Permit (85) CITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT Permit#: MEC2017 00833
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/25/2017
f g Parcel: 1 S 136CA07600
Jurisdiction: Tigard
Site address: 11030 SW 78TH AVE
Project: Buchanan Subdivision: 2001-033 PARTITION PLAT Lot: 1
Project Description: A/C and furnace installation with gas piping for water heater. Placement of A/C unit must comply with
manufacturer's installation requirements.
Contractor: DONS AIR CARE INC Owner: COLLINS, PAUL DAVID& LINDSEY MI
PO BOX 6408 11030 SW 78TH AVE
ALOHA, OR 97007 TIGARD, OR 97223
PHONE: 503-642-5844 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 10/25/2017 $46.75
Type of Use: SF Furnaces<100K BTU 10/25/2017 $46.75
Class of Work: ALT Type of Const: FlueNent For Any of Above 10/25/2017 $23.32
Occupancy Grp: Fuel Piping 10/25/2017 $14.15
Stories: 12%State Surcharge-Mechanical 10/25/2017 $15.72
Fuel
Fuel Types:
Gas Pressure:
Total $146.69
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: •• iiittee Signature:
(P411A0P,?k,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
iliN
Mechanical Permit A I •lica,;, .-A FOR OFFICE I_SF OM.1
Cl of TI and ") Received Permit No.:
`Jg A �)�' Date/By: ih i 7 rAi- t ,/ 1:
IIIw 13125 SW Hall Blvd.,Tigard,OR 97223 �Y
Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 WDate/By: di J)a,
T 1 G A K D Inspection Line: 503.639.4175 1 SV,4'i:to Ready/By: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Fin Supplemental Information
014:YV �
COMMERCIAL'FEE* SCHEDULE- USECHECKLISTt"
TYPE OF WO .. 0
Mechanical permit fees*are based on the value of the work
❑New construction b.Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF'CONSTRUCTION
a, RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ,
gl 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
JØ .f SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning ( 46.75 k(y.'7
Job site address: 't(-)3V 3 y- J 7cs Furnace 100,000 BTU(ducts/vents) f 46.75 fit.,75'
City/State/ZIP: -----7, •
vTFurnace 100,000+BTU(ducts/vents) 54.91
l 1 �� Heat pump 61.06
Suite/bldg./apt.no.: Project name: `L1 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
C; (i/ Residential boiler(radiator or
hydronic) 23.32
tut Unit heaters(fuel-type,not electric).
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above c1 23.32 2.3.. 3j-
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF'WORK Gas fireplace/insert 33.39
�,--` =.',., ,. Flue vent for water heater or gas
____. ..),?eCe is-f)cji , jetr 11.et-C-D fireplace 23.32
Log lighter(gas) 23.32
'-''" 1°=tA (-)/' Wood/pellet stove 33.39
11 Wood fireplace/insert 23.32
-�' J [,CLI !•'�-.:� ll F'ti2 7v it/7-6V-'�'1`CG's� '�/'� eP
Chimney/liner/flue/vent 23.32
,410-xi,e ('-f ,r^sw) M.S.I c�,>
Other: 23.32
M Et PROPERTY OWNER' - ,t
- - - 5-•, - Environmental exhaust and ventilation:
Name:
�� /. �� QU A _ Ci if
Range hood/other kitchen
s <_ CJvi' equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(...5- ...0 J ,t S"3'2.. Fax:( ) Attic/crawlspace fans 23.32
'APPLINTI - j r UNTACT PERSO 1` .
'f" Other:
CA23.32
^ Fuel piping:
Business name:2>,ZAS
,�.� Oct LSC' f i, r $14.15 for first four;$4.03 for each additional
Contact name: pe-z„‘„,.4tf4,.,05, /,)(-,,5, Furnace,etc.
Address: �{ Gas heat pump
�� V �, Wall/suspended/unit heater
City/State/ZIP: 4?/,5; oz. 70 77 Water heater f /11
Phone:( ) / - �' Fax::( )
Fireplace
C Range
E-mail: Barbecue
CONTRACTOR ;,' Clothes dryer(gas)
Business name: y� Other:
91 Th Q MECHANICAL PERMIT FEES* -`
Address: Subtotal l I,`../7
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) iS.,7),
CCB lic.: C I F4' A) // ' GA TOTAL PERMIT FEE /Lit.,&'1
This permit application expires if a permit is not obta ned within 180
days after it has been accepted as complete.
Authorized signature: td6.)/` * Fee methodology set by Tri-County Building Industry Service Board
Print name: i� b Date: /U ddd
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617Tf (11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
total l Cation Permi•t F
$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:
11030 SW 78TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2017-00833
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Owner having contractor install required tamper resistant access port caps, not
convenient for re inspection per owner.
Violation Summary:
Inspector Contractor