Permit (10) iiimi
CITY OF TIGARD MECHANICAL PERMIT
! COMMUNITY DEVELOPMENT Permit#: MEC2017-00322
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/09/2017
Parcel: 2S103CB01500
Jurisdiction: Tigard
Site address: 12340 SW JAMES ST
Project: Rosson Subdivision: WILLAMETTE NO.2 Lot: 40
Project Description: Natural gas water heater replacement.
Contractor: OWNER Owner: ROSSON, CHASE
CHASE ROSSON 12340 SW JAMES ST
12340 SW JAMES ST TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 916-871-8890 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Water Heater 05/09/2017 $23.32
Type of Use: SF Fuel Piping 05/09/2017 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 05/09/2017 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 05/09/2017 $52.53
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the, rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009. 'ou ' ay ob < copy of the rules
or direct questions to OUNC by calling 503.232.1 : - 800.332.2344.
11110.11°)*
Issued By:)67.1. 6..... Permittee Signature: / ��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic ELV FOR OFFICE USE ONLY
Cityof Tigard Received �1
g Date/By: ) g / Any - Permit No.: )7C- • 1 7�c.k),?.il i
NI II 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
_' Phone: 503.718.2439 Fax: 503.598.19AY 8 2017 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
t Co�Rf.:sVicEDULE-. SI*
REKUST
: . '11:44.1t4''' '';'''''''411"-'56'1'W;"1"----g-' ..- 1 : : '''' . Me.hanical7ermit fee *are based onthe vane
of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
a
_.� ll C TECO SOF CQI STRik$i tO l.. SII)... N Elkl'S ,. ..,_
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory buildingp information special in ormation use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
F t OJISIT kq. ATIOs-oo IF . „ aHeating/cooling:
Air conditioning
46.75
Job site address:12340 SW James St 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.: Project name:Water Heater Replacement/ ,. Heat pump 61.06
',-)::)i;\") 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: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 23.32
x OF WOIi Gas fireplace/insert 33.39
:.., 5 .. ... .: x..... . Flue vent for water heater or gas
Replace existing 40 gallon natural gas water heater with new unit fireplace 23.32
A.O.Smith model G12-FDT404ONV Log lighter(gas) 23.32
Wood/pellet stove 33.39
Self install Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROP O.r Other: 23.32
r
: ,. . :. H., i ® and ventilation:
� " `""' "� '��~=' •_• f- Environmental exhaust vend anon:
Name:Chase Rosson Range hood/other kitchen
equipment 33.39
Address:12340 SW James St Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(916)871-8890 Fax:( ) Attic/crawlspace fans 23.32
AG' IC �, i 0 C RC2 P RSQN —VP,' Other: 23.32
im
Business name:
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Chase Rosson Furnace,etc.
Address:12340 SW James St Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Tigard,OR 97223 I
Water heater
Phone:(916)871-8890 Fax: :( ) Fireplace
E-mail: Range
Barbecue
_.; ` `..t=_ ,.. . ., . (Z.ONTR TOR ,... :tet ...:., . ; ,> lrl. Clothes dryer(gas)
Business name: 0 € 2 Other
I}%IECIIAk11If*;I PEI2I5
Address:
Subtotal y3-3Z"
City/State/ZIP: Minimum permit fee($90.00) „..„44-regt d .
Phone:( ) Fax:( ) Plan review(25%of permit fee) .....12711r
State surcharge(12%of permit fee) 10.80
CCB lie.: TOTAL PERMIT FEE 100.80
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: _............"'"-- * Fee methodology set by Tri-County Building Industry Service Board
Print name: /)/((, �j— .5 e-- 9_,„,s5 `0 -, Date: 511( 17_
I:\Building\PermitS�MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12340 SW JAMES ST, TIGARD, OR, 97223 June 27, 2017 at 8:29:53 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00322
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Replace water heater. Approved
Violation Summary:
Inspector Contractor