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Permit (157) CITY OF TIGARD MECHANICAL PERMIT 1111 • COMMUNITY DEVELOPMENT Permit#: MEC2016-00807 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/30/2016 f_f r ,�It 1) 9 Parcel: 1 S135CD07200 Jurisdiction: Tigard Site address: 9719 SW LONDON CT - Project: Gant Subdivision: LONDON SQUARE NO.2 Lot: 24 Project Description: Installation of gas insert,liner&gas piping. Contractor: T&K MECHANICAL Owner: GANT, MANUELA MARIA PO BOX 116 9719 SW LONDON CT FOREST GROVE, OR 97116 TIGARD,OR 97223 PHONE: 503-844-9173 PHONE: 503-620-6538 FAX: 503-846-0195 FEES Specifics: Description Date Amount Gas Fireplace 11/30/2016 $33.39 Type of Use: SF Flue Vent for Water Heater or Gas 11/30/2016 $23.32 Class of Work: ALT Type of Const: Fireplace Occupancy Grp: Fuel Piping 11/30/2016 $14.15 Stories: 12%State Surcharge-Mechanical 11/30/2016 $10.80 Minimum Fee Adjustment-Mechanical 11/30/2016 $19.14 Fuel Fuel Types: Natural Gas Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct ques •. • OUNC • calling 503.232.1987 or 1.800.332.2344. Issued qy: ge,OP Permittee Signature: )./A )" Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applicatao , FOR OFFICE: USE ONLY f d Cl of Tigard ~ ,4 t, * Received / �}, Permit No.: ►,J ^ G `J g c,,,€ n Date/By: �� �l ' I{i/ I g C O`t/l rf,,_� 00 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: I I G A R D Inspection Line: 503.639.4175 �V�� s :Nib Date Ready/By: Jutis. ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information i felt C' "1 ", I,, FEEa 6 t l ;41sT Mechanical permit fees*are based on the value of the work ❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Val :$ x i'... CA'}'EGO11'1'O1CONS 1WCTJON , .. z .. �r ;,,,C44.1.4e" EQUUe-' $ isYRTE'." t. 12. C1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. 0 Multi-family El Master builder ❑Other: Description I Qty. I Ea. I Total . � R SITE o 1, AND LOCAT; ." Heating/cooling: xr . Air conditioning 46.75 Job site address: (;-1 5 u. La r do r) OA Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: .-c;)00\60om- q`7aa3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: 0)01/4y4 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: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 Gas fireplace/insert 1 33.39 33- 3 of '-° `�.` � ' VO ) "-4r` . Flue vent for water heater or gas l C� O t o 59-s\ be 5 1 1 flP fireplace 23.32 \ Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent i 23.32 3,3 oZ '.`. OPERTY OWN s# " ),',.;%e4. " ❑.TENANT „ - and ventilation: 23.32 Other .x ux Environmental exhaust Name: *in Q___\ lJ clo(\-}- Range hood/other kitchen W r 10..1 j �l^� equipment 33.39 C. Address: '-1'`1 5 ()0 6 Y - Clothes dryer exhaust 33.39 City/State/ZIP: --1/4•-• ; ciN Qj\d ©p. q aSingle duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(Sd3)(pa0- (Li S' Fax:( ) Attic/crawlspace fans 23.32 PIS., 47y i oc,+ T p„C' iia Other: 23.32 ' *. �:,. a i Fuel piping: Business name: •—rQcs)a !� IL YYLCfki $14.15 for first four;$4.03 for each additional Contact name: 4J,x ` Furnace,etc. Address: %)0t U)0 X 1 Gas heat pump Wall/suspended/unit heater City/State/ZIP: ,�t -+. (�rc t (I)r . q 111,U Water heater Phone:( 509 Cgq Li --q in `J Fax::( 56)$9(o —a (q 5 Fireplace t i y r�p `,� r�/� Range E-mail: '71A f S WO Or)0 l(\ `7 0 L O-p>iOx (pry)1 Barbecue -r_ "� gym. ,, 'tit r 13., � s,, 1;,. .` clothes dryer(gas) a, �. :,„, r,i,,, ,. , aux - (� ,�`,,,, , , co, Other: Business name: fa-K I 1 ._d I_A Y. i C. 17, �'i cm'..', q a,. -, ,,.. S Address: A)3 ,Q^ ',V ,: v Subtotal � �- City/State/ZIP: For e_cl-j J rav t 61 (t(pMinimum permit fee($90.00) ®• Plan review(25%of permit fee) -�— Phone:( c"6,5) O L�L _91 -73 Fax:(5(B) '1..( 4 —01Q 6 State surcharge(12%of permit fee) /O.q".6 CCB lic.: a I) t TOTAL PERMIT FEE j�:g� CJS p� This permit application expires if a permit is not obtained within 180 , days after it has been accepted as complete. Authorized signature: c\,\,‘” k/......---- * Fee methodology set by Tri-County Building Industry Service Board Print name: Date: 1:IluildingAP rmits\MEC PermitAPP_040113.doc 440-4617T(11/02/COM/WEB ) 1 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Tp al luafi g !9 the m $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\MEC PennitApp_040113.doc 2 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 9719 SW LONDON CT, TIGARD, OR, 97223 Record Type: Residential - Mechanical Inspection Type: 699 Mechanical final Result: PASS- NoCofO Comments: Standard pressure verified 10 psi for 15 min Violation Summary: Tel: 503.718.2439 Inspection Date: Record ID: MEC2016-00807 Inspector: Jeff Grove Inspector Contractor