Permit (41) 71 CITY OF TIGARD MECHANICAL PERMIT
. •y. COMMUNITY DEVELOPMENT Permit#: MEC2017-00962
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2017
Parcel: 2S111BC03300
Jurisdiction: Tigard
Site address: 10375 SW VIEW TER
Project: JOHNSON Subdivision: DOUGLAS HEIGHTS Lot: 8
Project Description: Gas fireplace insert.
Contractor: T&K MECHANICAL Owner: JOHNSON, DOUGLAS E&SUE ANN LIV
PO BOX 116 10375 SW VIEW TERRACE
FOREST GROVE, OR 97116 TIGARD, OR 97224
PHONE: 503-844-9173 PHONE:
FAX: 503-846-0195
FEES
Specifics: Description Date Amount
Gas Fireplace 12/06/2017 $33.39
Type of Use: SF Chimney/Liner/Flue/Vent 12/06/2017 $23.32
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/06/2017 $33.29
Occupancy Grp: 12%State Surcharge-Mechanical 12/06/2017 $10.80
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.198 • 1-6QQ. 32.2344.
Issued By: \ �\ '•rmittee Signature:
(
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONEti°
City of T1 and s R Received
g " Date/By: IIIIIFIlc Permit No.:
III
13125 SW Hall Blvd.,Tigard,OR 97223)bar L 7- -
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
Other Permit:7Q Date/By:
Inspection Line: 503.639.4175 rC` nTIARD Date Read /Bo`
See Page 2 for www.tigard-or.gov q Notified/Method: ,�' Supplemental Information
sy
TYPE OF'W 'ILD1 *ONi.)1 ' _ .:
COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATE(ORY Of tONSTRUCTION
RESIDENTIAL gQUI1MENT/SYSTEMS PEES*
I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
"` �`
40B SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: ! 1 c
�/3 ,,, 1 z,y_, V V Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:---r. (_.' (' Furnace 100,000+BTU(ducts/vents) 54.91
i L'\ 0 v (\ (_ 'i'-)( Heat pump 61.06
Suite/bldg./apt.no.: J Project name: lc t,i 0 `)121,'N 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
� SCR1 ,,�; ON Q WORT{ _ � x Gas fireplace/insert33.39 3 j)
'� " Flue vent for water heater or gas
C) ,"\ 5 <_ t l `->-.,'\f - Lk..vv...,Q._ (,tri p ( U,.( 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 3-3
;1' Other: 23.32
0 PR *44TY>pwls R> -o Tiii47
_ - Environmental exhaust and ventilation:
Name: (1. ,Ir. ;J , C,',,�' -1, �('�YM Range hood/other kitchen
1 /•� `l ` t equipment 33.39
Address: )V"3' 5(,�' if i (' 4 Q
z-u Y Clothes dryer exhaust 33.39
City/State/ZIP: � ' Single-duct exhaust(bathrooms,
c ti
toilet compartments,utility rooms) 23.32
Phone:(e5 ) LOCI £, 73'7 Fax:( ) Attic/crawlspace fans 23.32
'" .. 0AO'PLICANT. ' 0 CONTAC "PERSON . . Other: 23.32
Fuel piping:
Business name: --r,i__ V' t)1 L((t 1 r-,i i
F- 1 $14.15 for first four;$4.03 for each additional
Contact name: dV Furnace,etc.
Cn.
Gas heat pump
Address:
Li VDk ILC
Wall/suspended/unit heater
City/State/ZIP: .J
�-,r,'i y�`)` e" i t1i x-- 11x. c 1 r(7/ (i., Water heater
Phone:(e) ('))) SS Li1/4- Ci ( t ) 1 Fax::(L)(;`)1 c ' i 4 C)(i)'6.- Fireplace
E-mail: j ^S Range
�c.Qf . Vim.v C. 1 - N (i., q CJI 0 0 , C Yv'\ Barbecue
4 CONTRACT nt
dJR �x: Clothes dryer(gas)
Business name: Other:
} I'�`1 `1 � (' ( MECHANICAL PERMIT FEES*
Address: ... i 6()y. I ( Subtotal i
�-
City/State/ZIP: G� i�. Minimum permit fee($90.00) , .�
chit/ v` , t �(1 Plan review(25%of permit fee) ..../Phone:
( 1) — (i Fax:( /� ,y1(0 t--; State surcharge(12%of permit fee) ,
CCB lic.: 'a.` t(0 TOTAL PERMIT FEE k¼) W
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: \ _ �( /,-•�. * Fee methodology set by Tri-County Building Industry Service Board
Print name: il\ '
wvv�`'k 'Ic [.L 1116 Q- Date: i:) . 6 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: 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:
10375 SW VIEW TER, TIGARD, OR, 97224 December 7, 2017 at
7:09:55 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00962
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Gas insert to replace existing log lighter ok per installation instructions.
Violation Summary:
Inspector Contractor