Permit (10) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00019
i EG,JLJ 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2017
Parcel: 2S103BB09300
Jurisdiction: Tigard
Site address: 12303 SW KATHERINE ST
Project: RAGSDALE Subdivision: YE-OLDE WINDMILL Lot: 7
Project Description: Installation of(1)50k suspended heater, (1)B-vent&gas line for heater in garage.
Contractor: KEITH RAGSDALE Owner: RAGSDALE, KEITH&MARNIE
12303 SW KATHERINE ST 12303 SW KATHERINE ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-680-2427 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Unit Heaters(Fuel-Type,Not Electric) 01/10/2017 $46.75
Type of Use: SF Other,ExhaustNentilation 01/10/2017 $23.32
Class of Work: ALT Type of Const: Fuel Piping 01/10/2017 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 01/10/2017 $10.80
Stories: Minimum Fee Adjustment-Mechanical 01/10/2017 $5,78
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance • . work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification '-nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o,'direct questions to Oh C b, -: ng 503.232.1987 or 1.800.332.2344.
k„.
/ssued By: /' /' Permittee Signature: `� 1:(4,/L--
AzyOji-44--.----
, - 1A"
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
Mechanical Permit Application FOR OFFICE USF O\L\
71City of Tigard Received
g / DateEIVED /By: /
/O /7 / Permit No.: H /7*-e560/7
Other Permit:
13125 SW Hall Blvd.,Tigard,OR 9/i �,f Plan Review
i Phone: 503.718.2439 Fax: 503.598.1960
Date/By:
T I G A R D Inspection Line: 503.639.4175 JAN 1 017 0 2 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov IV / Notified/Method: Supplemental Information
CITY OF t1�I(A 'D
' TYPE �' bG[?IVISI0N COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical pemvt fees*are based on the value of the work
❑New construction IA Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
lEf 1-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 46.75
Job site address: 1 2.3 p 3 i SEA 5
i----; Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ^t 6,4-P-47/ (.)(Z, ti -7 2, Z 5 Furnace 100,000+BTU(ducts/vents) 54.91
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
/21 5-1— / Al-)-t r i?-4!-t 5 hydronic) 23.32
Unit heaters(fuel-t t electric), L
in-wall,in-duc suspenetc. \ 46.75 'f4 ,;7
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
,,.,DESCCRIPTION OF`'WORit' -1,,,,i4 I, Gas fireplace/insert 33.39
' '- Flue vent for water heater or gas
415774 4-(_ 56 l� 8 j- /uc..,y-L,(, f\c..� fireplace 23.32
I A! 64119 W CAE:-/
_Hit f• 6 l�r p,,kt CE t t✓( l6 Log lighter(gas) 23.32
f""� �l J I�f.C"l l" Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
P OPERTY OWNER
. . Other: 23.32
/` ' ❑4,,, T :> Environmental exhaust and ventilation:
Name: l Il'� R�4 oa L- Range hood/other kitchen
Address: /2 D 3 5 IL( 1 ,$Ef+e (�rcr. equipment 33.39
1� Clothes dryer exhaust 33.39
City/State/ZIP: 77 6,17/2-0 f>12, Q/ a z 3 Single-duct exhaust(bathrooms,
/ L toilet compartments,utility rooms) 23.32
Phone:609)6 90 2_Lt. 2_1 Fax ( ) Attic/crawlspace fans 23.32
• 0 APPLICANT- 0,CON'h,1T PERSON Other: iq- V i ( 23.32 2 i,J�
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater I ('I,I)
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: ) Lot'� E Other:
/L/ MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00) t .c�
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
/p. 8-0
CCB lic.: TOTAL PERMIT FEE (00, ge.
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:kr.::: -H glek6 s PA 1 Date: / f 0- 1 7
1:\Building\Permits\MEC_PermitApp_040113.doc 440-46171(11/02/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
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
12303 SW KATHERINE ST, TIGARD, OR, 97223
Record Type:
Residential - Mechanical
Inspection Type:
699 Mechanical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
January 30, 2017 at 1:39:21
PM
Record ID:
MEC2017-00019
Inspector:
David Young
Contractor