Permit (30) CITY OF TIGARDMECHANICAL PERMIT
` '! I ' COMMUNITY DEVELOPMENT Permit#: MEC2016 00094
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/09/2016
Parcel: 2S 103DA06400
Jurisdiction: Tigard
Site address: 13300 SW 110TH AVE
Project: PERRAULT Subdivision: MIRA PARK Lot: 2
Project Description: Gas piping for new range.
Contractor: EAGLE PLUMBING ENTERPRISES INC Owner: PERRAULT, STEPHEN L&KIMBERLY A
13801 S FORSYTHE RD 13300 SW 110TH AVE
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-650-8703 PHONE:
FAX: 503-650-8720
FEES
Specifics: Description Date Amount
Fuel Piping 02/09/2016 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 02/09/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/09/2016 $75.85
Occupancy Grp:
Stories:
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 copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � LG Permi tee Signature: ��
CCCGGGL� G/ _________
T_
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 Foli OFFI(': LSI:olt.'
F $ Received
CityOf Tigard 1.11, ,. Date/BINAti4IMy: Permit No.:
1114 11 13125 SW Hall Blvd.,Tigard,OR 97223r,�A �v}, I° Plan Review
Phone: 503.718.2439 Fax: 503.59$0i ,,i-i 4(l' 4 i Date/By: Other Permit: 'f r l
Inspection Line: 503.639.4175 r0
l I G r\R I7 ' v Date Ready/By: Juris. S See Pagel for
Internet: www tt and or ov •• b ri j Supplemental Information
g g U iN Notified/Method: Su leme
.-. '4,,i''
�y,. µv .T wy�¢* .y # '$ � ::. : , sir
�" i a. y av k�- , t t Y 1 ^ yF,;' +. }+ 4$ t:.' t: . .''''''-'''----'""r`-'4'-''';''''
., -''';' *A.N.,5^"i ?r'';'o t fl+'X,Swork �k
�4
Mechanical permit fees*are based on the value of the work
ElNew construction Addition/alteratio a 11..‘,1,..., ' performed.Indicate the value(rounded to the nearest dollar)of all
ID Demolition ❑Other: 1...--
Value:
- mechanical materials,equipment,labor,overhead,and profit.
moi) t V .$
..._r ' : .. 4' r �.;.. P5C1C,:nnerCi:174ind'u'stri:1'
�� r _ ° }.,. . ' �:mZ�r 3„ I i f alue k. 0,, e .:::c '� � ' to``;.. �. .. . .1-and -familydwelling ❑Accessory building For special information use checklist.
❑ Multi-family 0 Master builder ❑Other: Description I Qty. I Ea. I Total
.; n Heating/cooling:.4"'::•1,,'`,:;:v:77:4,f a) t {7(6.'4"4"(_ r - k ,''' � ; Il'::r. , , ,..ti„ s'.4. -4"""'''''-'''%'`',. ' " '. . '' . Air conditioning
• 46.75
Job site address: 133 r- c i I � Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 0 �.� Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: Duct work 23.32
Cross street/directions to job site: 4 � l j Hydronic hot water system 23.32
i 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: 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
' ” � Flue vent for water heater or gas
,,7 p ,t16 /d � � fireplace 23.32
��/� � � ` Log lighter(gas) 23.32
1V C. Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
Rt i>ru --so t^ _` ,; T� `r_ `
•^. 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/crawlspace fans 23.32
W"'
' 45 t , 4,-� .".,.f, :� " Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range ( /17.b's.
E-mail: Barbecue
$3,144, At nr' .,:,r,,,,,,,-are s,-» s ti x
y a t
so �1 - { Clothes dryer(gas)
p'.x' kn .., sy Nr. ,. Nt �CF'" \.tti..�,, A:'r"� �. "'8+Y h ..t➢x+e ,.
Business name: E �c� PLS v-t/,,Al Ct Other
�
3�ok s ft t lei) :,E r Subtotal.., jf. ,
Address: f � Subtotal 1./
City/State/ZIP: Ci i ttfi—_ -?Otr Minimum permit fee($90.00) cl
Phone:(/�� _%7,c1.3Fax ( ) Plan review(25%of permit fee)
ti/ State surcharge(12%of permit fee)
CCB lic.: y 7��� TOTAL PERMIT FEE 00,,w
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 name: OWL ( Q3 Date-9 " 16
1:\Building,Permits,MEC_PermitApp_0401 13.doc 440-4617T(II�02iCOMWEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
., s .��-
'� ,;4,1 Ems_ ,eaet'�:� .x"`-��, ••:� €v4h ..
$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\Permits\MEC_PermitApp_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
13300 SW 110TH AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00094
David Young
Violation Summary:
Inspector Contractor