Permit (21) CITY OF TIGARD MECHANICAL PERMIT
IIIa COMMUNITY DEVELOPMENT Permit#: MEC2016-00389
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/31/2016
T t C,"A R g Parcel: 2S102DB00203
Jurisdiction: Tigard
Site address: 9301 SW HILL ST
Project: Neubo Subdivision: BURNHAM TRACT Lot: 7
Project Description: Kitchen hood installation.
Contractor: OWNER Owner: NEUBO,CRAIG& KRISTY
CRAIG&KRISTY NEUBO 18418 OLD RIVER LANDING
18418 OLD RIVER LANDING LAKE OSWEGO,04 97034
LAKE OSWEGO,OR 97034
PHONE: 503-577-6883 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 05/31/2016 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 05/31/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/31/2016 $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 1.8'A. . - .
Issued By: Permittee Signature:
Call 503.6 •.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
Received
fiNt'
filIMME1=11
City of Tigard Date/By: 5/3//j(p Permit No.: �" ,Zpico_tiuryf
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / �((J f{J 1
Phone: 503.718.2439 Fax: 503.598.1960 % 2016 Date/By: Other Permit:�� �7r�/cr`/�
Inspection Line: 503.639.4175 Q y y; L®4Seee•PPagle 2 for
11(i;\I:I i li.a Read/B Juris:
Internet: www.tigard-or.gov 5lc 1�3 Gtified/Method: 7z6 Supplemental Information
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�� .x'`, :��-c��^ `'.:'a .i,,.,**.�-.�` �: 4 r..,�ti��a-as"t. ��S 3 „•:�: v,r ''-::',,e','4. �� ' r :. ! - _. ., w 0-,'�^�-
• - Mechanical permit fees*are based on the value of the work
❑New construction tig Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.g ,;vr4 s r ix . its* ` ti Value $
' A".,..:.L.,1-,.,,bi1 ipti' r' �, 6�9 r -tai nsr dar.#c 40 z v 4 w� --....-•,.4,,,-0.-
.� . ,,' , = ., % . ..—.4t, . -„pyx„ -.arkt— ,ri. ' ..'. t J.�3 tiat y r '
41 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
,:to,,, 'vim °.it x, , s 4.n,;, : t''r `x V ^, ri �.., '• ”, „,,-,1,-,,,,,,,;:j,� Heating/cooling:
sty ; `� `. t . Air conditioning 46.75
Job site address: - . S'( j/ (5�” r _ , Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: I. i co +� >:;rIJL / YlLz3 Furnace 100,000+BTU(ducts/vents) 54.91
"'1i �'�'r� ( J 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
ESRH'TTON OF WORK Gas fireplace/insert 33.39
y Flue vent for water heater or gas
r�ci-164-1 t c-) \( L� t-ol fireplace 23.32
++ �� 'J Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
' Other: 23.32
t tv ai ' ,7 0 TR ANT
s Environmental exhaust and ventilation:
Name. A ( O.di)
Range hood/other kitchen
e ui ment A 33.39
Address:(130/ ANS 3 1-1,t-, f� ( . Clothes dryer exhaust 33.39
City/State/ZIP: / /Nie`')62„ '1 z3 Single-duct exhaust(bathrooms,
_/ toilet compartments,utility rooms) 23.32
Phone: J 5 Fax..F ' v v L.�'. Attic/crawlspace fans 23.32
3 e3, _ l[,1CANT to CON!ITACrf"PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc. _
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace -
Range
E-mail:
Barbecue
CON3RACTOR Clothes dryer(gas)
Business name: ,Other.
�T � IECRAIY16,ti PE*WI;Ej j _
Address: Subtotal
Minimum permit fee($90.00)
City/State/ZIP: -
Plan review(25%of permit fee)
Phone:( ) Fax:( ) •
State surcharge(12%of pennit fee)
CCB lic.: TOTAL PERMIT FEE a7y`J�)
This permit application expires if a permit is not obtained wiin 180
r
V
� days after it has been accepted as complete.
Authorized signs ii ' its' ,(1KI )(--) * Fee methodology set by Tri-County Building Industry Service Board
Print name:j' , r Date:66173( 02' b
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