Permit (84) CITY OF TIGARD MECHANICAL PERMIT
I , COMMUNITY DEVELOPMENT Permit#: MEC2018-00144
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/28/2018
Parcel: 2S110DD10600
Jurisdiction: Tigard
Site address: 10940 SW HIGHLAND DR
Project: HAYWOOD Subdivision: SUMMERFIELD NO.6 Lot: 322
Project Description: Mechanical for remodel:(1)mini split heat pump,(1)range hood,(1)clothes dryer exhaust,(3)exhaust fans,and
gas piping for(1)fireplace and(1)range.
Contractor: BRIDGETOWN HEATING LLC Owner: HAYWOOD, CHARLES W 1991 REVOCABL
14161 SE BRYN MAWR CT. WIEST-HAYWOOD, G 1999 REVOCABLE
MILLWAUKIE, OR 97267 TRU
10940 SW HIGHLAND DR
TIGARD, OR 97224
PHONE: 503-789-5544 PHONE:
FAX: 503-353-6783
FEES
Specifics: Description Date Amount
Heat Pump 02/28/2018 $61.06
Type of Use: SF Range Hood/Other Kitchen 02/28/2018 $33.39
Class of Work: ALT Type of Const: Clothes Dryer Exhaust 02/28/2018 $33.39
Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 02/28/2018 $69.96
Stories: Utility Rooms)
Fuel Piping 02/28/2018 $14.15
12%State Surcharge-Mechanical 02/28/2018 $25.43
Fuel
Fuel Types:
Gas Pressure:
•
Total $237.38
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling5A3: 7 or 1.80
Issued By:vgv Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. -y\
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigardill 1 F B,..eived
g
c
_� a e/B I Permit No.: N ,s
13125 SW Hall Blvd.,Tigard,OR 97223 ,-_i y l ' ''"''w v
g l Plan Review t,
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: V r 0 Nil 4
Inspection Line: 503.639.4175
T I G A K D (-{� /qq Date Ready/By: See Page for
Internet: www.tigard-or.gov 'c B 2 2 u.- Notified/Method: ,.IMI Supplemental Information
� + ^ i'a
TYPE OF W(1tRK rr COMMERCIAL Fes* SCHEDULE -USE CHECKLIST
.;� ,t'"'rtivi I Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteratiol' � performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION �r ', xi
Value:$
-' RESIDENTIAL EQUIPMENT=/SYSTEMS FEES*
J1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE" NFORMATION AND LOCA`T'ION Heating/cooling:
Air conditioning 46.75
Job site address: �0 cj C 5 Lil sk uh,,,,s) c 1� ,v 0 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ('- v[,A r-� I 0 C e(j „�J Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump / 61.06 6(..(&.../
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
�.+M,vtne^�i c) cc, Grid- Ct t c( -^ 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
, DESCJIWTION OE ,w ,a ' Gas fireplace/insert 33.39
Flue vent for water heater or gas
6-ii.- ,--i-
sic 41,t i l '-1 10 r`� Yvt ".; S i+L,-(- k-e t Pc"iv fireplace 23.32
' 4;ham. �J �F.,'f e. V Log lighter(gas) 23.32
U
t (`'L`'`" v'�t.( r u"V'f e Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
•••g.
er: 23.32„: PRQTY ER s � ❑ TENANT ` ;
• ” � ' ' `' ' .• • - -�
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 1 33.39 33:3 r4
Clothes dryer exhaust t 33.39 ' IL)
City/State/ZIP: Single-duct exhaust(bathrooms, 1
toilet compartments,utility rooms) ,S 23.32 Orr ci t f
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
APPLICANT 7.'r 171 C01446' PERSON Other: 23.32
Business name: i_ Fuel piping:
-i cl .y_v ba W l v c t� $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: Fireplace /f//,.i5
(�0�) �t c- t;--c t `� Fax::( ) Range (
E-mail: Barbecue
e NIRA
� hf ,� � CO cirPR e e�. � Clothes dryer(gas)
.
Business name: % Other:
p4.
11EGHANIC,t�L PERM )�EES*1 5°
Address: Q (d , b c,:t 6 715 I Subtotal 01/1 (i' '—
Minimum 2 Minimum permit fee($90.00)
QG Gsil• z los ct7
Plan review(25%of permit fee)
Phone:(( ) Fax:( ) State surcharge(12%of permit fee) t au
CCB lie.: t S Z 3 a G% TOTAL PERMIT FEE .1.-;7/ Ig
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: 6..d• T
v- t,r 5 Date: ) 2.-b l k.
1.\Building\Permits\MEC_PermitA p_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
ee$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:
10940 SW HIGHLAND DR, TIGARD, OR, 97224 November 30, 2018 at
11 :18:44 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00144
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor