Permit CITY OF TIGARD MECHANICAL PERMIT
III ' COMMUNITY DEVELOPMENT Permit#: MEC2015-00682
Date Issued: 2015
10/08/
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 10/2S104AA04100
Jurisdiction: Tigard
Site address: 12670 SW KAREN ST
Project: Arid LLC Subdivision: BELLWOOD Lot: 25
Project Description: Install new furnace,duct work and gas piping for the water heater,furnace and range.
Contractor: OWNER Owner: ARID LLC-CHRIS STOCKS
4800 E HUMMINGBIRD LN
PARADISE VALLEY,AZ 85253
PHONE:
PHONE: 602-478-8888
FAX:
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 10/08/2015 $46.75
Type of Use: SF Duct Work 10/08/2015 $23.32
Class of Work: ALT Type of Const: Flue Vent for Water Heater or Gas 10/08/2015 $23.32
Occupancy Grp: Fireplace
Fuel Piping 10/08/2015 $14.15
Stories:
12%State Surcharge-Mechanical 10/08/2015 $12.90
Fuel
Fuel Types:
Gas Pressure:
Total $120.44
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
, IIIssued By: j %.-4/ / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received / / ,'j Permit No /
N 13125 SW Hall Blvd.,Tigard,OR 97223
! Phone: 503.718.2439 Fax: 503.598.1960 0 C T 8 2.015 Date/By:Review Other Permit:
T 1 GA R D Inspection Line: 503.639.4175 Date Ready/By: funs, Id See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
— Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
® Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-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: 12670 SW Karen Furnace 100,000 BTU(ducts/vents) x 46.75 `,7 ,75-
City/State/ZIP:Tigard,OR 97233 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:Scholls Ferry Rd&SW 121 st Ave 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 x 23.32 2-3,32
DESCRIPTION OF WORK • Gas fireplace/insert 33.39
Flue vent for water heater or gas
Install New furnace and Duct Work L 1 f {1�4;f� 4 Ga.S P'.n.e fireplace x 23.32 23.31
CC '' Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER ❑ TENANT
,0 / Environmental exhaust and ventilation:
/�7
Name:Arid LLC 5,q- i61r1.6�ft “C /C u2 i S 51194,k3 Range hood/other kitchen
' equipment 33.39
Address: 12670 SW Karen Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97233 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(602)478-8888 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACTItSON Other: 23.32 ,
/ Fuel piping:
Business name: stcAn P o,r cc 6a E $14.15 for first four;$4.03 for each additional /I.K
Contact name: Furnace,etc. I
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater I
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: p rA)APe2
MECHANICAL PERMIT FEES*. .
Address: Subtotal
fO7.Sy'
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) /d.."M /
CCB lie.: TOTAL PERMIT FEE /20.0
This permit application expires if a permit is not obtained within 180
�a days after it has been accepted as complete.
Authorized signature: (_....-.-� ' Fee methodology set by Tri-County Building Industry Service Board
Print name:Arid LLC,Chri tocks I Date:9/23/15
3t'o , 32--
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation Ferniit 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.
I:\BuildingWermits NEC_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
12670 SW KAREN ST, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
FAIL
January 29, 2016 at 1:21:35
PM
MEC2015-00682
David Young
Provide permit for AC installed without permit.
Provide tamper proof access port caps on AC. M1411.6
Gas range not vented to exterior.
Bath fans not on timer or de humidistat.
Add dryer vent to permit.
Note: no record of mechanical rough in inspection.
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
12670 SW KAREN ST, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00682
David Young
Corrections complete.
Violation Summary:
Inspector Contractor