Permit :1 I :1 •• CITY OF TIGARD MECHANICAL PERMIT
N- c COMMUNITY DEVELOPMENT Permit#: MEC2015-00707
Date Issued: 10/19/2015
TIGARD, 13125 SW Hall Blvd ,Tigard OR 97223 503 718 2439 Parcel 1S125DB04700
Jurisdiction: Tigard
Site address: 7175 SW SHADY CT
Project: Hamilton Subdivision. SHADY DELL NO 2 Lot. 21
Project Description: Gas piping for range
Contractor: HOLMES INSTALLATION SERVICE Owner: HAMILTON, RICHARD F&JUDY E
33535 NW VADIS RD 7175 SW SHADY CT
CORNELIUS, OR 97005 TIGARD,OR 97223
PHONE 503-647-9320 PHONE
FAX
FEES
Specifics: Description Date Amount
Fuel Piping 10/19/2015 $14 15
Type of Use: SF 12%State Surcharge-Mechanical 10/19/2015 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/19/2015 $75 85
Occupancy Grp:
Stories:
Fuel
Fuel Types Natural Gas
Gas Pressure
Total $100 80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules
or direct questions to OUNC by calling 503 232 1987 or 1.800 332.2344
Issued By: 7---12 Permittee Signature. ii&litit
Call 503.639.4175 by 7:00 a.m.for the next available inspection da e.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatk FOR OFFICE USE ONLY �1
City of Tigard Date/13y:/ / i s� S- 70 Received IVA D � � /.- 'ermrt No. �� �f7
° 13125 SW Hall Blvd,Tigard,OR 97223 Plan Review
a Other Permit
Phone: 503.718.2439 Fax: 503 598 19K T 201 C� Date/By
TI G A R D Inspection Line. 503 639.4175 Date Ready/By Duns El See Page 2 for
Internet: www.tigard-or gov Notified/Method• Supplemental Information
CITY OF f 1t�jARE
TYPE 1 iC M`r NO `+j�
COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value.$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
.1t.
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
Multi-family E]Master builder ❑Other: Description Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 7 f 75- 5(,..), S j„4.')%/ Ch' 1--- (requires site plan showing placement) 46.75
City/State/ZIP: Tk O G 0 f✓_ 5'7 �2 3 Furnace 100,000 BTU(ducts/vents) 46.75
I I Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23 32
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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other. 23 32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23 32
Gas fireplace 33 39
^" ) 1 6`ttul�J O �i ( p (p I 1 v v-, Flue vent for water heater or gas
1 r / fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Ilc PROPERTY OWNER El TENANT Chimney/liner/flue/vent 23 32
Other 23 32
Name: v I IA"4,(`0/N Environmental exhaust and ventilation:
Address: 7 f 7 54.+, SA cj Range hood/other kitchen
equipment 33 39
City/State/ZIP:1`c ql,c) 0 Vt_ 7i 2- Clothes dryer exhaust 33.39
I.+_3 ��7 i rte„ toilet compartments,exhaust(bathrooms,
Phone:.933 5 � � � � Fax:( ) toilet compartments,utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Business name: Other. 23.32
Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Address: Furnace,etc
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( ) Fax: :( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name LA�.P . � Clothes dryer(gas)
Other.
Address: -33 c Aj��+�} vA_I.s R,u MECHANICAL PERMIT FEES*
City/State/ZIP: v is(' ( -S O y-e- q -pi 3 Subtotal Qo r o I
Minimum permit fee($90.00) _
Phone:c03)2_ 7 7 y Fax:( ) Plan review(25%of permit fee) _
CCB lie.: fol. 4(' 3 State surcharge(12%of permit fee) JO •pG
TOTAL PERMIT FEE /OO,e
Authorized signature: This permit application expires if a permit is not obtained within 180
>'>n �,��— A �r 4"'� I 1.�•► days after it has been accepted as complete.
Print name:Ra �L�l a ,P.�.e1� Date: j/ i w L� ' Fee methodology set by Tri-County Building Industry Service Board
1\Building\Permns\MEC- ermmApp doc 09/09/10 4400-4617T(I 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 doc 09/09/10 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
7175 SW SHADY CT, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00707
David Young
Violation Summary:
Inspector Contractor