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Permit Support Document CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2017-00211 Date Issued: 03/27/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 U/69 SIMParcel: 2S103AA01000 Jurisdiction: Tigard Site address: 10965 SW ERROL ST Project: O'BRIEN Subdivision: ECHO HEIGHTS Lot: 5 Project Description: INSTALL DUCTLESS UNIT. 9/11/17:REPRINTED permit to include gas piping for(4)appliances. 11/16/17: REPRINTED permit to include(1)range hood,(3)bathroom exhaust fans,and(1)laundry room exhaust fan. Contractor: A TEAM HEATING Owner: JEFF O'BRIEN 5957 MOUNT ANGEL HWY NE 10965 SW ERROL ST SILVERTON, OR 97381 TIGARD, OR 97223 PHONE: 503-365-8326 PHONE: FAX: 503-365-8333 FEES Specifics: Description Date Amount Furnaces<100K BTU 03/27/2017 $46.75 Type of Use: SF Heat Pump 03/27/2017 $61.06 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/27/2017 $12.94 Occupancy Grp: Investigation Fee 09/11/2017 $90.00 Stories: Investigation Mechanical 12%State 09/11/2017 $10.80 Surcharge Fuel Piping 09/11/2017 $14.15 12%State Surcharge-Mechanical 09/11/2017 $1.70 Range Hood/Other Kitchen 11/16/2017 $33.39 Fuel Single Duct Exhaust(Bathrooms,Toilet, 11/16/2017 $93.28 Fuel Types: Utility Rooms) Gas Pressure: 12%State Surcharge-Mechanical 11/16/2017 $15.20 Total $379.27 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires yoy;to follow tllo�rules adopted by the Oregon Utility Notification Center. Those rules are set forth i OAR 952-001-0010 through OAR 952x00'-p090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 0 1.800.332.' 44. /' F �I Issued By: / Per na ire: / .ati f, Call 503.639.4175 by 7:00 a.m.for the next availabl>inspec on date. This permit card shall be kept in a conspicuous place on the job site'.until 'ompletion o .t e project. Approved plans are required on the job site at the time of h inspection. Mechanical Permit Application II �. FOR OFFICE USE ONLY d" City of Tigard Received t /// w at J� Date/By: 1 i GGA (7 A l Permit No.: _ - i 7._ �t 13125 SW Hall Blvd.,Tigard,OR -k 74 Plan Review C Phone: 503.718.2439 Fax: 503.59 60 1 Other Permit: Date/By: T 1 G A R D Inspection Line: 503.639.4175 `, '� Date Ready/By: IO See Page 2 for Internet: www.tigard-or.gov ��f „ xitNotified/Method: EN Supplemental Information n TYPE OF L .`i. C ''' M � � COMERCIALS *SC3IEIJLE — USEFCHEG ISTD ; Mechanical se permit fees*are based on the value of the work 1=1 New construction 1=1Addition/alte> 0t> placement performed.Indicate the value(rounded to the nearest dollar)of all O Demolition 0 Other: e AN mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRU w. , i,.,� RESIDENTIAL EQUIPMENT/SYSTEMS FEES* O 1-and 2-family dwelling 0 Commercial/industrial '. t ij s.ry building For special information use checklist. ❑Multi-family 0 Master builder all Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: /pgL;5 ` `�.�/J 521-, Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 6 ✓ Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: ' f Project name: a`6 \e,,..) Heat pump 61.06 �t^. 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 DE •!ste,x-o i, WORK Gas fireplace/insert 33.39 .' _�w '.a u:-, >' / / Flue vent for water heater or gas Get;J4 C/J• e .'L ,f/ a^'� e-,citA-4,37t'--JC fireplace 23.32 i/ Loglighter(gas) 23.32 7 h�Pit-um5- `tip �� Jf -Y714v -be" / t Wood/pellet stove 33.39 l „milt //? =✓tnWood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 0 PRS ** OWNER 0 TENANT • . ,.. '2'4;4''` Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment / 33.39 '31 34 Address: Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) / 23.32 ti3 4 Phone:( ) Fax ( ) Attic/crawlspace fans 23.32 ' '' X Other: 23.32 APPLICANT [ tQNTACT'PERSON ?a Business name: r q ) Fuel piping: ' { �u c( $14.15 for first four;$4.03 for each additional Contact name: ,�� ` i 1,1 1 Furnace,etc. Address: `. f n i` ei - /y Gas heat pump 1 �' mit N !/r Wall/suspended/unit heater City/State/ZIP: • 1 IC j �� q .7. 3 Water heater Phone:(1G ) /0 •�7 `/ d Fax::( ) Fireplace 6 l // �� Range e 1 n � E-mail: N CC o 1 L 3+- /� Barbecue u dryer(gas) �:_ i CONTRACTOR- ':;; 5t�� � Clothes as �^ Other: Business name: 4 --re,m � IVIECIiANICAL PERMIT i EIES* ,i'" Address: Subtotal I)4;,(p 1 City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) /5 )j CCB lic.: ( 1..8,7iii PERMIT FEE I Pi f 17 J This permit application expires if a permit is not obtained within 180 / afters e. Authorised signatu * Fee methodologydays set byit Trhai-Countybeenaccepted Buildingas IndustrycompletService Board Print n.. i, _ 0 h Date: drffill I:\Building\Permits\MEC_PermitApp_040113.doc 441 4617T 1/02/ •M/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 MECHANICAL PERMIT r 71 2. COMMUNITY DEVELOPMENT t Permit#: MEC2017 00211 Date Issued: 03/27/2017 T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 PM= Parcel: 2S103AA01000 Jurisdiction: Tigard Site address: 10965 SW ERROL ST Project: O'BRIEN Subdivision: ECHO HEIGHTS Lot: 5 Project Description: INSTALL DUCTLESS UNIT. 9/11/17: REPRINTED permit to include gas piping for(4)appliances. Contractor: A TEAM HEATING Owner: JEFF O'BRIEN 5957 MOUNT ANGEL HWY NE 10965 SW ERROL ST SILVERTON, OR 97381 TIGARD, OR 97223 PHONE: 503-365-8326 PHONE: FAX: 503-365-8333 FEES Specifics: Description Date Amount Furnaces<100K BTU 03/27/2017 $46.75 Type of Use: SF Heat Pump 03/27/2017 $61.06 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/27/2017 $12.94 Occupancy Grp: Investigation Fee 09/11/2017 $90.00 Stories: Investigation Mechanical 12%State 09/11/2017 $10.80 Surcharge Fuel Piping 09/11/2017 $14.15 12%State Surcharge-Mechanical 09/11/2017 $1.70 Fuel Fuel Types: Gas Pressure: Total $237.40 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 • .800.332..2k11. , ,---r Issued By: // � O Signature f 'h -4' Call 503.63 by 7:00 a.m.for the next available in pec on date. (a"/" .."°-- ----.\ This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application 1' i n Hoa OFFICE USE o NL1 AA ceived / ' City of Tigard r _10 I /By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 �a 1 Os: �� C Phone: 503.718.2439 Fax: 503.598.1960 `` ' . Review Other Permit: Date/By: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: la See Page 2 for Internet: www.tigard-or.gov [_p t f 1 2111 7 Notified/Method: PliA Supplemental Information f TYPE OF WORKCITY OF yy1,.GAR]) COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work New construction -cc r,i-ir;i cig ft% 0 Addition/alterati ` 1' -, ' performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. O Multi-family ❑Master builder 0 Ot - • iDescription Qty. Ea. Total �► ' JOB SITE INFORMATION AND LOCATIO t lbOHeating/cooling: Air conditioning 46.75 Job site address: o`1�r �-- St J ,terr✓�/� , IOW Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: IA Furnace 100,000+BTU(ducts/vents) 54.91 1 '�� � / Heat pump 61.06 Suite/bldg./apt.no.: Project name: &eri'esiNi 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 DESCRIPTION Ft WORK '. Gas fireplace/insert 33.39 Flue vent for water heater or gas ,� Jc ) l ,{{{ � �Xl1 Wj fes'777, fireplace 23.32 7�'�' ��/Y Log lighter(gas) 23.32 /llt=om`•'20 0 Is OC1j{ Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 „ • � Other: 23.32 S yrs 'ROII`ERTY OWNER 0 TENANT; Environmental exhaust and ventilation: Name: �� Ltji' .. C Range hood/other kitchen`"~� - equipment33.39 ,,\I Clothes dryer exhaust 33.39 City/State/Z : t! o�/ C` �� Single-duct exhaust(bathrooms, V toilet compartments,utilityrooms) 23.32 Phone:(( ) ( Fax:( Attic/crawispace fans 23.32 .. t,4,46,s,- Q ., gi s r e Other: 23.32 Fuel piping: Business name: L 1 e t t,,-'�/V__ $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 Range E-mail: Barbecue -jkliT Clothes dryer(gas) Business name: 4 ,7_, / 3 '�'HF��✓� „' I+I m,PERMIT FEES*4, Address: Sct 5.7 / ' _ ,i.-- NE Subtotal City/State/ZIP: lI J ,�,,) '�!"/1--73:61'�` " 1 i/ Minimum permit fee($90.00) t l V r�' ", Plan review(25%of permit fee) Phone:(5 c3) S .3� Fax:( ) State surcharge(12%of permit fee) CCB lic.: f d D 74 TOTAL PERMIT FEE ` / This permit application expires if a permit is not obtained within 180 / if days after it has been accepted as complete. Authorized signature a /" * Fee methodology set by Tri-County Building Industry Service Board Print name: • I 6" ll(..... '' Date: et li I:\Building\Permits\MEC_PermitApp_040113.doc 440-4Iti 7T(11/02//CM/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.. r , 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: 10965 SW ERROL ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Mechanical MEC2017-00211 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Not ready for inspection. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 10965 SW ERROL ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Mechanical MEC2017-00211 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10965 SW ERROL ST, TIGARD, OR, 97223 September 11 , 2017 at 10:27:01 AM Record Type: Record ID: Residential - Mechanical MEC2017-00211 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Provide approved electrical inspection for mini split. Circuit for mini split not installed to code. Unprotected Rolex at interior and exterior. Note: stop work order posted on site for work being done without permits. New below grade window wells, new gas line to interior. Violation Summary: Inspector Contractor