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Permit Support Document MECHANICAL PERMIT NICITY OF TIGARD © = Permit#: MEC2018-00080 COMMUNITY DEVELOPMENT Date Issued: 02/01/2018 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103CB04000 Jurisdiction: Tigard Site address: 12330 SW MARION ST Project: Install Subdivision: WILLAMETTE NO.2 Lot: 19 Project Description: Install gas furnace. 2/7/2018: REPRINT permit to add gas piping. Contractor: ENERGY SAVERS INC Owner: FULLER, BRIAN PO BOX 2829 FULLER, SASHA OREGON CITY, OR 97045 1665 BERTRAM ST HONOLULU, HI 96816 PHONE: PHONE: 503-679-1724 FAX: 503-512-5339 FEES Specifics: Description Date Amount Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $0.00 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: Permittee Signature: Fid "f1/4,1,/("71-770",-\// 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 A lie,:: :: - t,�,,. �" FOR OFFICE USE ONLY � [.,l#}' (3 TiTigard - ','' D t lwr t ' Fet7ntt No ce%2e'it )✓(Jed 4�t cart r3, �7//� r q 13125 SW 1tail13lsd,Tigard,OR 97223 „ Plan Pet 2 ' Pham( 503.71$2439 Fix- 501 593.t 9 I t Other toes). [? t° <)a 3 Dat Cay: TIGARD` Inspection Lana 503.639.4175 Date Ready Reis: El See Page 2 fur ' Internet \sw ttratd ?r.Sztrc CITY Y i )a i t t a. z> 4,3 ?; NotrtedMetlxxl: Supplenrentatinformation ,.,.. t' � � 1 COMMERCIAL S(UIDUII USE CHECKLIST i TY ' LOR1. k Mechanical permit lees`are based on the value of the work ❑Ness construction ❑Addition/alteration/replacement performed indicate the value(rounded to the nearest dollar)of all mechanical materials.equipment,labor,overhead,and profit. 111 13emaliticn Other: I Value: CATEGORY OF CONSTRUCTION RLSIfDR RESIDENTIAL F(tJif' IIa,N I'14YS1'F.MS FEES* 171-and 2-f'amilydwelling 0Comnnetcial./industrial fl Accessory building For special information arsechecklist C] Multi-family C]Master builder []Other: Description Qty Ea. Total 1Hea ring/cooling: l JOB SITEINFORMA1IQi" AND LOCATION ° 4675 t l Air conditioning Job Site address: i,` -2.> ,a : L p s t"-k Y.:° f__.e ;$ _ l PI Eccu'iazt apCtetrn14p 0,407 B l (duet've)esi L6-7� Cit State/fiP: Iurnace100�0001fU(duetsheats)_4,_ 54.91 `e \ .c i � t � r _� — 61.06 SunelbIdg apt,no.: Project name: 1 Duct work I 2a 32 Cross streetidirections to job site: 4 Hvdronie hot slater system i__. _ 23.32 __-_ __ Residential boiler(radiator or hydropic) 23.32 _ _. ._ I Unit heaters{fuel-typc,not electric), in-wall,in duet,suspended,etc. ! _,__ _46.75 I'}ue.='vent for any of above 23.32 _.. Other: 2132 l.ot no.' �--- —. ___ Subdivision: ()titer fuel a barters: Fa map/parcel no.: WW ater!eater I 23.32 Gas frepta e insert t 39 i7LSC.ILtF*"I I(�'S E91? WORK ___,. w _ ...... _._... __ Flue vent(hr water heater oras gas �3 32 t s fire'lace .,,_._. L oilirter(was) �'�� ( �{" � I �400dlpellet stove r 33.39 Wood fireplace/insert .._ 23N3 Clttauteeilrnctr`ftu 2 Other: 73.32 LI PROPERTY' OWNER U I' N&N ------------ _ ..._ __ _w_: .- Environmental exltestan ventilation: _, Name: Ramie hood/totter kitchen -- equipment 33.39 I Address: Clothes dryer exhaust 33.39 Single-duet exhaust(bathrooms (itylSt etc zip, toilet compartments,utility rooms) 2332 -.-j Fay( } rltttc='crawispace fans Phone:( 4 Other: Fuel_piping: Business name: `c,l4.IS fur first four;54,03 for ea €a additional ._ Contact,name: Furnace,etc. ____ _ _, II II t Las ht-ai roan}r Address: Wall/suspended/unit heater — 1 City/State/`/IP: _ Water heater _._ ___ -__._____ .. .,.a_ .__ ._ Fireplace p . !!tree:( ‘) t as ( Range _i_ I mai( Barbau, €:(li'm'a RAC I OR Clothes dryer(gas) a 1 Other: Business nam.._e - ! . r C $ G ck.A' 's---k'. .�_. v... ___ ....-...�..__ ......_. .._._. 1CCI[ANIf.Al.PERMIT 1+ ES° Address: 2 ',�1�s " Subtotal �� Minimum permit fee.($94 00) Cary/Stat'GdP. i-,i ,. -., ( ,e c ' 0 I tE. - I Planreview(25%of permit fee) I IPhone:f .. c _. ¢ i .. _ Fax:t } State surcharge(17°I of permit les) . �'I'Cli Rl PERMIT FEE 1 �. t C E3 lie.: � L....=._ 1 t`-' �., .___ ...._ __ _. —..._..._. _. ._ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Autlztrri:zctl signature: r4,..,,,,_,------,,_ ' ,Tse rnctliodloii Oct Le„"Cn-County Building industry Seryico(Sited i.notcl ,a;.ni,s,,iCC PIN mil:App.(.451i3.mc 147.,4€4617.3 U'a:('.0VW14114 CITY OF TIGARD „�•�^ ' MECHANICAL PERMIT COMMUNITY DEVELOPMENT �' �` Permit#: MEC2018-00080 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/01/2018 T t r ;t I=.t7 g Parcel: 2S103CB04000 Jurisdiction: Tigard Site address: 12330 SW MARION ST Project: Install Subdivision: WILLAMETTE NO.2 Lot: 19 Project Description: Install gas furnace. 2/7/2018: REPRINT permit to add gas piping. 2/12/18:REPRINT to add(3)gas lines. Contractor: ENERGY SAVERS INC Owner: FULLER, BRIAN PO BOX 2829 FULLER, SASHA OREGON CITY, OR 97045 1665 BERTRAM ST HONOLULU, HI 96816 PHONE: 503-679-1724 PHONE: FAX: 503-512-5339 FEES Specifics: Description Date Amount Furnaces<100K BTU 02/01/2018 $46.75 Type of Use: SF Duct Work 02/01/2018 $23.32 Class of Work: ALT Type of Const: Fuel Piping 02/01/2018 $14.15 Occupancy Grp: Minimum Fee Adjustment-Mechanical 02/01/2018 $5.78 Stories: 12%State Surcharge-Mechanical 02/01/2018 $10.80 Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 4- / Permittee Signature: cr. ileGj Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application ,, g0 ,. ON olll(_1, I S1.o\I.l City of Tigard eReceived 13125 SW Hall Blvd.,Tigard,OR 97223 Plate/By: NOW}_ _ Pecmit Nol . i i Phone: 503.718.2439 Fax: 503.598.1960 1 14" / /�plan Review �. InspectionIII Line: 503.639.4175 (/` Day= Other Permit: Internet: W W w.tigard or.gov Supplemental Date Ready/By: laths: See Page 2 for Notified/Method: SInformation TYP}OP,WORK GOMMRRCIAL FEB*sC$EDUt,Ig '; SE cicusr Mechanical permit fees*are based on the value of the work ❑New construction 0 Addition/alteration/replacement Performed-Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CAT ECOA`IF OF`CONSYRT7CTJIUIV Value $ ❑ 1-and 2-family dwelling 0 Co.„ „,Commercial/industrialS 'RESIDENITALEOWME TIS 11 Sit 0 Accessory building For special information use checklist ❑Multi-family ��� " 0 Master builder 0 Other: Description Qty. ` Ea. I Total JOB SITE INFORMATION AND 1,0 /'!ON ; Heating/cooling: Job site address: 123 3 0 ,6ck yA t ,S( Air conditioning 46.75 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: i ,,.,,j, Of_.., q---/ Q,3 Furnace 100,000+BTU(ducis/vents) 54.91 Suite/bldg./apt.no.: j Project name: Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler(radiator or bydronic) 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: Other: 23.32 Lot no.: Tax map/parcel no.: Other fuel appliances: Water heater 23.32 DE,CRIIPTjo?Y`OF WORK" Gas fireplace/insert 33.39 Ht dtd �� i Flue vent for water heater or gas CCC��� e4..1 11 t \-- fireplace 23.32 CV. Cr 2-0 1 q - Dar,-5 0 �"�1^''tLog lighter(gas) 23.32 Wood/pellet stove 3339 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER Other: :� ❑TENANT 2332 Name: Environmental exhaust and ventilation: Range hood/other kitchen Address: equipment 33.39 City/State/ZIP: Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms, Phone:( ) toilet compartments,utility rooms) 23.32 Fax:( ) 0 APPLICANTAttiGcrawlspace fans 23.32 CONTACT PERSON Other: 23.32 Business name: Fuel piping: Contact name: $14.15 for first four;$4.03 for each additional Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) ( Fax::( ) Fireplace E-mail: J Range Barbecue CONTRACTOR Clothes dryer(gas) Business name: ericav-ovi < Other: Address: o pj — 2. MECHANICAL PERMIT FEES* City/State/ZIP: �c/Ctv�'��� Subtotal9 .CAS �t Q� "j 04_4 c— Minimum permit fee($90.00) Phone: t O ( F :( ) Plan review(25%of permit fee) CCB lie.: r`� �� State surcharge(12%ofpermit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within ISO Authorized signature: —a_ days after it has been accepted as complete. - e Fee methodology set by Tri-County Building Industry Service Board Print name:.,,,,:)e �1\t"i't,,}l c ' I I Date: 2-iz r 1 v I:iBuilding\Pcrmits\MCC_PcrmitApp_040 13doc � 490-46177"(I 1102iCOM7WEg) City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12330 SW MARION ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Mechanical MEC2018-00080 Inspection Type: Inspector: 699 Mechanical final Allyson Armstrong Result: PASS - NoCofO Comments: Branch lines added to permit. Correction complete. Violation Summary: Inspector Contractor