Permit CITY OF TIGARD MECHANICAL PERMIT
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1 .," COMMUNITY DEVELOPMENT Permit#: MEC2017-00094
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 02/06/2017
TtGARD 9 Parcel: 2S103BD11800
Jurisdiction: Tigard
Site address: 12610 SW 121ST AVE
Project: Nix Subdivision: 2008-056 PARTITION PLAT Lot: 2
Project Description: Adding(1)mini split system and(1)microwave venting for upstairs bonus room,and installing(1)gas water heater.
Per inspection notes for MST2016-00216,mechanical final for house passed,and a new permit is required for the
mini split system and microwave venting in bonus room.
Contractor: CLEAN ENERGY COMFORT Owner: NIX, DAVID C
7287 BROOKSLAKE RD NE NIX, JULIA A
SALEM, OR 97305 12630 SW 121ST AVE
TIGARD, OR 97223
PHONE: 503-982-5927 PHONE: 503-314-0798
FAX: 503-304-2921
FEES
Specifics: Description Date Amount
Heat Pump 02/06/2017 $61.06
Type of Use: SF Water Heater 02/06/2017 $23.32
Class of Work: ALT Type of Const: Range Hood/Other Kitchen 02/06/2017 $33.39
Occupancy Grp: 12%State Surcharge-Mechanical 02/06/2017 $14.13
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $131.90
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 'c -- "--
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicationFOR OFFICE I_SF OMLv
City of Tigard Received
t Date/By: ,. 7 1� Permit No.: %.
13125 SW Hall Blvd.,Tigard,OR '' 2 d Plan Review
C Phone: 503.718.2439 Fax: 503 59 . ':1 Date/By: Other Permit: _ . I
T I GA R D Inspection Line: 503.639.4175 y I Date Read/B cur
Internet: www.ti and-or. ov6y _ Ready/By: See Page 2 for
g g ;\--- Notified/Method: Supplemental Information
TYPE OF14671X0 vamist011an COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Q New construction 0 Addition/alIt i Mechanical permit fees*are based on the value of the work
t cement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
OA-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:
/....Z
/vT f` � Air conditioning 46.75
Job site address: / bA 1/4/4.,21/4/4.,2 / / s tL< Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: / /,�,<-,, Furnace 100,000+BTU(ducts/vents) 54.91
�/ Heat pump / 61.06 614)4,
Suite/bldg./apt.no.: Project name: ,!', /X Duct work 23.32
Cross street/directions to job site: �i Hydronic hot water system 23.32
'z'/„- 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: Other: 23.32
Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater f 23.32 )-3. ),
DESCRIPTION OF ii4RK ,`: .-,:V4.': Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
`, '.,,,,,V,.7Other: 23.32
': PROPERTY OWNER ' f, ] TENANT ,> s
?... Environmental exhaust and ventilation:
Name: l'Q/-'/j , ' x- Range hood/other kitchen
equipment i 33.39 1) 1
Address: !/� `. ' Clothes dryer exhaust 33.39
City/State/ZIP: 5>7 �' Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT' '13,CONTACT PERSON `*4. '” '' Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: 5'74-e . - l- //{/ Furnace,etc.
Address: p Q- (7)c- OV Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Gi/r'-z,%�e)lr Z' Water heater
Phone O 7 S2 _��Q� Fax::( ) Fireplace
�/ Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:%fav C`J!'� '
v �C /�Jy MECHANICAL PERMIT FEES* .
Address: 71-1Z 4 7 -ec S of r c.0_ /L-e'! AL's Subtotal (17-77
City/State/ZIP: q7es,— Minimum permit fee($90.00)
i Plan review(25%of permit fee)
Phone:(.5(3 ) -.D„-7)..4 Fax:( ) g permitfee) l /./3
i)� State surcharge(12%of w
CCB lic.: /ft 3d6..., TOTAL PERMIT FEE 1 (?
This permit application expires if a permit is not obtained avithin 180
days after it has been accepted as complete.
A. Authorized signature: �� �� / * Fee methodology set by Tri-County Building Industry Service Board
xPrint name: �Q�C „0(j'/ ((( Date:J •- e -/7-
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
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399 Plum `kd' ac`xer m.
Plumbing final FAIL Aaron C
01/31/2017
ilio-Lobel Date: 1/31/2017
Provide caulking around laundry sink. Provide
sink clips for underside of laundry sink.
Master water closet not flushing.
Provide caulking at shower 90 for hand held
master shower.
Provide caulking/grout around hall bath tub.
Hot and cold crossed at hall bath tub.
Provide insulation on exposed water lines in
garage.
Seal and secure hot and cold hose bibs right side
of garage and all other exterior hose bibs.
Exterior clean outs need to be glued in place and
brought down to grade.
399 Plumbing final 02/01/2017 PASS Don Sylvester Y Date:2/1/2017
1.Corrections are complete-plumbing final
approved.
2. Note:up stairs living space is for plumbing
rough-only, new permits and inspections will be
required in order to finish.
199 Electrical final 02/02/2017 PASS David Young Date: 2/2/2017
Provide breakerlock for kitchen dishwasher not
plug and cord connected.422.30
Will check at building final inspection.
Provide permit for heat pump connected without
permit.
Separate electrical permit for mini split required.
No hot tub installed at this time.
699 Mechanical final 02/02/2017 PASS David Young Date:2/2/2017
Provide new permit for mini split installed without
permit at bonus room.
Provide permit for microwave venting in bonus
room.
Mechanical final for house only ok.
CaseActivityShortForm.rpt
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13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
12610 SW 121 STAVE, 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:
Record ID:
MEC2017-00094
Inspector:
Aaron Cillo-Gobel
Contractor