Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
do, A
COMMUNITY DEVELOPMENT § (� MECHANICAL
MEC2017-00785
f GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2017
Parcel: 2S104CD05400
Jurisdiction: Tigard
Site address: 13975 SW BENCHVIEW TER
Project: Natureworks Subdivision: HILLSHIRE ESTATES Lot: 54
Project Description: Run gas pipe to fireplace. 1/2/18: REVISED description. Run gas pipe to fireplace,grill, power burner,and heater
in new outdoor living space.
Contractor: MIKE PATTERSON PLUMBING Owner: JOST, ANDREW M &MINH THU LY
15028 S MITCHELL LN 13975 SW BENCHVIEW TER
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-632-7374 PHONE:
FAX: 503-632-5647
FEES
Specifics: Description Date Amount
Gas Fireplace 10/10/2017 $33.39
Type of Use: SF Log Lighter(Gas) 10/10/2017 $23.32
Class of Work: ALT Type of Const: Other,Fuel Appliances 10/10/2017 $23.32
Occupancy Grp: Fuel Piping 11/13/2017 $14.15
Stories: 12%State Surcharge-Mechanical 11/13/2017 $11.30
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $105.48
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: . /` ✓/�iro 47.e"..J Permittee Signature: crt e77',/(''$-15. 2.-1`
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.
CITY OF TIGARD II. ,. MECHANICAL PERMIT
IICOMMUNITY DEVELOPMENT Permit#: MEC2017-00785
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2017
Tim Parcel: 2S104CD05400
Jurisdiction: Tigard
Site address: 13975 SW BENCHVIEW TER
Project: Natureworks Subdivision: HILLSHIRE ESTATES Lot: 54
Project Description: Run gas line to BBQ and fireplace. 11/13/2017: REPRINT to add patio heater and gas piping.
Contractor: MIKE PATTERSON PLUMBING Owner: JOST,ANDREW M&MINH THU LY
15028 S MITCHELL LN 13975 SW BENCHVIEW TER
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-632-7374 PHONE:
FAX: 503-632-5647
FEES
Specifics: Description Date Amount
Gas Fireplace 10/10/2017 $33.39
Type of Use: SF Log Lighter(Gas) 10/10/2017 $23.32
Class of Work: ALT Type of Const: Other,Fuel Appliances 10/10/2017 $23.32
Occupancy Grp: Fuel Piping 11/13/2017 $14.15
Stories: 12%State Surcharge-Mechanical 11/13/2017 $11.30
Fuel
Fuel Types: Natural Gas
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 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.
Permittee Signature: /(� ff 7� �C � C --70
Issued By: <a."- //72,--it.'
i � -..�-._.. "�/
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.
Nov. 10.2017 04 :48 PM Mike Patterson Plumbing 503 655 4349 PAGE. 1/ 2
Mechanical Permit Applicata II ..- 1'l►1;()Hi( I. I til ()NIA
City of Tigard �, oeidtieed.. // /3//7 arn,;tNn.:NI�C J/ — '7j-5
Air
w 13125 SW 11411 Blvd.,Tigard,OR 97223 N t'V I i) 2017 Plan Review ..
I Phone: 503.718.2439 Fax: 503.598,1960 CITY
Data/By: Other PornliL
I I c;n It I ]nspeclion Line: 503,639.4175 - ;� Data Ready/Dy: loris, BI Seo Page 2 for
Internet: www,ti and-or. ovBUILDING otificd/Method: Supplementallnforntntlon
g g �1�fl�i�`��' .. ... .
lr a s 1 ,.�,. .0 FI',W ,�t�4goy�"�,,�-n,.�,yu Yr;t 5d�. ,,.y ,y.'c'..
r -4 t. Q s ,� + .1;c 1�1
hi��l:'• rr �#,45F r7h�RJ;.g 1.,dlr,�l �,r./A:J'" ."I! ,rte r° oa'r B k. t'1,, 't;AGV �Yl' M; 4 ;1ih,Y'.4,( V.,AAT? ' '' 1�;. ' yx .,?e• ;' . l.t`'a-„rn r .�'
Mechanical permit foes aro based on the value of the work
❑New construction CO Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition 0 Other: Value:$
4 (�� eu wrn,h, `01, ;ty a4All'. '! t�, h}71•x{ SS a` r + ` a - � ••••••-•„,•!„.,,,,,,,,••,••,,,.„„,,„
F1 1 y 1 I� r i t ,4i,1.?: 7`'p ^y,,Y i' •r • ,� 't
, e;H.,6n;iv;h ;Kittete".eYlin L .� S•I_ .1;; i$ ; .. , t .,,t,t.4( ',1n:'ar voi4,c1,;:m.t, FtliJ,.^,.r rk 0,, 15, �,) 4'i0. �� S.tr.ik,y.t kl,,,, 4.
® 1-and 2-1:iunily dwelling 0 Commercial/industrial 0 Accossory building For specialluforntnllou use checklist.
❑Multl-family ❑Master builder ❑Other: Description Qty. Lu. Total
or:M':',n-ia. Akt�+i:1n;
f VI.,t „.a W.r 1�� . i .a ,, TkE : �adp:vf " ' !leadoff/cooling:
'ee ,yr;M,a.fr, a6 � likseenif1 )r l1,,,nis{h . �. .,,Iu:5A)i;k° n,�nfa,utrk" .R.:)i.g ti,,4i), Airconditioning
46,75
Job site address;1397.5 SW Beuchview'I'er .. .W Furnace l00,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTUsdueln/vanln) 54,91
Boat pump 61.06
Sulte/bldg/apt,no.: I Project name:Natureworks Duct work 23.32
Cross street/directions to job site: I•lydronie hot water system 23.32
Residential boiler(radiator or
hydronic) 23,32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,ctc. 46.75
Nue/vont for any of above 23�_332 ___.___
- Other: 23.32
Subdivision: I Lot no.: _ _ Other fuel appliances:
Tax map/parcel no,: Water heater23.32
kI tti,, i t'tk4� i'7,' wr: ;loiso " ti �. ,010iifit.gt:Ic � .`. kGas fraplacainsart 33,39
.cv.uNy�4+",�. � ,1 4,�-L; r ,,. ,., �T r + .•' ��, ,.,171 ; ,; ,, . W1 '
Tluo vont Dm avatar heater or gas
Please add additional fixture to run gas pipe to at heater fireplace _23.32,,
Log lighter(sus) 23,32
Existing permit#M h.(:a017-00785 Wood/pellet stove 33,39
Wood fircpincc/inscrt 23.32
.. Chimney/liner/flue/vent 23.32
Sltlfit:"
1 23.32 23,32
Oiu.t ) riYen4 +!t„ F r,,r• .r tr ' ll'' ; i „:,,z,,,:04 4h<rOther:Heater
:,.1,,�'-ht ,4% k.l4,oe(o ,',40N7,"-1,rry ''', h ' 'V'.. k '' 'tvironmentalexhaustandventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
Cit /State/Z1P: Single-duct exhaust(bathrooms,
Y toilet compartments,utility rooms) 23.32 ,
Phone:( ) Fax:( ) Aule/orawispace thns 23.32
I'y, I e,'$ *.ii:M 'dl1:a ,,i rr 6.tld F):q,rpt+�''"A(fir t.j�t1 i.. ril.,y`,.r I'M fig,t iktcl y'i Other: 23.32
.1 ,! l t' i §N 1' } F 4 W-,,,Arl 0 , uual a,,. u fl S'!,
C.,s y�?�.,/' ,�Y.ua "n i,m�'„a n'�,,1'4�k w Nuel it
Business name: $14.15 for first fou ;$4,03 fur each additional
Contact name: Furnace,etc.
Ous heat pump - - :-T---------------
Address: Well/suspended/unit heater
City/State/ZIP; Water heater
... . .
Phone:( ) I rax;:( ) I Fireplace Runge .. . .
R-mail: Barbecue
„ eFtJ�Arl�;/ y>4-,,> :4'Y'h.4'1,!6 `lth` a' aR�40l y41,t�i 1144,n110:1' ,lt ie qtr: ik''y`'X'1h11,t1'?' Clothes dryer(gas).. ._ _. .. .,
I�7�1.u:?x'tl Id,,,11,1' •l�',:r kr.,,,,1, ;nod:41::..{,J - R. r,.....,.S f ,rp )t k.4:l:-R n L,ii;L..Z. 0.,,0 r.., ,...1
Other: �y
Business name;Mike Patterson Plumbing,Inc - 'C :`, „ ',n,, L;4'41:7,1'.. c+ s 4. ,...Gr ',71:1j..1:F1;7 `J;/y' �ut,i•,'+fq. .,?ty
'Vi,n4 i°J I•:1,11
Address:PO ox 850 Subtotal
Minimum permit tea($90.00)
City/State/ZIP:Gladstone,OR 97027 Plan review(254%,of permit fee)
Phone;(503)655-4306 Fax:(S03)655-4349 ' • - State surcharge(12%of permit fee)
CCB lie.:81746 TOTAL PERMIT FEE
. This permit appllentian expires Rh permit Is not obtained within ISO
*� �i days niter ft has been accepted ns complete.
Authorized signature: . Fee methodology act by Th-County Building industry Service Board
Print name:Jennifer Bergen Date:11/10/2017
I;1uuIIdlny11,pn11a1MiC P9rmltApp_0Jul tidoe ,14046 ITT(I 1/02/COMIwCn)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13975 SW BENCHVIEW TER, TIGARD,
OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2017-00785
Inspection Type: Inspector:
699 Mechanical final Allyson Armstrong
Result:
PASS - NoCofO
Comments:
Correction complete
Violation Summary:
Inspector Contractor