Permit CITY OF TIGARD MECHANICAL PERMIT
1 • COMMUNITY DEVELOPMENT Permit#: MEC2015-00493
T R ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2015
Parcel: 25111 CC01800
Jurisdiction: Tigard
Site address: 10315 SW CENTURY OAK DR
Project: Lehman Subdivision: SUMMERFIELD Lot: 15
Project Description: Installation of gas line for new range.
Contractor: OWNER Owner: RON LEHMAN
RON LEHMAN 10315 SW CENTURY OAK DR
10315 SW CENTURY OAK DR TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-806-6013 PHONE: 503-806-6013
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 07/21/2015 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 07/21/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 07/21/2015 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notificati.. _ • -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct q - ions to OUN • c. •• 503.232.1987 or 1.800.332.2344.
Issue- By: Permittee Signature:
� 6,77 „LL
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic FOR OFFICE USE ONLY
Received �� ��
City of Tigard Date/By: �� /Ste( Y� Permit No.: ile
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.190 2 1 2 015 Date/By: Other Permit:
T I G A R U Inspection Line: 503.639.4175 4 Date Ready/By: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
C111'OF TRAM)
TYPIMUGDIVISTM COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction 14 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-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:JO 01) /r / x V �p� PR. Furnace 100,000 BTU(ducts/vents) . 46.75
City/State/ZIP: 7Lliq1'f 7(/.1 / 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: )) Eitft.rr► ./.„ /d c.1 IA 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
j,'!/�tC /17 .--2 o 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
//I/,S VI t L km 5 i//I/t fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
RI PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name: ROA/ 2911104n-A/ Range hood/other kitchen
equipment 33.39
Address:J d 3/(} GJE/lu Xy 4 Ak Ae. Clothes dryer exhaust , 33.39
•
City/State/ZIP: U�z,�`/� �� 9 722 ' Single-duct exhaust(bathrooms,
f toilet compartments,utility rooms) 23.32
Phone:ç5 , ) G�b •6 0 f, Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
,� Fuel piping:
Business name: :I4)°?L 1) /06 ii?' $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)
a i/
Other:
Business name:
j)/� "-'�— MECHANICAL PERMIT FEES*
Address: Subtotal
�D
City/State/ZIP: Minimum permit fee($90.00) �f yy��/'
Plan review(25%of permit fee) - --#
Phone:( ) Fax:( ) State surcharge(12%of permit fee)* /t) 80
CCB lic.: TOTAL PERMIT FEE j .VI
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signs / ' Fee methodology set by Tri-County Building Industry Service Board
Print name: , l / Date: - /. ,
1:\Building\Pcrmits\MEC_PermitApp_0401 I3.doc 440-4617r(11/02JCOM/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
10315 SW CENTURY OAK DR, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00493
David Young
Violation Summary:
Inspector Contractor