Permit (102) CITY OF TIGARDFri MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00076
��al/ Date Issued: 01/31/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S125DD06800
Jurisdiction: Tigard
Site address: 9565 SW VENTURA CT
Project: Hart Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 76
Project Description: Modifying duct work for master bedroom. 2/14/2018: REPRINT permit to add(2)bath fans.
Contractor: OWNER Owner: HART, SHAUN&MACKENZIE
SHAUN&MACKENZIE HART 9565 SW VENTURA CT
9565 SW VENTURA CT TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-519-8669 PHONE: 503-519-8669
FAX:
FEES
Specifics: Description Date Amount
Duct Work 01/31/2017 $23.32
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 01/31/2017 $46.64
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: Minimum Fee Adjustment-Mechanical 01/31/2017 $20.04
Stories: 12%State Surcharge-Mechanical 01/31/2017 $10.80
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 1.800.332.2344.
Issued By: Permittee Signature:
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 Application wit lit t,l t it i , ;l t l„
City of Tigard OVE ---M1911169
13125 SW Hall Blvd.,Tigard,OR:AVPlan Review
Phone: 503.718.2439 Fax: 503.5 Dale/By: Other Permit:
t c Inspection Line: 503.639.4175 qQQ Date Ready/ily: iif See Page 2 for
Internet: www.tigard-or.gov B � Zo lt9 Notified/Method.ed/Metltod. 11. y
appkmeatal Information
Mechanical permit fees*arc based on the value of the work
❑New construction [3 Addition/al tt performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,andel rofit.
Value:
® I-and 2-family dwelling Commercial/industrial I t J fr ,,
❑Accessory building For special InIn formation use checklist
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
�� a� 61.a t' ',' .u, Hatinp(cooting:
Aireconditioning 46.75
Mb site address: 9565 SW Ventura Ct Furnace 100,000 BTU(ducts/vents) 46.75
City/State/zIP: Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: J Project name:Master bedroom and bath remodel Heat pump 61.06
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: Washington Square Estates J tot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
;.a t e ( r Gas fireplace/insert 33.39
� ._ � h" Flue vent for water heater or gas
Adding 2 bathroom fans to permit MEC2017-00076 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
"li a I36:
. R A 4 '711 O
Other. 23.32
����1'.+ W, _ Environmental exhaust and ventilation:
Name: Mackenzie Hart Range hood/other kitchen
equipment 33.39
Address:
9565 SW Ventura Ct Clothes dryer exhaust 33.39
City/State/ZIP: Tigard, OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 2 23.32 46.64
Phone:( 503)519-8669 I Fax ( ) Atticicrawlspace fans 23.32
Other: 23.32
Business name: Owner Fuel piping:
514.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) ( Fax::( ) Fireplace
Range
E-mail:
Barbecue
Clothes dryer(As)
Business name: Other.
Address: at ,_,I r ._*7 $'a Ea
Subtotal
City/State/ZIP: Minimum permit fee(590.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge 12%of t fee)
CCR lie.: � ( P�
TOTAL PERMIT FEE
/
'Fhb permit application expires if a permit 4 not obtained within 1110
days after It has been accepted as complete.
Authorized signature: . • Pee methodology set by Tri-County Building Industry Service Board
Print name: m(Il-k e4.17.1 C 1-1 mi.-4-- I Date: 2I 13)1 g
I:1BuildingtPermiutMEC_PermitApp_040113.doc 440.4617T(1I/02/COM/WEB)
Scanned by CamScanner
CITY OF TIGARD MECHANICAL PERMIT
11: COMMUNITY DEVELOPMENT Permit#: MEC2017-00076
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/31/2017
Tf }'' Parcel: 1S125DD06800
Jurisdiction: Tigard
Site address: 9565 SW VENTURA CT
Project: Hart Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 76
Project Description: Modifying duct work for master bedroom.
Contractor: OWNER Owner: HART, SHAUN &MACKENZIE
SHAUN &MACKENZIE HART 9565 SW VENTURA CT
9565 SW VENTURA CT TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-519-8669 PHONE: 503-519-8669
FAX:
FEES
Specifics: Description Date Amount
Duct Work 01/31/2017 $23.32
Type of Use: SF 12%State Surcharge-Mechanical 01/31/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/31/2017 $66.68
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: . Permittee Signature: ,,It///1
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLI
City of Ti and Received
g Date/By: f O Permit No.: Y - 7
III 1 r "AI0.
13125 SW Hall Blvd.,Tigard,OR 97223 'Plan Review ,.
Phone: 503.718.2439 Fax: 503.598.1960 ..,1 , Date/By: Other Permit: :5 -.io r 1
.,
T-I G A R D Inspection Line: 503.639.4175 � �h t')k Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: f i Supplemental Information
TYPE;OF WORK - �! /, g n , COMMERCIAL,FEE* SCHEDULE - USE CHECKLIST
❑New construction ,�,( l4 ` # Mechanical permit fees*are based on the value of the work
�y Addition/alteratiotLrp+laeitte t performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition � t Ii �
❑Other: �;i �,� II
mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* -
zi 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
o 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: 61 5(0 5 5(A) V e til ru ra. G� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: fi i j k/ 0 lz, q q-2 .3 Furnace 100,000+BTU(ducts/vents) 54.91
"�k/VV%Gl.-f/t Heat pump 61.06
Suite/bldg./apt.no.: Project name: Tvw 1Duct work ( 23.32 ,2-3...;IA
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: ( 4 ra�, 'S t, 3 Lot no.: '� Otther 23.32
"J �L Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
J�1 Flue vent for water heater or gas
1111Ci Ej �l l;(' -i-S fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39 _
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
. . PROPERTY OWNER 2 0 TENANT Other: 23.32
(^ `"' '-nn `'' Environmental exhaust and ventilation:
Name: `j V 1��In -►-Y Y I ac k.Q/iit. m.-t Range hood/other kitchen
Address: 1 6lt/ 5 s W Vim, Y- C� equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: -rj J cYl-oL , 0 K % 9-- 5 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(5r3) 51 I — $c,Gj cf Fax:( ) Attic/crawlspace fans 23.32
' EtAPPLICANT 0 CONTACT'PERSON = ;: Other: 23.32 1
Business name:
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: B w .(/1/- Other:
MECHANICAL PERMIT FEES*
Address: Subtotal a3' .3•
City/State/ZIP: Minimum permit fee($90.00) la,t-
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lir.: TOTAL PERMIT FEE i op,,eftt
This permit application expires if a permit is not obtained within 180
/ / '• days after it has been accepted as complete.
Authorized signature: /A * Fee methodology set by Tri-County Building Industry Service Board
Print name: d l,t/..-Pj/1 4( /1--6jv)-- Date: 1 ki / —
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9565 SW VENTURA CT, TIGARD, OR, 97223 February 28, 2018 at
1 :27:51 PM
Record Type: Record ID:
Residential - Mechanical MEC2017-00076
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor