Permit (16) CITY OF TIGARD MECHANICAL PERMIT
1II.. COMMUNITY DEVELOPMENT Permit#: MEC2017-00133
T f GA t O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2017
Parcel: 1S134CB01800
Jurisdiction: Tigard
Site address: 12130 SW SUMMER ST
Project: LAMB Subdivision: SUMMER HILLS PARK Lot: 21
Project Description: (1)furnace,(1)water heater,and gas piping for range. Plumbing permit for water heater will be submitted at a later
time.
Contractor: OWNER Owner: LAMB, PIERCE
PIERCE LAMB 12130 SW SUMMER ST
12130 SW SUMMER ST TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-351-9886 PHONE: 503-351-9886
FAX:
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 02/16/2017 $46.75
Type of Use: SF Water Heater 02/16/2017 $23.32
Class of Work: ALT Type of Const: Fuel Piping 02/16/2017 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 02/16/2017 $10.80
Stories: Minimum Fee Adjustment-Mechanical 02/16/2017 $5.78
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: r- 44/01--6
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
Received /���
City Tigard ,2 o /7 fJ// Permit No.: /Yi i '7 r r.,t 33
1,1 . DatclBy: � � f f 1
13125 SW Hall Blvd.,Tigard,OR 97223 yv. ,, .r`` Plan Review q� j
Phone: 503.718.2439 Fax: 503.598. Other Pemiit: �= ..d()l 7"in i ,
nate/By:
TIC,:1 RD Inspection Line: 503.639.4175 '�Q\ Date Ready/By: sins: I ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
r N'. ,A Mechanical permit fees*are based on the value of the work performed.Indic
INTYPE OF WORK`,fir O( �\l\ \ 1 the nearest dollar)of all mechanical materials,equipment,labor,overhead,a
ul Additionlalteratioi S0pt1� e lhtt Value:$
❑New construction )��°
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑Demolition ❑Other: For special information use checklist
. CATEGORY OF CONSTRUCTION Description I Qty. I Ea. '
®1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Heating/cooling:
Air conditioning 46.75
❑Multi-family ❑Master builder 0 Other: Furnace 100,000 BTU(ducts/vents) i 46.75 i 4,--75---
JOB SITE INFORMATION AND LOCATION Furnace 100,000+BTU(ducts/venls) 54.91
Job site address: I II 'gO -" .S.-04 Ole,—SI- Heat pump 21.02
Duct work 2332
City/State/ZIP: "'r,,,COL Ore 67 2.z 3 Hydronic hot water system 23.32
Suite/bldg./apt.no.: ti Project name: Residential boiler(radiator or 23.32
hydronic)
Cross street/directions to job site: Unit heaters(fuel-type,not electric), 46.75
i in-wall,in-duct,suspended,etc.
`Z t 5 It ‘+" 1 is'�o� � Flue/vent for any of above 23.32
Other: 23.32
Other fuel appliances:
Water heater ! 23.32 2.,`J
Subdivision: Lot no.: Gas fireplace/insert 33.39
n Flue vent for water heater or gas 23.32
Tax map/parcel no.: 15 _3 k L 130 r f[)0 fireplace
DESCRIPTION OF WORK Log lighter(gas) 23.32
Wood/pellet stove 33.39
1 I Jt t o e x c-t (n dI dim- t/'vt,t, i} C v1o14ot 1 Wood fireplace/insert 23.32
U a-S {` l� . +Cry„ Chimney/liner/flue/vent 23.32
Other: 23.32
Environmental exhaust and ventilation:
Range hood/other kitchen 33.39
equipment
l}PROPERTY OWNER ❑ TENANT Clothes dryer exhaust 33.39
Name: PiGr-7R UmiA Single-duct exhaust(bathrooms, 23.32
/ toilet compartments,utility rooms)
Address: 174 jt) 5 '5 LAvrt,aw—S F Attic/crawispace fans 23.32
City/State/ZIP: Trovrk �i i? 1i7 Other: 23.32
V Fuel piping:
Phone:(50,) 3 5 ii k9 G Fax:( ) $14.15 for first four;$4.03 for each additional
® APPLICANT 0 CONTACT PERSON Furnace,etc.
Business name: Gas heat pump
Wall/suspended/unit heater
Contact name: ,) t't.l'& /..4„,„1/1„ Water heater
7 C S 7 Fireplace
t 24 3
Address: 0 5 ( - 6,-, r�-1- Range � Pi t45
City/State/ZIP: 7-,,,,,,,,-,x 6 i? el 7 �i Barbecue
Phone:( 3) l4,7-6> Fax::( )
Clothes dryer(gas)
Other.
E snai: (eli✓ s c(� , / � 5fL(t` <0,1
MECHANICAL PERMIT FEES*
CONTRACTOR Subtotal
Business name: Minimum permit fee($90.00) ?t.) Lr
, ,
Plan review(25%of permit fee)
Address: State surcharge(12%of permit fee) ,Ee,-x
City/State/ZIP: TOTAL PERMIT FEE it/,as
This permit application expires if a permit is not obtain jithin ISO days after
Phone:( ) Fax:( ) complete.
* Fee methodology set by Tri-County Building Industry Service Board
CCB lic.:
Authorized signature: / .*___._ `_
Print name: p(trzt_ 14S l•✓�' Date: 0--/4%
COMMERCIAL FEE* SCHEDULE-USE CHECKLIST
1:\Building`PcrmitsVvlEC_PcnnitApp_JW)l 13.doc 440-4617T(1 i!t12:OM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12130 SW SUMMER ST, TIGARD, OR, 97223 May 11 , 2017 at 1 :04:37 PM
Record Type: Record ID:
Residential - Mechanical MEC2017-00133
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Existing installation appears ok.
Violation Summary:
Inspector Contractor