Permit (156) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00915
f[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2017
Parcel: 2S111CD03700
Jurisdiction: Tigard
Site address: 9575 SW BRENTWOOD PL
Project: Meadows Subdivision: SUMMERFIELD NO.9 Lot: 526
Project Description: Kitchen and master bathroom remodel:(1)range hood,(2)bathroom exhaust fans,and Gas piping for range.
Contractor: B&S HEATING&AIR CONDITIONING LLC Owner: MEADOWS, CHARLES L&MELISSA A
PO BOX 1623 9575 SW BRENTWOOD PL
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503-720-5608 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 11/20/2017 $33.39
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 11/20/2017 $46.64
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: Fuel Piping 11/20/2017 $14.15
Stories: 12%State Surcharge-Mechanical 11/20/2017 $11.30
Fuel
Fuel Types:
Gas Pressure:
Total $105.48
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 we s not sta within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to .I. the rul-: -.opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0I s 0. You m- .. ain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 . 6332-2944, '
Issued By: tures
Call 503.639.4175 by 7:00 a.m.for the next available inspection •ate.
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 OM.\
City of Tigard Received / Permit No.:
AN1i1) Date/By: if A Rom
Auf'�
II IIII13125 SW Hall Blvd.,Tigard,OR ' -c Plan Review
I: Phone: 503.718.2439 Fax: 503.5 ' ' JCV)
Date/By: Other Permit:at,c, 1 7 )r -
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov 9,® '01 Notified/Method: INI Supplemental Information
(� t ���j COMMERCIAL FEE* SC!IEDULE-- USE CHECKLIST
TYPE OF WO,��+ 1� c. ,e
1 Mechanical permit fees*are based on the value of the work
❑New construction el-Additionialtercia10Antlit performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: WOW mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTLMS FEE * x. z
Al-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
70I3 SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 9 S 7 S S'us) 31 kisicir2 . Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: )i tv,q r a pf' Cy 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
� i7 Gas fir lace/insert 33.39
DESCRIPTION OF,Wbl m-" ep
Flue vent for water heater or gas
1e..1}Chc^ Bal*I'N 16 ) fireplace 23.32
J Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
❑ PROPERTY OWNER Q T N
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39 3 3.3 9
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) Z 23.32 1(p,bit
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 121�CONTACT PERrN Other: 23.32
Business name: c Fuel piping:
c�Ylne Gt :"'"""' $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
E-mail: Range 1 /11./S--
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: , �-i
S I'l Cra 't) It, q(._ Other:
MECHANICAL PERMIT FEES*
Address: —1-1.3 1O)t \o?_ Subtotal < / /Z'
City/State/ZIP: p•Ccy s+ C-'s<Jt t O cl)di S Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:CM ) 7Z-6—Std€ Fax:( ) State surcharge(12%of permit fee) /'J
CCB lie.: 1 GZZZ TOTAL PERMIT FEE , j 16
This permit application expires if a permit is not ob med within 180
days after it has been accepted as complete.
Authorized signature: �* Fee methodology set by Tri-County Building Industry Service Board
Print name: C'li6il i' y h c." Date: 1 -2.0—)7-
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Pere 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:
9575 SW BRENTWOOD PL, TIGARD, OR, 97224 April 10, 2018 at 9:34:27 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00915
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor