * Fee methodolo set by Tri-County Building Industry Service Board
Print name:Kristal Reed Date:6/29/2015 O'i)' 4977.,o
I:\Building\Permits\MEC_PermitApp_0401 I 3.doc 440-4617T(1 I/02/COM/WEB)
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
9640 SW SERENA WAY, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
FAIL
MEC2015-00437
George Heimos
1. AC Unit locking access port caps not installed. M1411.6
2. Recall inspection when correction has been completed.
NOTE Home owner does not need to be home for inspection.
Electrical minor label number ELS479682
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
9640 SW SERENA WAY, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00437
David Young
Minor label # ELS 479682
Violation Summary:
Inspector Contractor