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Permit CITY OF TIGARD MECHANICAL PERMIT 114 # ' COMMUNITY DEVELOPMENT Permit#: MEC2017-00900 [GAR) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/15/2017 Parcel: 2S 111 DA04100 Jurisdiction: Tigard Site address: 8646 SW BELLFLOWER ST Project: GIGON Subdivision: APPLEWOOD PARK NO.2 Lot: 36 Project Description: Furnace installation. Contractor: HEAT MASTER CORP. Owner: GIGON, ROLAND&CATHE LIVING TRU 14456 AMES ST 3545 FIELDCREST AVE OREGON CITY, OR 97045 FAIRFIELD, CA 94534 PHONE: 503-233-2727 PHONE: FAX: 503-723-4381 FEES Specifics: Description Date Amount Furnaces< 100K BTU 11/15/2017 $46.75 Type of Use: SF 12%State Surcharge-Mechanical 11/15/2017 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/15/2017 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By. V--- se •ermittee Signature: u Call 503.639.4175 by 7:00 a.m.for the next available inspectidn date. This permit card shall be kept in a conspicuous place on the job site until completion of the project"` Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONE1' City of Tigard Received g r Date/By: j? t. Permit No.: q 13125 SW Hall Blvd.,Tigard,OR 9722 'z AN 1 ' Plan Review f III 111 Phone: 503.718.2439 Fax: 503.598.19 i .-/ Date/By: Other Permit: T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: 1111 El See Page 2 for Internet: www.tigard-or.gov 6 2-° - !i Notified/Method: Supplemental Information A{ U TYPE OF WORK 11 1416N-" COMMERCIAL PEE* SCHIrDULE - USE CHECKLIST �' icli / y1 i,‘;,r .Z Mechanical permit fees*are based on the value of the work 0 New construction Addition/alteratiotiti'e �,q i:•s performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: tWi l ) mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* JZ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: // G C=(.v " ( ( FL-c)(.Ll er , Furnace 100,000 BTU(ducts/vents) 46.75 44,. "7S— City/State/ZIP: , f0 /(7) y Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 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 ASCRIPTION OF-WORK; "� Gas fireplace/insert 33.39 Flue vent for water heater or gas fiA. iZ.IA/ /A'C,-f' - . (--P1- G L fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 0 I'ItOPERT '`+OWNER # (3''T.TENANT Environmental exhaust and ventilation: /� Name: /1-1-i-t /j,•T--6 67)-1 Range hood/other kitchen equipment 33.39 Address: C (.4_: c7 ( 1(— Lc,w</t Clothes dryer exhaust 33.39 City/State/ZIP: , a-„0 Lr--12 C/--7a Z y Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( t7. ) t Z 7 3 ) 1 7 Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT n�� x" '.'"''''-p CONT --T,PERSON '471 Other: 23.32 Business name: /_` Fuel piping: e / f _e't er C.5�_/'F $14.15 for first four;$4.03 for each additional Contact name: ,e (za('`-S Ail u (''' Furnace,etc. Address: I 9 4 S ( 14-7v3 e 5Gas Usus pump Walsuspended/unitheatet City/State/ZIP: e,� z�/ 0� Water heater Phone:(s�3 -_ 7Z-i _cf 22S 47, Fax::( ) Fireplace Range E-mail: -TT 66A Cet G lj<' 1 6•, 5 D c t,/i-.ti- - c c)a''''-‘ Barbecue O1NT1tACTOR' Clothes dryer(gas) Business name: ,/� � �,Other: fr/eiet--/- F L/ rj l�C`' (/B 4 p f l.C, .�N MECHANICAL PERMIT FEES* F- Address: / t--' 9 5 C A-7-1 e 5 O✓J ./ yam ct - Subtotal — City/State/ZIP: 7 7o 4/5 ' Minimum permit fee($90.00) c© rc) Phone:( 503 ../Z2--I cc/ . Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) `a 0 CCB lic.: C L/ TOTAL PERMIT FEE `/ o Iv / �� ! ,£ �f l�� This permit application expires if a permit is not obta ned withinw180 days after it has been accepted as complete. Authorized signature: - * Fee methodology set by Tri-County Building Industry Service Board Print name: x 7 /me q L K Date.///c- ate. S I:\Building\Permits\MEC_PernitApp_0401113.doc 44-4617T(11/02/CO 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: 8646 SW BELLFLOWER ST, TIGARD, OR, 97224 November 20, 2017 at 4:08:58 PM Record Type: Record ID: Residential - Mechanical MEC2017-00900 Inspection Type: Inspector: 615 Mechanical rough-in David Young Result: FA I L Comments: Provide access for inspection. R109.1 No one home. 4:07 pm. Violation Summary: Inspector Contractor