Permit (87) CITY OF TIGARD MECHANICAL PERMIT
` 111COMMUNITY DEVELOPMENT Permit#: MEC2017-00538
13125 SW Hall Blvd.,Ti Date Issued: 07/25/2017
and OR 97223 503.718.2439
T[ r10 9
Parcel: 1 S 136AA01800
Jurisdiction: Tigard
Site address: 6817 SW OAK ST
Project: Shepard Subdivision: FUR VALLEY Lot: 3
Project Description: Install(1)gas furnace,duct work, (1)range hood,(1)dryer exhaust, (1)bathroom exhaust fan&gas piping for
furnace,future fireplace, range&clothes dryer.
Contractor: SHEPARD BROTHERS MANAGEMENT LLC Owner: SHEPARD,AMOS
2830 NW 29TH 2830 SW 29TH AVE
PORTLAND, OR 97210 PORTLAND, OR 97210
PHONE: 360-772-0355 PHONE: 360-772-6355
FAX:
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 07/25/2017 $46.75
Type of Use: SF Duct Work 07/25/2017 $23.32
Class of Work: ALT Type of Const: Range Hood/Other Kitchen 07/25/2017 $33.39
Occupancy Grp: Clothes Dryer Exhaust 07/25/2017 $33.39
Stories: Single Duct Exhaust(Bathrooms,Toilet, 07/25/2017 $23.32
Utility Rooms)
Fuel Piping 07/25/2017 $14.15
12%State Surcharge-Mechanical 07/25/2017 $20.92
Fuel
Fuel Types:
Gas Pressure:
Total $195.24
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo ria- •btain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 0 /
f
Issued By: _ Permittee Signature:
`W
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicati FOR OFFICE USE ONL.V
City of Tigard GENE Received
Date/By: l ,eC�!7�O 5-31��
1111
13125 SW Hall Blvd.,Tigard,OR 97223 7 p Permit No: ''(
p Plan Review
Phone: 503.718.2439 Fax: 503.598.1960Other Permit:
n{7 Date/By:
T I G A R D Inspection Line: 503.639.4175 J U `}f' Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITE'OFTIGAR.D{�r
TYPE OF SiliLDING DIVISION ISION COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ,l Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
a 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:
Air conditioning 46.75
Job site address: ` } /� -
(`.��j � 5,--(;) On (` Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP: '"1 l&a...A.4.k_ f t j 7 z2.,( Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work i 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 23.32
."7-,-4...., '1>ESCRIPTI+ON OF`WOI K Gas fireplace/insert 33.39
} --'4' : ' x - �'' Flue vent for water heater or gas
ld� •L ,,,_ �.,k � c _ fi r- c fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
1'R TY ?VI'NE + s Other: 23.32
," _ .. '= , , .. T��. r Environmental exhaust and ventilation:
Name: Je Range hood/other kitchen
equipment F 33.39
Address:
3�I ? St,_) UA Z. Clothes dryer exhaust 1 33.39
City/State/ZIP: 1- 6 4a i et-2 2-2--( Single-duct exhaust(bathrooms,
4 toilet compartments,utility rooms) 1 23.32
Phone:(3o ) t-7 . G .�--\-'' Fax:( ) Attic/crawlspace fans 23.32
PLiCANT - ❑" ®i 4#.4.„,,r,,, „.:,E a Other: 23.32
.u" Fuel t rn
Business name: p p g'
({"t�-"'"ZsC-c-^�- $14.15 for first four;$4.03 for each additional
Contact name: p--v Furnace,etc. 1
Address: �� Gas heat pump
v Wall/suspended/unit heater
City/State/ZIP: Zy yA , ' &IL Q )a 1 ij Water heater
Phone:( ) Fax::( ) Fireplace {
Range I
E-mail:
j'e...„ L ip vt,L. t Barbecue
w ti, .CON'RACTOR A: ,. : ,,pt, Clothes dryer(gas) 1
Business name: ? Other:
�, , L� dL.- A dK $
9 r..
(' x MECHANICAL PE SES* :;,
Address: gifh2 i. .5 C.' 71 L✓ 2.„qi -�- Subtotal i/7 3��
City/State/ZIP: t�Td-1. _ y�� c '-)2.i 0 Minimum permit fee($90.00) -
(J Plan review(25%of permit fee)
Phone:(3b ) -7-7 2 - 63 S. -w Fax:( )
State surcharge(12%of permit fee) .0?() ,ga„
CCB lic.: 6 et 7- "b c- TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ♦A. * Fee methodology set by Tri-County Building Industry Service Board
Print name: '
7`K -1. '�' ` "" Date: 1/7_,I2.�j-!7-7
I:\Building\Permits\MECC__PennitApp_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\Pennits\MEC PennitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6817 SW OAK ST, TIGARD, OR, 97223 October 13, 2017 at 9:45:18
AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00538
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Meter installed with no green tag or record of inspection. 1 piece track pipe installed to
furnace only, no other appliances installed at this time, no other future piping installed at
this time. No apparent leaks in one piece pipe. Permits and inspection required at time
of installation of other branch lines.
No bath fan or microwave hood fan installed.
Existing bathroom with no changes, self vent microwave above electric range.
Violation Summary:
Inspector Contractor