Permit Support Document (23) INI
CITY OF TIGARD f MECHANICAL PERMIT
COMMUNITY DEVELOPMENT -
42,AIM
Permit*: MEC2017 00587
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2017
Parcel: 2S103CB08400
Jurisdiction: Tigard
Site address: 12399 SW QUAIL CREEK LN
Project: J2955-1 Subdivision: QUAIL HOLLOW-EAST Lot: 33
Project Description: replace AC. 8/28/2017: REPRINT permit to add gas line for range.
Contractor: COMFORT SOLUTIONS HEATING&COOLING Owner: KELLEY, DAVID P&
PO BOX 1233 DELORES M
CLACKAMAS, OR 97015 12399 SW QUAIL CREEK LN
TIGARD, OR 97223
PHONE: 503-698-2665 PHONE:
FAX: 503-658-4011
FEES
Specifics: Description Date Amount
Air Conditioning 08/08/2017 $46.75
Type of Use: SF Fuel Piping 08/08/2017 $14.15
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/08/2017 $29.10
Occupancy Grp: 12%State Surcharge-Mechanical 08/08/2017 $10.80
Stories:
Fuel
Fuel Types: Electricity
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 4 e --4iPermittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Aug 23 17,08:25a Comfort Solutions 503-427-0034 p.1
Mechanical Permit Applirrific , J) FOR OFFICE USF,ONLY
Received permit No.: `?�� p
City of Tigard DateBy: f/73,/,
/7 / f ;„ .
111 m n 13125 SW Hall Blvd.,Tigard,OR 93¢-Mr q ?fan Review Other Permit:
Phone: 503,718.2439 Fax: 503.59Mdli G A 2U7 DateBy;
Inspection Line: 503.639.4175
T t G hR D .639.4175 �"� Date Ready/By: Jw, 8 See Page 2 Thr
Internet: www.tigard-or.gov CI TY V ' RD Ilot::ied'Methed:
�1 /t G C2/ Supplemental information 1
GA
T1 E DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*arc based on the value of the work
❑New construction eAAdditiontalteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment.labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRTJCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
Er1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
i ❑Multi-family ❑Master builder ❑Other:
Description Qty. Ea. 1 "Total
Ileatinglcooling:
JOB SITE INFORMATION AND LOCATION Air conditioning 16.75
Job site address: G-,*,.d� �v`
_J .° {, Ct l LIJ Furnace 100.000 BTU(ductsivents) 46.75
City/State/ZIP: ,mac, - i. C, -�- �i Furnace 100,000+BTU(ductvvents) 34.91
Heat pump ' 61,06 I
Suiteibldg.lapt.no.: Project name: Ductwork 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 _ 2132
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: j Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39 ,
Flue vent for water heater or gas
S. ��.. � (C' C -« fireplace 23.32
C— 1 ^ Log lighter(gas) 23.32
• r Ca'to &4_. C.A. �� r—7 Woodipellet stove 33.39
J Wood fireplace/insert 23.32
Chimneyliiner/lluelvent 23.32 ,
Other: 23.32
R'PROPI;RTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: 1ctr. Range hood/other kitchen '
IC 't equipment 3339
Address: �-. ..,1,e_ trv....L ...7 'N,j..(2 _ Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms, i
City/State,rLlP: toilet compartments,utility rooms) , 23.32 I
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
Q APPLICANT� ❑ CONTACT PERSON Other: 23.32
CAN-y‘ \1 G ,4 , Fuel piping:
Business name: Ci ��. 17 514.15 for first four;S4.03 for each additional
Contact name\ce .•� ' Furnace,etc.
I Gas heat pump
Address: I
Wall/suspended/unit heater
City;State/ZIP: Water heater
Fireplace
Phone:( ) Fax::( ) Range
E-mail: i Barbecue
I CONTRACTOR Clothes dryer(gas)
_ { Other i
Business name: � < `1�.1 o1-3r. , MECHANICAL PERMIT FEES*
Address: ..k.--IC) e--i-)ys, 1 Subtotal
+ teak�( t., O ` - Minimum permit tee($90.00))
CitylState/ZIP: Plan review(25%of permit fee)
Phone: t C� 0c- Fax? i3? t' -.�j'`j I State surcharge(12%of permit fee)
TOTAL PERMIT FEE
CCB lic.: ‘',..-V -1, '����_
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-Caunty Building industry Sen+ice Bawd
' \ 1
Print name:13( 1 Lk✓ at ..s Date:15 P"511 -
CiBui;ding\Perrniuia1EC PemvtApp_stol 13.doc 440-4617t'(1 1102'COWfiVEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12399 SW QUAIL CREEK LN, TIGARD, OR, August 31 , 2017 at 10:00:21
97223 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00587
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Corrections from previous inspection complete.
Violation Summary:
Inspector Contractor