Permit (30) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
14
Permit#: MEC2016-00334
T IGAR,D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2016
Parcel: 2S102CA00600
Jurisdiction: Tigard
Site address: 13402 SW BARNUM DR
Project: Ashwood Estates,Lot 8 Subdivision: FREWING'S ORCHARD TRACTS Lot: 18
Project Description: NC installation. Placement of A/C unit must comply with manufacturer's installation requirements.
Contractor: INTEGRITY AIR LLC Owner: LF 4 LLC
7301 SW!CABLE LN, STE 500 9700 SW FREWING ST
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503-572-3594 PHONE:
FAX: 503-598-8498
FEES
Specifics: Description Date Amount
Air Conditioning 05/10/2016 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 05/10/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/10/2016 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / .441111111P—
' 'ermittee Signature: '� ���
TOr
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard �ECEIVEL� y , Ml. PermitNo.. V _ .1 omit
r
Date/
By.
SW Hall Blvd.,Tigard,OR 9722 Plan Review
Phone: 503.718.2439 Fax: 503.598.19 0 Other Permit: .11
Inspection Line: 503.639.4175
Date/By: 41r� I.
I I Ci A It I+ 2016 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov MAY 10 Notified/Method: >i. Supplemental Information
TYPE OF ITY OF TIGARD �� �✓
DINGDING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
�.4 Mechanical permit fees*are based on the value of the work
0 New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
[ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address:13402 SW Barnum Dr Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Ashwood Estates Duct work 23.32
Cross street/directions to job site:Frewing Street 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.:8
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
Air Conditioning fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:LF 4,LLC Range hood/other kitchen
equipment 33.39
Address:5285 Meadows Rd Ste 171 Clothes dryer exhaust 33.39
City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)657-3402 Fax:( ) Attic/crawlspace fans 23.32
ID APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:JTSC,LLC
$14.15 for first four;$4.03 for each additional
Contact name:JERED OTEY Furnace,etc.
Address:5285 Meadows Rd Ste 171 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Lake Oswego,OR 97035 Water heater
Phone:(503)890-0840 Fax::( ) Fireplace
Range
E-mail:JOTEY@JTSMITHCO.COM Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:INTEGRITY AIR LLC Other:
MECHANICAL PERMIT FEES*
Address:7301 SW KABLE LN STE 500 Subtotal
City/State/ZIP:PORTLAND,OR 97224 Minimum permit fee($90.00)
Phone: Plan review(25%of permit fee)
(503)572-3594 Fax:( )
State surcharge(12%of permit fee)
CCB lie.:203869 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 name:Janelle Gu':o Date:05/10/2016
I:\Building\Permits\MEC_PermitApp_.-: .doc 440-46I7T(11/02/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
13402 SW BARNUM DR, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00334
Jeff Grove
Violation Summary:
Inspector Contractor