Permit (62) CITY OF TIGARD MECHANICAL PERMIT
IN 41COMMUNITY DEVELOPMENT Permit#: MEC2017-00641
-f-f GRD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2017
Parcel: 2S 111 CC13200
Jurisdiction: Tigard
Site address: 10295 SW HIGHLAND DR
Project: CARRINGTON Subdivision: SUMMERFIELD NO.4 Lot: 183
Project Description: (1)range hood and(1)bathroom fan.
Contractor: Owner: CARRINGTON, RENEE M
10295 SW HIGHLAND DR
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 08/28/2017 $33.39
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 08/28/2017 $23.32
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: 12%State Surcharge-Mechanical 08/28/2017 $10.80
Stories: Minimum Fee Adjustment-Mechanical 08/28/2017 $33.29
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �� Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Mechanical Permit Application c FOR OFFICE USE ONLY
City of Tigard Received
i ���F/t� t PermitNo. c.,2(...)/2 ✓�(�i 1 1''
13125 SW Hall Blvd.,"Tigard,OR 97223 ,j Date/By: I �{/�P
(� 'Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 D _, _ Other Permit:
6 TIGARD Inspection Lme: 503.639.4175 � '
I . - eady/By: Juns: H See Pa e 2 Tor
Internet. www.tigard-or.gov { '� r0 + � thod: g
r Supplemental Information
TYPE OF WORK "'l lB e
COMMERCIAL CAL FH E* SC HE DI1I E USh',CFILCKL(ST
❑New construction ®Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials_equipment,labor,overhead,and profit.
Value:$
_
CATEGORY CONSTRUCTION
RESIDENTIAL EQItIP]WENT/SYSIEMS FEES" I
[ .1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special in/orntntmn use clrecbh.sr. ;1
❑ Multi-family 0 Master builder0
Other: Description j Qty j la /. � total
JOB SITEINFORMATION AND LOCATION Heating/cooling:
'1
Air conditioning5 j
Job site address: Oatit) 1 46_7_
w�/ Y • Furnace 100000 BTU(duets'eras) 46.75 j 1
( Ity/State/71P �af D� 100,000+ — -
Cl��2� Furnace BTU(ducts/cents) 7=1.91 j i
Suite/bldg./apt.no.: Project name: Q� i Heat pump 6 1_06
'-"��� Ductwork � 2332 �
iICross street/directions to job site: Hydronic hot water system 23.32
il
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 23.32fl
1
Subdivision: Lot no.: Other: 23 32
— — Other fuel appliances:
lax map/parcel iii).: Water heater2
23.32
I J - -+ .DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue— L ^ /�
( I�r-.71-L (Z(�iV\ . vi fireplacet for water heater or gas 23.32
Log lighter(gas) 23.32
Wood/pellet stove 1 33,39
— Wood fireplace/insert 1 23 ,2
Chimney/liner/flue/vent -_- ( 73)2
El PROPERT3 OWNER ElTENANTOther: 1 23.32 J — ,
Environmental exhaust,and ventilation:
Nan1e: —_— __
en�� �Ql/r� Range hood/other kitchen
J
Address /az�/r .JG, / /Q equipment �,39
_
�r
Clothes dryer exhaust ;y
(ity/State/ZIP: -- II
-
�� 92I Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 1 1 2> ;2
H1'hone: , / = li
�l7J ) b .�' Z vs 7 Fax:( ) :,
Atucicrawlspace fans 1 23 32
0 APPLICANT �'',CONTACT PERSON Other: L ,7
4
Business name:, Nuel d-- Co / UCt/v Yl Fuel piping: —. — 11
/ dry' 514.15 for first four:54.03 for ea(h radrtimrai
Contact name: h I'/S l `,e Furnace,etc. T — —
Address: LA Ax /9 Gas heat pump
/� Wall/suspended/unit heater
City/State/ZIP: GQ�•e /i��e d 0� q 7QJ�
L/ Water heater
Phone:(�U3),'76 ST7. 76 I Fax::(-a3 ) 63A fig 470
Fireplace
Range t
I h-mail:
(2%, /� �L,2LN13 1.
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: II Oar,' (Ind CC)o�irl �[j� Other.
eo-1n
_ MECHANICAL PERMIT FEES*
Address: 2 -
�' 1 SW ? JI e 5-s ` �5 D A Subtotal
ity/State/LIP: ct2'L ) Minimum permit fee(590 00) �
(.
( -?-q
Plan review(25"o of permit lee)
Phone:(
503) a c( �C�2$ Fax:( ) —
State surcharge(12°/6 of perntll t.e)
('CR2 lie.: 11)1'.11,PERMIT FEE F 1 X71) -
�'1his permit application expires if a permit is not oblaineiriitllin LSO
Authorized signature:
days after it has been accepted as complete.
4� .‘14r
Fee methodology set by I ii-County Buildine Indu,n, .Sen ii c;3oao-t 1
Print name: 7 A/ .pit Date: 5--i$ 1
Ir.Building\PermitsvMGC—Peri nut Ai —4011 t doc 440-4617T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10295 SW HIGHLAND DR, TIGARD, OR, 97224 October 23, 2017 at
10:36:50 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00641
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor