Permit p CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00050
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2016
Parcel: 2S102AC00500
Jurisdiction: Tigard
Site address: 12492 SW MAIN ST
Project: Baileys on Main Subdivision: BURNHAM TRACT Lot: 1
Project Description: Gas line and final inspection for completion of hood installation. See MEC2015-00759.
Contractor: PREMIER PLUMBING Owner: WOODARD LIVING TRUST
20 SW 131 ST AVE PO BOX 23303
BEAVERTON, OR 97005 TIGARD, OR 97281
PHONE: 503-469-8631 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Misc Administration Fee 01/21/2016 $90.00
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $0.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces—100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $90.00
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
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 no tarted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio he ul s adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. o ay obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: rmittee Signature:
Call 503.69. 75 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 01 1 0 L WW Kom
10 Received 71t
City of Tigard a y a— permit iNw!coxm�X
Date/By:13125 SW Hall Blvd.,Tigard,OR NO D te/By--
Phone: 503.718.2439 Fax: 503.5 1 6 0 Ri Plan Review Other Perini
9" 66 Date/By:
Vo Y
Inspection Line: 503.639.4175 loris:�101 9 Date Ready/By: Page for
Internet: www.tigard-or.gov r1 Se a
% '�' Notified/Method: Supplemental Information
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Mechanical permit fees*are based on the value of the work
New construction El Addition/alterplacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition El Other: oll, mechanical materials,equipment,labor,overhead,and profit.
sr r
Value:
'77"❑ 1-and 2-family dwelling (&Commercial/industrial E]Accessory building For special information use checklist.
❑ Multi-family E]Master builder El Other: Description Qty. I Ea. T—Total
Heating/cooling:
Air conditioning 46.75
Job site address:
'W YA-cc( Furnace 100,000 BTU(ducts/vents) 46.75
City/State/Zl!771ig�sp� (�)(e_'i7 21� _3 Furnace 100,000+BTU(ducts/vents)_ 54.91
Heat uinp 61.06
Suite/bldg./apt.no.: Project name: p
/V 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
ON OF,WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
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
ERhTANT
Environmental exhaust and ventilation:
Nam Range hood/other kitchen
Address: equipment 33.39
\o�q �e— Clothes dryer exhaust 33.39
City/State/ZIP: 0 Single-duct exhaust(bathrooms,
toilet corn partments,utility rooms) 23.32
Phone: Fax: Attic/crawls pace fans 23.32
Other: 23.32
-N
Fuel piping:
Business name-'--�--, Ca $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
�
Address:
Gas heat pump
-2�Aq 2- Gas
heater
City/State/ZF . OF—, Water heater
Phone: 7� 1 Fax: Fireplace
Range
E-mail:
Barbecue
Clothes dryer(gas)
MOO
Business name:Vf4f_\(\A�ejr lk-� Other
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:363 Fax:1 State surcharge(12%of permit fee)
CCB lic.: Z TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: Fee methodology set by Tri-County Building Industry Service Board
Print nam Date:
L,Building,Pemits\MEC,-Pe�milApp_040113.doc 440-4617T(I 1,0-/COMINVEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
$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\Pennits\MEC_PennitApp_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
12492 SW MAIN ST, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00050
Jeff Grove
Violation Summary:
Inspector Contractor