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Permit CITY OF TIGARD f MECHANICAL PERMIT COMMUNITY DEVELOPMENT ntviPikiPermit#: MEC2015-00784 Date Issued: 11/18/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25111 DD05200 Jurisdiction: Tigard Site address: 15855 SW STRATFORD LP Project: Skjelstad Subdivision: STRATFORD Lot: 6 Project Description: Installation of gas stove,venting and gas line. 1/28/16:Reprinted permit to include(1)additional gas line for clothes dryer. Contractor: R& D INSTALLATIONS Owner: SKJELSTAD, GARRETT 5246 SE 62ND THOMAS, MARGARET PORTLAND, OR 97206 SKJELSTAD,ARIC C ET AL 15855 SW STRATFORD LOOP TIGARD, OR 97224 PHONE: 503-774-7142 PHONE: FAX: 503-774-7142 FEES Specifics: Description Date Amount Gas Fireplace 11/18/2015 $33.39 Type of Use: SF Flue Vent for Water Heater or Gas 11/18/2015 $23.32 Class of Work: ALT Type of Const: Fireplace Occupancy Grp: Fuel Piping 11/18/2015 $14.15 Stories: 12%State Surcharge-Mechanical 11/18/2015 $10.80 (manual) Minimum Fee Adjustment-Mechanical 11/18/2015 $19.14 Misc Administration Fee 02/18/2016 $45.00 Fuel Fuel Types: Natural Gas Gas Pressure: Total $145.80 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 stions to 0. C b ing 503.232.1987 or 1.800.332.2344. Issued By: , �i , � Permittee Signature:o�q�7 r p 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. a OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2015-00784 l A 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2015 ��+t p Parcel: 25111 DD05200 Jurisdiction: Tigard Site address: 15855 SW STRATFORD LP Project: Skjelstad Subdivision: STRATFORD Lot: 6 Project Description: Installation of gas stove,venting and gas line. Contractor: R& D INSTALLATIONS Owner: SKJELSTAD, GARRETT 5246 SE 62ND THOMAS, MARGARET PORTLAND, OR 97206 SKJELSTAD,ARIC C ET AL 15855 SW STRATFORD LOOP TIGARD, OR 97224 PHONE: 503-774-7142 PHONE: FAX: 503-774-7142 FEES Specifics: Description Date Amount Gas Fireplace 11/18/2015 $33.39 Type of Use: SF Flue Vent for Water Heater or Gas 11/18/2015 $23.32 Class of Work: ALT Type of Const: Fireplace Occupancy Grp: Fuel Piping 11/18/2015 $14.15 Stories: 12%State Surcharge-Mechanical 11/18/2015 $10.80 Minimum Fee Adjustment-Mechanical 11/18/2015 $19.14 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 Utilit tificatiecenter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: i I,�'�/ Permittee Signature: (r1"---7/------ 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 Cl of Tigard CEIVEP Received City g Date/By: 6r! /py C Permit Nu.: Hea,dQvS co 71V III I • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revicn Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: I I,,,x I;t 1 Inspection Line: 503.639.4175 NOV 18 ?015 Date Ready/By: Juris: Vi See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE COMMERCIAL FEE* SCHEDULE – USE CHECKLIST Mechanical permit fees*are based on the value of the work tZ1Sew 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:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. El Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total 15855'" JOB SITE INFORMATION AND LOCATION Heating/cooling: �� 5 J _ Air conditioning 46.75 Job site address: �1 Kpl�/•L Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: .6 Kri,L�o f-r 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 LI.39 I��,y , � .Mole I Flue vent for water heater or gas ∎ t,,.s �}+` 1] v PIS` -4L C fireplace 23.32 Log lighter(gas) 23.32 S W`--Q Wood/pellet sto ve 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 1 23.32 a3.3y Other: 23.32 ❑ PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 33.39 Address: Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawispace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 _ Business name: Fuel piping: 514.15 for first four;S4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace ( /1(.IS~ Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name: S ( 4 (G ii S lam_ Other: c� / i MECHANICAL PERMIT FEES* Address: ç , 5c Subtotal City/State/ZIP: vL )CJ Minimum permit fee($90.00) 95 oO W7 Plan review(25%of permit fee) M Phone:(6i3 / /7/ 1/2.... Fax:( ) State surcharge(12%of permit fee) lD.eg) J CCB lic.: C, TOTAL PERMIT FEE /DO. 86 This permit application expires if a permit is not obtained within 180 fdays after it has been accepted as complete. Authorized signature: f' — * Fee methodology set by Tri-County Building Industry Service Board Print name: Gt�y� C ��b P Date: f /' /J 7 l:Building Permits\MEC_PermeApp_040113.doc 440-46171(1 1 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. I:\Building\Permits\M EC_PcrniitApp_0401 1 3.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 15855 SW STRATFORD LP, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical ﬁnal FAIL MEC2015-00784 David Young No access for inspection. 12:27 pm Schedule gas line inspection for meter hook up an green tag. Change permit to reﬂect correct unit. (B) 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 15855 SW STRATFORD LP, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical ﬁnal FAIL MEC2015-00784 David Young No access to ﬁreplace for inspection, covered by drywall. Add branch line for gas dryer to permit. Call gas line inspection for green tag as noted on previous inspection. Violation Summary: Inspector Contractor