Permit (22) CITY OF TIGARD MECHANICAL PERMIT
r 2 COMMUNITY DEVELOPMENT Permit#: MEC2016 00695
13125 SW Hall Blvd.,Ti Date Issued: 10/04/2016
T[CJaT�.1 and OR 97223 503.718.2439 9
Parcel: 2S 112CA04200
Jurisdiction: Tigard
Site address: 15235 SW 79TH AVE
Project: GIBBONS Subdivision: DURHAM ACRES Lot: 29
Project Description: Furnace,NC and duct work installation. Placement of A/C unit must comply with manufacturer's installation
requirements.
Contractor: HOME ENERGY GROUP INC Owner: GIBBONS,JEFFERY D
PO BOX 820474 15235 SW 79TH
VANCOUVER,WA 98682 TIGARD, OR 97223
PHONE: 360-944-8616 PHONE:
FAX: 360-892-6259
FEES
Specifics: Description Date Amount
Air Conditioning 10/04/2016 $46.75
Type of Use: SF Furnaces<100K BTU 10/04/2016 $46.75
Class of Work: ALT Type of Const: Duct Work 10/04/2016 $23.32
Occupancy Grp: 12%State Surcharge-Mechanical 10/04/2016 $14.02
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $130.84
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332. 344.
Issued By: '/` `% `r` Permittee Signature: --'""J ,- -
y
Call 503.639.4175 by 7:00 a.m.for the next available' ea—tion date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application rout(), 1 ic L I r ()NI.)
City of Tigard ....., ,4 4 : 1 Veceived.
Permit No.: ...,a i ta....i. ei c---
, .1..-, , -4,, Pate/By. /0 ' 61 407
11 sii 13125 SW Hall Blvd.,Tigard,OR 97223 K ( ' l'. '-` A'
' Plan Review
' O
' Phone: 503.718.2439 Fax: 503.598.1960 -' '4 ' '
Date/By: Other Permit:
r I(. R 1.) Inspection Line: 503.639.4175 , i., Date.Ready/By. -ed/Method:
VI See Page 2 for
Internet: www.tigard-or.gov T 4 .0 lu Notified/Method: Supplemental Information
-, .
y øi I i6Aito coriciaRciE
a,na.,SOIDULE
TYPE OF iifCtRIerf 4 -USECEECKST
Mechanical permit fees*are based on the value of the work
0 New construction 74: Addition/alteratiqt VM44ritsittz I:- ' ' ' '' performed.Indicate the value(rounded to the nearest dollar)of all
.1.....N.-,.r.
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCtiON
gi
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB S1TE INFORMATION AND LOCATION Heating/cooling:
Air conditioning / 46.75 ii‘.
Job site site address: /<-7.-;C 5t4/ -?-/ils Furnace 100,000 BTU(ducts/vents) / 46.75 94, 7C-
City/State/ZIP: 7? 6-ite-4) eA q? -z-'( Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:
Duct work i 23.32 23'.71-
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
Gas fireplace/insert 33.39
,
Flue vent for water heater or gas
N 'ea /4/6\'‘) FL(telOiir--C /AC./ 'D,A.L--r wo a4c. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove , 33.39
Wood fireplace/insert , 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0 PROPERTY OWNER , , - Ci TENANT
Environmental exhaust and ventilation:
Name: 31."--"fr::F cy--1 5 f34,,v c Range hood/other kitchen
Address: /5-2 5*-- 5-t...-1 qe-,r- equipment 33.39
Clothes dryer exhaust
33.39
City/State/ZIP: Ti 6-442,0 e,"Z q 7-2z_V. Single-duct exhaust(bathrooms,
/ toilet compartments,utility rooms) 23.32
Phone:(''1i) 4/040 '470k, 7 Fax:( ) Attic/crawlspace fans 23.32
id
Other: 23.32
APPLICANT Q.CONTT .
Fuel piping:
Business name: 1-turiAC c„.-biell-G-Y (.7-12-44,'? $14.15 for first four;$4.03 for each additional
Contact name: "jIkr-.0 Al iri/C.-7r1- Furnace,etc.
Gas heat pump
Address: 170 V 0 A. g TOtil 4
Wall/suspended/unit heater
City/State/ZIP: 1,/Ali catv ell/ t.4 P /saiiir 2. Water heater
Phone:( ;40) f,ii I/- gt,i te Fax::(5102) IS1 2.- - 4;Z5-1 Fireplace
Range
E-mail: /1ey:1,4 zi j A e4 cyptii,j. 1 a„,..,
Barbecue
CONTRACTOR -..`- ' - ' ---' '- ' " - Clothes dryer(gas)
Other:
Business name: ti t)V14.co-- EM.94--CrY C2.tA4? MECIIANICAL PERMIT FEES*
Address: PO it.))c 8,7,1t1 7-`i Subtotal e //lit, A
City/State/ZIP: ki hi t 04 lotLYI, ire A 'In.,y1- Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(560) Yle- Sr?'le Fax:(NO) "1 -602-C-`, State surcharge(12%of permit fee) l'il,.CA
CCB lie.: 1(9 y z_s-s- icy!3A(p TOTAL PERMIT FEE /3(3. 211
.
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:--(5)45 2/ii 14/e74-t- Date:
I\BuildingTermits\MEC_PermitApp_040113 doc 440-4617T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15235 SW 79TH AVE, TIGARD, OR, 97224 April 21 , 2017 at 9:48:43 AM
Record Type: Record ID:
Residential - Mechanical MEC2016-00695
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
No answer at door, 9:48 am.
Provide access for inspections.
Violation Summary:
Inspector Contractor