Permit Support Document (20) q CITY OF TIGARD r ' �� MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT ® �` Permit#: MEC2017-00221
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/31/2017
Parcel: 2S 111 CA03700
Jurisdiction: Tigard
Site address: 9715 SW LAKESIDE DR
Project: Tensae Subdivision: SUMMERFIELD NO.12 Lot: 657
Project Description: Installing Mini Split/Heat Pump.4/3/17,REPRINTED to correct scope of work,remove heat pump and add gas for
barbecue.
Contractor: WOLFERS HOME SERVICES Owner: PETERSON,A PAUL&S DIANE
1365 N FRONT STREET 9715 SW LAKESIDE DR
WOODBURN, OR 97071 TIGARD, OR 97224
PHONE: 503-981-4511 PHONE:
FAX: 503-981-0801
FEES
Specifics: Description Date Amount
Fuel Piping 03/31/2017 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 03/31/2017 $10.80
Class of Work: ALT Type of Const: (manual)
Occupancy Grp: Misc Administration Fee 04/04/2017 $45.00
Stories: Minimum Fee Adjustment-Mechanical 03/31/2017 $75.85
Fuel
Fuel Types:
Gas Pressure:
Total $145.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to O NC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 'A/ /7G-%e 9 7/0"1
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
2017/APR/03/MON 09: 51 IOLFERS HEATING FAX No, 5039810801 P. 001/001
Mechanical Permit Applicati9p.i ' y '-,, ,.. FOIL Of FICL. i'SC()NIA
City of Tigard i , , Received
Date/By:
' ' ' '-' ' /OEM/i PI •
Permit No.: r--1-
14__- .. 13125 SW Hall Blvd.,Tigard,OR 97223
Ran Review _, .017-G4M
0 Phone; 503.718.2439 Fax: 503.598.1960 ,-7- DateIBT Other Permit;
Inspection Line: 503.639.4175 ? „ '
A i?D Date Ready/By: lurk; 0 See Page 2 for
Internet www.tigard-orgov Notified/Method: Supplemental Information
.
. TYPE OF* .
OM( ..• 1• ' : :' -•, COMMERCIAL PBZ* ScBIEDUI..E-IJSB,CEIZCKUST
Mechanical permit fees*are based on the value of the work
0 New construction El Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)pf all
111 Demolition 0 Other; mechanical materials,equipment labor,overhead,and profit
Value:$
• • CATEGORY OF CONSTRIXTION ' • ______
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special htfurmation use checklist.
0 Multi-family El Master builder El Other: Description Qty. Ea. Total
JOB Sir E INFORZYIATION AND LOCA1TON Resting/cooling .
Air conditioning 46.75
Job site address:9715 SW Lakeside Dr
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents)
Heat pump 61.06
Suite/bldg./apt.no.; - Project name: ....—
Duct work 23.32
Cross street/directions to job site: — Hydronic hot water system 2332
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 2332
Other: 23.32
- _
Subdivision: I Lot no.;
Other fuel appliances:
Tax map/parcel no.: Water beater 23.32
7:
.,
pikRu7/04 oF wow< -., . .. ": . ',d,',''' Gas fireplace/insert 33.39
' .•
" Flue vent for water heater or gas
•—•17-00,9,0,1 2O/ 2 :n , .___O/0e, fireplace 2332
Installing Gas Piping to BBQ [9c. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
•
2332
El
PROPERTY OWNER ' • ',. - ,• -El TENANT Other:
„. Environmental exhaiist and ventilation: ,-
Name:Paul Peterson Range hood/other kitchen
equipment 3339
Address:9715 SW Lakeside Dr
• Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms, •
- toilet comyartments,utility rooms) 23.32
Phone:(503)310-0283 Fax;( ) Attic/crawlspace fans 23.32
IZ APPLICANT 11 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Wolfer's Inc
814.15 for first four;$4.03 for each additional
Contact name:ICristi Losehiavo Furnace,etc.
Address:1365 N Front St Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Woodburn,OR 97071, Water heater
Phone:(503)981-4511 Fax::(503)981-0801 Fireplace
Range
, E-mail:permits@wolfersheating,com
Barbecue 1 14.15
CONTRACTOR Clothes dryer(ga.9Thr
Other:
Business name:Wolfer's Inc —
. iviECHANICALITIIMIT FEES*
Address:1365 N Front St
Subtotal 45.00
City/State/ZIP:Woodburn,OR 97071 Minimum permit fee($90.00) _
Plan review(25%of permit fee)
Phone:(503)981-4511 Fax:(503)981-0801
State surcharge(12%of permit fee)
CCB lic.:1911 ' TOTAL PERMIT FEE 45.00
—. ., This permit application expires if a permit Is not obtained ithin HO
days after it has been accepted as complete.
Authorized signature: e.sA I / J I .- 1 ..44 ,/, iii) • Fee methodology set by Tri-County Building Industry Service Board
4 A
Print name:Kristi Loa' iavo - Date;04/03/2017
.._ ....._,..._________.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9715 SW LAKESIDE DR, TIGARD, OR, 97224 February 26, 2018 at
10:20:54 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00221
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor