Permit (144) p CITY OF TIGARD MECHANICAL PERMIT
I - COMMUNITY DEVELOPMENT Permit#: MEC2016-00162
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/09/2016
Parcel: 2S 103 BA00141
Jurisdiction: Tigard
Site address: 11965 SW LYNN ST
Project: DUTTON Subdivision: LERON HEIGHTS NO.2 Lot: 31
Project Description: Duct work and(1)bathroom exhaust fan for bedroom and bathroom remodel.
Contractor: OWNER Owner: DUTTON, BRIAN & DEBRA
BRIAN DUTTON 11965 SW LYNN ST
11965 SW LYNN ST TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-572-7392 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 03/09/2016 $23.32
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 03/09/2016 $23.32
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: Minimum Fee Adjustment-Mechanical 03/09/2016 $43.36
Stories: 12%State Surcharge-Mechanical 03/09/2016 $10.80
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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a co of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. n
Issued By: / Permittee Signature: ///
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 1012 torr-1( I I sl. 01.1
City of Tigard Received Permit No.:
a 13125 SW Hall Blvd.,Tigard,OR 97223 ( '1 Date/By: 3 Q I(�r '- /t'1o2Cjl�.�, ��
Plan Review
' a Phone: 503.718.2439 Fax: 503.598.1 o, Date/By. Other Permit:Mc r o i L.
i 1 G \R D Inspection Line: 503.639.4175 p �Q�6 Date ReadyBy: Jas: &1 See Page 2 for
Internet: www.tigard-or.gov A J Notified/Method: '7'��/
l\ A 1. Supplemental Information
\y \k".;‘( i` ` s+ tP
t,, Mechanical permit fees*are based on the value of the work
❑New construction n Addition/alteratio ent performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:
0 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family 0 Master builder ❑Other: Description I Qty. I Ea. I Total
;•''.. sr, I ' 4 {=�"14Heating/cooling:
Air conditioning 46.75
Job site address: f/' 5 z 16 L y,LW sr Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -rI 6, •
4 OaE-66/Q c 7zz 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:
Duct work X 23.32 23-�-.),
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
s _ 0, .',:::._,,,,-:.,t t Gas fireplace/insert 33.39
Flue vent for water heater or gas
/4(4.--mo Esa 6m /flubekt.iecolvk fireplace 23.32 l
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
3, Chimney/liner/flue/vent 23.32
Cr; . . , ' i..` i sY J.,,=f;.;'!,-,,., . ....4,f,-, . ..--.-;•;-'.i",� ` . `` .: Other: 23.32
Environmental exhaust and ventilation:
Name: d/'e i/Uli J lirreIJ Range hood/other kitchen
equipment 33.39
Address: /1 q&S 6-r.,0 L yMA) S-c Clothes dryer exhaust 33.39
City/State/ZIP: - exhaust(bathrooms,
T(G, g �`/f(e - ?7 j toilet compartments,utility rooms) X 23.32 3.')_
Phone:L96) Z ' cf Z Fax:( ) Attic/crawlspace fans 23.32
�`� `4F'44;7'. r, 4r ;?« ` -t ,. x Other: 23.32
r FuelPP r ing
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: IC\�/112.1 DIVAN Furnace,etc.
Address: /19 Gas heat pump
65 s� vn S Wall/suspended/unit heater
�L�A7G� 6,2.6 V)223
City/State/ZIP: Water heater
Phone:(S 03) g9 Z 731 z I Fax::( ) Fireplace
Range
E-mail: 44,4,. a ',A' Cc� Barbecue
,r r : ce �i�r 11 (gas)
, :i wx> _ t4 a xnti .-4 .,1-4,: ' 7 _ C-7-. 8�' _. .' Clothesdryer as
L�� Other:
Business name: vv� 4,-, 1.,',. .-''7,.:` �-- �
,
c4 -��^ '�� '�. �,"
Address: _,.: .. .,�..._.. _�
Subtotal
City/State/ZIP: Minimum permit fee($90.00) la,.; -
Plan review(25%of permit fee)
( ) Fax:( )
Phone: State surcharge(12%of permit fee) lif_ I
CCB lic.: TOTAL PERMIT FEE !t!,U.'g'
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: eva.,,,,-
014
ai_. • Fee methodology set by Tri-County Building Industry Service Board
Print name: 64 I ru 4 .,07-geld Date: 3..-q_14
1:\Building\Permits\MEC_PennitApp_040113 doc 440-4617T(11/02/COM/WEB)