Permit CITY OF TIGARD MECHANICAL PERMIT
"`7 :
COMMUNITY DEVELOPMENT Permit#: MEC2017-00573
13125 SW Hall Blvd.,Ti Date Issued: 08/03/2017
ffFt.G and OR 97223 503.718.2439 9
Parcel: 2S 111 AD03900
Jurisdiction: Tigard
Site address: 14595 SW 89TH AVE
Project: GOEBEL Subdivision: PINEBROOK TERRACE Lot: 36
Project Description: New furnace and NC. Placement of NC unit must comply with manufacturer's installation requirements.
Contractor: AZURE HEATING&AIR CONDITIONING INC Owner: GOEBEL, GREGORY K&ELSA L
PO BOX 62 14595 SW 89TH AVE
GLADSTONE, OR 97027 TIGARD, OR 97224
PHONE: 503-706-2568 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 08/03/2017 $46.75
Type of Use: SF Furnaces<100K BTU 08/03/2017 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/03/2017 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 2-001-0090. You i obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ''`/ 9----- Permittee Signature: ..-vim
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Ee
i s 17c)JC7
13125 SW Hall Blvd. Tigard,OR 97223Phone: 503.718.2439 Fax: 503.598.196 w
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Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 3 Date Ready/By:
Internet: www.tigard-or.gov (�� ((��q S See Page 2 for
AUG �lJ l� Notified/Method: Supplemental Information
TYPE OF WO Il RL
I�1Y�� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
0 New construction AAddition/altera�tt -111111TVISION
I' "SON Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
§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: V--\\S qs ,��j F l("T Air conditioning f 46.75 7
` Furnace 100,000 BTU(ducts/vents) / 46.75 kip(7S—
City/State/ZIP: V A f?.,- C •7 Z 2-14 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: 7 Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: r rl -L--�'-e.'r- 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.: � 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater
- `'" , ES'",RIPTION'OF ORK , ", 23.32
� r ' � � �_ � Gas fireplace/insert 33.39
ci 113 ..,,„Z t� c 'til , ( � �. Flue vent for water heater or gas
(19.7- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ ioPLRT:y owN i* 'f : T } Other: 23.32
Environmental exhaust and ventilation:
Name: ,r c,oe g
�M �' Range hood/other kitchen
Address: 1 L(5O S ' ( -A-14\
CP A V /� Clothes dr 33.39
<.� v `C--.• Clothes dryer exhaust 33.39
City/State/ZI: '�` ` -2,....--3
s•-' '�y If'7�* Single-duct exhaust(bathrooms,
r ` ' 1 toilet compartments,utility rooms) 23.32
Phone:(,j), 2 3"2.j 2_S`, Fax:( )
� Attic/crawlspace fans 23.32
_#. CI APPLICANT - ,.4:116.$10T: ..,. ON 4 Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:
Water heater
Phone:( ) Fax::( ) Fireplace
E-mail: Range
Barbecue
$
, w dryer er(g as)
Business name: A LAA.Q_(_. \,:...\ :...6,7-1 Other:
Address: ( , t�(1.� � .- P, .Z4 «IMECHAN L'°1
Subtotal RMITf=
/a,
Ci ate :
�'/St /ZIPG r r��) co�-1'e.,,. Z r2... cl'10 Z. Minimum permit fee($90.00)
Phone:6 3) c,) 4, #2,,s(4.53 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of pennit fee) t //,AA
CCB lic.: ” 1 t.{5± TOTAL PERMIT FEE'/O'f 7t,
\ This permit application expires if a permit is not obtained within 180
1 -— days after it has been accepted as complete.
Authorized signs e: `�-' ')
` -' * Fee methodology set by Tri-County Building Industry Service Board
Print nam( y�` efs .5 "A SSr`t` Date:
I:\Building\Permits\MEC_PermitApp_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\Permits\MEC_PermitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14595 SW 89TH AVE, TIGARD, OR, 97224 August 29, 2017 at 10:39:28
AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00573
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Corrections complete.
Violation Summary:
Inspector Contractor