Permit (10) CITY OF TIGARD MECHANICAL PERMIT
IN Ai
. COMMUNITY DEVELOPMENT Permit#: MEC2016-00684
TLGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/28/2016
Parcel: 2S111CA15500
Jurisdiction: Tigard
Site address: 9876 SW PEPPERTREE LN
Project: REED Subdivision: 1990-084 PARTITION PLAT Lot: 2
Project Description: Replacing furnace and NC unit. Placement of A/C unit must comply with manufacturer's installation requirements.
Contractor: BEAVERTON HEATING&NC INC Owner: REED TRUST
5400 SW 170TH AVE BY REED, DENNIS E&SUSAN J TRS
ALOHA, OR 97007 9876 SW PEPPERTREE LN
TIGARD, OR 97224
PHONE: 503-649-1271 PHONE:
FAX: 503-649-6446
FEES
Specifics: Description Date Amount
Air Conditioning 09/28/2016 $46.75
Type of Use: SF Furnaces<100K BTU 09/28/2016 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 09/28/2016 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9524001--0090: .You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issued By: '�s4_ O ` Permittee Signat
7�L/1 , '.0
•
Call 503.639.4175 by 7:00 a.m.for the n xt avail.•e inspection date.
This permit card shall be kept in a conspicuous place on-the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE F;SE ONI.\711 '
City of Tigard Received q
Date/By: / ri '
Other Permit:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /
Permit No.:
ap
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: riiffj-c(-?+ '
T I G A R D Inspectionterne: Line: 503-or.go175 l � � q Date Ready/By: See Page 2 for
Internet: www.tigard-or.gov Notified Method: ffiliSupplemental Information
IA
TYPE OF WORISE) 6 1� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
}��,� IRD Mechanical permit fees*are based on the value of the work
❑New construction ,Qddition/alteraf Vr"" ; ►� performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: t1G DIVIS‘� mechanical materials,equipment,labor,overhead,and profit.
�f(1���,.w,. Value:$
ATEGOIY OF COSTRUCTIOIV RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
al-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
JOB SITE INFORMATION;AND LOCATION Heating/cooling:
Air conditioning i 46.75 lit; 5-
Job site address: eM�ev .cry /4'77111 .-/-4'.e.`": 4A/ Furnace 100,000 BTU(ducts/vents) / 46.75 ii(,,:15
City/State/ZIP: 3.„,,") ®is 5•7.0..Z 471 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: /rs:0Duct 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: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
- DES ON OF WORK Gas fireplace/insert 33.39
' `` // Flue vent for water heater or gas
, 1,44.4. f=�,r�C.c ,s/'', IC e �.44.-7:-.0--r
.� .— fireplace 23.32
44
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
%PROPERTY OWNER $:tJ TENANT,.
S$ ,, - Environmental exhaust and ventilation:
Name: iZE�D Range hood/other kitchen
equipment 33.39
Address: 9876 s<^ l"arnei.o mac 4,7 Clothes dryer exhaust 33.39
City/State/ZIP: 77r.--/,,r A72 4/7,42- z Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(S77 ) 6,,,c,' 04; '/7 Fax:( ) Attic/crawlspace fans 23.32
Eir APPLICANT n. 0 CONTACT.PERSON Other: 23.32
Business name: ,4 f Fuel piping:
i $14.15 for first four;$4.03 for each additional
Contact name: ./';/4 , Furnace,etc.
Address: /tctc - Ei ,f>n 7"4 "re e.... Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: 8G.cil/e..../44 c"-se. : 974007 Water heater
Phone:(Tel ) 9-9 /Z 7 / Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:jr.. _._ 6r- c tke...��t >�*c Other:
MECHANICAL PERMIT FEES*
Address: 5'44c-.e, S/ 1 /7e / .�=''C Subtotal 413, 5Z
City/State/ZIP: , ,,,.rpt tax 4'7.22 ,% Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(5—p5 ) Vii ii/ / 7/ Fax:( ) State surcharge(12%of permit fee) II ,
CCB lic.: I i 63 eV`// /' TOTAL PERMIT FEE /01. 7 A
�,
This permit application expires if a permit is not obtained within 180
/_ f �i�. . days after it has been accepted as complete.
Authorized signature:/,,,t * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,iftl /IfSt"fi43,t:__ Date: � / ass
I:\Building\Permits\MEC PermitApp_040113.doc /40-4617 (I1/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$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\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
9876 SW PEPPERTREE LN, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00684
Jeff Grove
Violation Summary:
Inspector Contractor