Permit _� CITY OF TIGARD MECHANICAL PERMIT gi
COMMUNITY DEVELOPMENT Permit#: MEC2015-00727
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/27/2015
Parcel: 25111 CD01900
Jurisdiction: Tigard
Site address: 15613 SW SUMMERFIELD LN
Project: McGraw Subdivision: SUMMERFIELD NO.7 Lot: 346
Project Description: Install new gas stove&venting
Contractor: R& D INSTALLATIONS Owner: MCGRAW, MICHAEL S& KATHIE L
5246 SE 62ND PO BOX 189
PORTLAND, OR 97206 DENALI PARK,AK 99755
PHONE: 503-774-7142 PHONE: 907-378-2491
FAX: 503-774-7142
FEES
Specifics: Description Date Amount
Gas Fireplace 10/27/2015 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 10/27/2015 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: 12%State Surcharge-Mechanical 10/27/2015 $10.80
Stories:
Minimum Fee Adjustment-Mechanical 10/27/2015 $33.29
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No tira'on Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy the rules
or ct questions OUNC b calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: Vt-
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
lo/a 7/5--(fig Mf_�'o1U'S- '7 '7 ■
"-.1.TON Mechanical Permit Application
Washington County www.co.washington.or.us Phone: 503-846-3470 Fax: 503-846-3993
-.., 155 N. 1St AV, Suite 350-12 Inspection Request Line: 503-846-3699
°AtnoN Hillsboro,OR 97124
Land Use Approval: Project#: _Permit#:
TYPE OF WORK COMMERCIAL FEE SCHEDULE - USE CHECKLIST
nNew construction ❑Addition/alteration/replacement Mechanical permit fees are based on the value of the work performed.Indicate
❑Demolition 0 Other: the value(rounded to the nearest dollar)of all mechanical materials,
equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION
I Value:$
-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
RESIDENTIAL EQUIPMENT/SYSTEMS FEES
❑Multi-family ❑Master builder ❑Other:
For special information use checklist.
JOB SITE INFORMATION AND LOCATION Description Qh. I Ea. I Total
Job site address: /510 1 3 503 'jv rn„4 .ed Heating/cooling
�l Furnace,incl.ductwork,vent,and liner 8.75
City/State/ZIP: ` , Air conditioner(site plan required) 8.75
Suite/bldg./apt.no.: 1 Project name: !i tk n heat pump(site plan required) 8.75
!ll---�� Duct work,alterations and additions 8.75
Cross street/directions to job site: Hydronic piping system 8.75
Boiler,incl.vent** State Permit Required
Gas heaters/unit in-wall,in-duct,
suspended,etc.not incl.vent. 8.75
Other:
Other fuel appliances
Subdivision: I Lot no.: Water heater 8.75
Tax map/pal el no.: Gas fireplace/inse stov 1 8.75
DESCRIPTION OF WORK Gas log log lighter 8.75
7h- Pool or spa heater,kiln* 8.75
l' f.v.,o a( 4.c VV ck)e S Wood pellet stove/insert 8.75
041A., 0 YN1 Wood fireplace 8.75
i Chimney/liner/flue/vent w/o appliance I 8.75
Oil tanks/gas/diesel generators 8.75
Other:
PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation
Range hood/other kitchen equipment 8.75
Name: (� t
1 1 1L�L Clothes dryer exhaust 8.75
I Address: Single-duct exhaust(bathrooms,toilet
compartments,utility rooms) 8.75
City/State/ZIP: Attic/crawlspace fans 8.75
Phone:(9"') Whole house ventilation or Radon
) �� Fax:( 1 mitigation 8.75
APPLICANT Other:
Business name: Fuel piping
$8.75 for first four;$1.05 for each additional
Contact name: Furnace By outlet#
i _
Address: WalUsuspended/unit heater By outlet# _
Water heater By outlet#
City/State/ZIP: '
Fireplace/log lighter/gas log By outlet# ,
Phone:( ) Fax:1 1 Range By outlet#
Barbecue By outlet#
E-mail:
Clothes dryer By outlet#
CONTRACTOR Other:
Business name: tfirV ___1...e164s ttjg'Jta-s - c MECHANICAL PERMIT FEES
Address: Zl.��o , Cat w H-14 Subtotal $
Minimum permit fee Sera- Ye-°a
City/State/ZIP: T44 A U l7d...0 b Plan review(65%of permit fee) $ ______-
' Phone: ) 7)/_:-.)) 7 Fax:( ---&- State surcharge(12%of permit fee) $ to.eo
l 111-11_2,1 TOTAL PERMIT FEE $ /00•Se
E-mail: MC V)1 L(i-mil p. cO rrN
� �7, This permit application expires if a permit is not obtained within 180
' CCB lic.: q�l.c3G City or metro • 3 al__ days after it has been accepted as complete.
Authorized Site plan required for an outdoor unit
**State Building Codes Division's approval required
signature:
Print name: I L ,v C fl UbJ- Date:/YJ Zhj' 440-4617T(06/I 1/COM/WEB)
1
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
15613 SW SUMMERFIELD LN, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
FAIL
MEC2015-00727
David Young
Provide draft stopping at top of fireplace chase.
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
15613 SW SUMMERFIELD LN, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
October 29, 2015 at 8:17:43
AM
MEC2015-00727
David Young
Correction complete per provided pictures.
Violation Summary:
Inspector Contractor