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Permit (42) CITY OF TIGARD MECHANICAL PERMIT III 2 ' COMMUNITY DEVELOPMENT Permit#: MEC2016-00237 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/04/2016 Parcel: 2S 111 BC00500 Jurisdiction: Tigard Site address: 10055 SW INEZ ST Project: GRADIN Subdivision: TIGARDVILLE HEIGHTS Lot: 19 Project Description: Dryer vent installation for laundry room on second floor. Contractor: OWNER Owner: GRADIN, DANIEL L&SALLY K DANIEL GRADIN 10055 SW INEZ ST 10055 SW INEZ ST TIGARD, OR 97223 TIGARD, OR 97224 PHONE: 360-200-2707 PHONE: FAX: FEES Specifics: Description Date Amount Clothes Dryer Exhaust 04/04/2016 $33.39 Type of Use: SF 12%State Surcharge-Mechanical 04/04/2016 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/04/2016 $56.61 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: 87.01.7.N.0.4....1/4Permittee Signature: Da# -/Kei 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 ISI. O\I.1 �j Received na City W Tigard y�`i�� Date/By: U L. �� Permit No.: `. 13125 SW Hall Blvd.,Tigard,OR 972 [V`V� Plan Review 'IN Phone: 503.718.2439 Fax: 503.598.1 ► Date/By: Other Permit:io JV,,j Gi,, ,00 i'i 1 1 G,\it t) Inspection Line: 503.639.4175 116 Date Ready/By: Juris: 0 See Pagegg2 for Internet: www.tigard-or.gov �� l-U Notified/Method: - 'p Supplemental Information u*te,, 3'4 et ' t "" m s.. 'i r''r`N,�'++4 L 4 ,o-' 4 „q' 0 e ,„. . �I, ," S ra 'i• ,. :''..:,:31;:f �.�•, r ..,,.. Trr t fees*are NewFconstruction Addition/alteration « px performed.Mechanical at the value(rounded to the nearest dollar)Pofr # ate,. °sx , on the value of the work ❑ t all ❑ Demolition Other: CN" mechanical materials,equipment,labor,overhead,and profit. ^ Kin " a= y iia �• - Value $ i, tt' 4..,,' . w -4.,*,_X16 ,. i, 1 � �-a�� ie l �`itr;: ��.,t �. � ��� `.. '; � ��'��as ��� � �K 211. 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. 0 Multi-family 0 Master builder ❑Other: Description I Qty. I Ea. I Total ,---';''''''',4,5;-:.:7- '. hf .1 t 'Afon � iodotiF1x s r.;¢.,t,,{ T„,,,,,,,,,' x ^ Heating/cooling: ,,r,:-',9°.°:',.`,",",,,'"' ah . y '1'1' . Air conditioning 46.75 Job site address: Ov 'S S €.2- S Furnace 100,000 BTU(ducts vents) 46.75 City/State/ZiP: TTS r-4' 0�_2 2� Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: R(Oyq 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 Other: 23.32 Subdivision: Lot no.: 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 S ei dr er ��j� 1)1 n 4 fireplace 23.32 n i7 /� A�� Log lighter(gas) 23.32 *'i�w,^C / ' rn �'Ml t " Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/clue/vent 23.32 Other: 23.32 lalitt 'IE iiii l 'Y+tER', 1, © TE '= Environmental exhaust and ventilation: . Name: -W as ,� 4/ Range hood/other kitchen eqAddress: /005-5- S� J C --- St- Clothes nt 33.39 L Clothes dryer exhaust ( 33.39 ,,3, 3 City/State/ZIP: 7- 3e 9 2 Z� Single-duct exhaust(bathrooms, 7 toilet compartments,utility rooms) 23.32 Phone:(360 2 00 — 2_7-0,?- Fax:( ) Attic/crawlspace fans 23.32 r` r�):4 p 40 i F i '°4. 0 th t p rs ,I Other: 23.32 Business name: Fuel piping: (�y,i -C-` $14.15 for first four;$4.03 for each additional Contact name: v Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) I Fax::( ) Fireplace Range E-mail: Barbecue ii,-;.1. z; �'' e :utMAu . "' ,'� Clothes dryer(gas) Business name: �- in-n� Other: iy k «w Ar�dt.'v,l,}+KL ,;:_ ,:•1ey Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) q p,ao Plan review(25%of permit fee) — Phone:( ) Fax:( ) State surcharge(12%of permit fee) jU. CCB lic.: TOTAL PERMIT FEE /,(). 1 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: 3 e>•C��./ � "�'T Date: ,,� t- IaBuddin,Permits MEC PennitAPP 040113.doc 440-46)7T I1,02COM WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi Family Fee Schedule: h gatrNM $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\Pennits\M EC_PennitApp_0401 13.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 10055 SW INEZ ST, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical final PASS - No C of O MEC2016-00237 Jeff Grove Violation Summary: Inspector Contractor