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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2017 00100 Tr GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/08/2017 Parcel: 2S 114BA06800 Jurisdiction: Tigard Site address: 9760 SW COOK CT Project: Brown Subdivision: COPPER CREEK Lot: 10 Project Description: Installation of gas piping for range. Contractor: HOLMES INSTALLATION SERVICE Owner: BROWN, MABEL M REVOCABLE TRUST, 33535 NW VADIS RD 9760 SW COOK CT CORNELIUS, OR 97113 TIGARD, OR 97224 PHONE: 503-647-9320 PHONE: 503-624-9850 FAX: FEES Specifics: Description Date Amount Fuel Piping 02/08/2017 $14.15 Type of Use: SF 12%State Surcharge-Mechanical 02/08/2017 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/08/2017 $75.85 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules : :::e5t0n00;:oh: c503.232.1987 or 1.800.332.2344.i / r Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applic t' FOR oFF1(I: Iisl:ONE) Rt City Of Tigard Received 6 -'' "4- '(- Date/B /1M f. Permit No.: �ii1 /7..---60/66) 13125 SW Hall Blvd.,Tigard,OR 97223 y` `-1 ■ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review C Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 FEB (?1 r Internet: www.tigard-or.gov 8 2 0 NotiDatefiReady/By:ed/Method: SuJuris: r See Page 2 for pplemental Information CITY OF FIGARO Typo I i icll"Ii �r COMMERCIAL FEE* SCHEDULE USE CHECKLIST ❑New construction Addition/alteration/replacement !! Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL"EQUIPMENT/SYS I7,M$FEES* IC'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: Job site address: .. t,6 Air conditioning 46.75 ` �L IT �+ `+ Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: IT v5 G.N,. "'ti/ Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydrohic) 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 ,� DESCRIPTION 40, Yq , , „ 5 , y Gas fireplace/insert 33.39 , ' �`+ 1 --� " i''' "_ /> Flue vent for water heater or gas 5 9 f ., 1 1 N 4 (i4-j Jt(!L't(' e fireplace 23.32 t / J Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 A , ROPERTY OWNER ,.. ❑ TENANT x - " Other: 23.32 • " ,- 't" Environmental exhaust and ventilation: Name: lc LAA).-61 Q �V'O`N/J Range hood/other kitchen Address:9 0 S W c,,.0 2 C-1 "-- equipment 33.39 fClothes dryer exhaust 33.39 City/State/ZIP: ---r,..5 t3,i,) 3 `1,.9 _ Single-duct exhaust(bathrooms, Phone:( ) f ij�;,! J �� ( ) toilet compartments,utility rooms) 23.32 Li ./ F Attic/crawlspace fans 23.32 :.© APPLICANTa U CoN1 ACT;PERSON .:' Other: w 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax::( ) Fireplace Range �(` E-mail:l: Barbecue 1 CONTRACTOR Clothes dryer(gas) Business nay (I,n.�5 k'''/V5 ICA ( V Other: Address: 5 Ai,tA. V (fie AMECHANICAI PERMIT FEES* V ) Subtotal City/State/ZIP: C3 a Az t.,../7t:`..)'1.-(i_' % 7(1 3 Minimum permit fee($90.00) Phone: 7)02 0 5 7 r Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) If CCB lic.: t Q 9 l 1 3 TOTAL PERMIT FEE /en. 8C) This permit application expires if a permit is not obtained within 180 P7 ��' days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: /2A • '- 4....0.,&I "ie-3 Date: d.'? ,.2 ' Y� Ay i �. /= i 7 I:\Bui1ding\Permits\MEC_PernutMpp_040113.doc 44d 461 i(I 1/02/COM/WEB) MPageechanical2 Permit ApplicationInformation - City of Tigard - Supplemental 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: 9760 SW COOK CT, TIGARD, OR, 97224 Record Type: Residential - Mechanical Inspection Type: 699 Mechanical final Result: PASS- NoCofO Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: Record ID: MEC2017-00100 Inspector: Chip Barnett Contractor