Permit (61) q CITY OF TIGARD MECHANICAL PERMIT
1111 2' COMMUNITY DEVELOPMENT Permit#: MEC2016-00122
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/23/2016
Parcel: 1S 134C B02300
Jurisdiction: Tigard
Site address: 12235 SW SUMMER CREST DR
Project: Adams Subdivision: SUMMER HILLS PARK Lot: 14
Project Description: Installation of gas furnace and gas piping.
Contractor: ADVANCED HEATING&AIR CONDITIONING INC Owner: ADAMS, DOUGLAS ALAN&TAMMY DELO
5825 SE FOSTER RD 12235 SW SUMMER CREST DR
PORTLAND, OR 97206 TIGARD, OR 97223
PHONE: 503-774-0161 PHONE:
FAX: 503-774-4391
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 02/23/2016 $46.75
Type of Use: SF Fuel Piping 02/23/2016 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 02/23/2016 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 02/23/2016 $29.10
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: gt..... ....s_e_______ '•r ••Signature: Ile,
i
/if
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application �j Ell
FOR OFFICE. LSE ONLY
City of Tigard�l �1
Date/By:: i� Permit No.; �gC�/6�`a..
1 1111 UUJ ii y
NI q 13125 SW Hall Blvd.,Tigard,O 3 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:,
T I G A R D Inspection Line: 503.639.4175 F..1 ., 1 ,A Date Ready/By: tris
Internet: www.ti and-or. ov 2 y od S See Page 2 r
g g Notified/Method: InformationSupplemental
' . i fUAKU COMMERCIAL FEE* SCHEDULE DULE - USE CHECKLIST>
.0 a Ir ':. 'mom ' '7. 4,i= «3 's pii;4, n
a i . [l VT�)(� Mechanical permit fees*are based on the value of the work
❑New construction ii Addition a era ion/re)ilacemetf� performed. Indicate the value(rounded to the nearest dollar)of all
ED Demolition 0 Othermechanical materials,equipment,
m n
t labor,overhead,and profit.
Value:$
ID ,,,EQL1IPIVIENT/ MS.FaEES 113
El
-
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. (4-
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total u.
1
r '1 ..... It i AND LOCATION
Heating/cooling: I
Air conditioning 46.75
Job site address: 12235 SW Summer Crest Dr. Furnace 100,000 BTU(ducts/vents) . 1 46.75 46.75
City/State/ZIP:Tigard,Oregon 97223 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: 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
"` .` ,:I .,1Olt F#W,0 Iiw Gas fireplace/insert 33.39
Flue vent for water heater or gas
Installing a gas furnace fireplace 23.32
Gas line to furnace 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 0 TENANT Environmental exhaust and ventilation:
Name:Doug Adams Range hood/other kitchen
equipment 33.39
Address: 12235 SW Summer Crest Dr. Clothes dryer exhaust 33.39
City/State/ZIP:Portland,Oregon 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)789-0245 Fax:( ) Attic/crawlspace fans 23.32
❑=AEPLIC.ANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc. I 14.15
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Advanced Heating&Air Conditioning,Inc Other:
MEgIA TICAL PERMIT,FEES*
Address:5825 SE Foster Rd. Subtotal
City/State/ZIP:Portland,Oregon 97206 Minimum permit fee($90.00) 90.00
Phone:(503)774-0161 Fax:(503)774-4391 Plan review(25%of permit fee)
State surcharge(12%of permit fee) 10.80
CCB lie.:98573 TOTAL PERMIT FEE 100.80
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatur 2` "INV-22-3 * Fee methodology set by Tri-County Building Industry Service Board
Print name:Kristal Reed Date:2/22/2016
I:\BuiIding\Permiis\MEC_PermitApp_040113.doe 440-4617T(I I/02/COM/WEB)
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
12235 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00122
Chip Barnett
Minor Label ELS489684
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
12235 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00122
Chip Barnett
Minor Label ELS489684
Violation Summary:
Inspector Contractor