Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2018 00199
T GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2018
Parcel: 2S 114AB03400
Jurisdiction: Tigard
Site address: 16465 SW 93RD AVE
Project: CSO PROPERTY HOLDINGS LLC Subdivision: KNEELAND ESTATES Lot: 21
Project Description: NC installation. Placement of NC unit must comply with manufacturer's installation requirements.
Contractor: DONS AIR CARE INC Owner: CSO PROPERTY HOLDINGS LLC
PO BOX 6408 185 NE 33RD CT
ALOHA, OR 97007 HILLSBORO, OR 97124
PHONE: 503-642-5844 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 03/26/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 03/26/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/26/2018 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:.6‘ o • ignature: �+
7DA4;—.()
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE l Sl.ON!.l
City of Tigard .
R :
111
13125 SW Hall Blvd.,Tigard,OR 9722340'. ° Date/By: r Permit No.: s
Phone: 503.718.2439 Fax: 503.598.196Plan Review
Inspection Line: 503.639.4175 „,�\ , Date/By: Other Permit:
TIGARD p i Date Read/B
Internet: www.tigard-or.gov ��la c� t 6 tReady thud: H See Page 2 for
Supplemental Information
, '$i>. ike f yrs
TYPE OFVORK ��laV,j COMMERCIAL FEE*SCHEDULE — USE CHECKLIST
0 New construction a Mechanical permit fees*are based on the value of the work
Addition/alteratiolnP't�nt performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
[ 1-and 2-family dwelling 0 Commercial/industrialRESIDENTIAL EQUIPMENT/SY`TEMS FEES*'
0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description I Qty. I Fa. I Total
JOB SITE INFORMATION AND LOCATION . Heating/cooling:
Job site address: 7k) ��(. 1 O� o'er' Air conditioning 1 46.75 %( , �'
r Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -----r:;, 1 (?�1 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Li I Project name: G (.) j,� ��` Heat pump 61.06
��; �;/ hr 1 �, "*1 Duct work 23.32
Cross street/directions to job site: UV Hydronic hot water system 23.32
Residential boiler(radiator or
fki 7` '{ z,,,,,,ens-�-" hydronic)
23.32
Unit heaters(fuel-type,not electric),
vin-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
N Subdivision: I Lot no.: Other: 23.32
(Y Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
v
DESCR oN OF 1•'olikin Gas fireplace/insert 33.39
f Flue vent for water heater or gas
��10( /1.:/c.,
Cic�.� ��1 ��r���_ fireplace
23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
4 Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
`J li PTtOPEItil OWNER, r Other: 23.32
Name: r Environmental exhaust and ventilation:
,; ,�i,. ,✓f-tr 91,Z'{ Ar/J,> /4.�6.1..,,4s,_
Range hood/other kitchen
Address: ��`` equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
Phone: toilet compartments,utility moms) 23.32
( ) Fax ( ) Attic/crawlspace fans 23.32
i. APF :IcANT tf i
: .11CONTAGTPERSON Other: 23.32
Business name: i T—, Fuel piping:
Contact name:'
`x f�r �� t $14.15 for first four;$4.03 for each additional
r� 4 1(- LCA 1/4 e'..._< Furnace,etc.
Address: C^ ii, Gas heat pump
City/State/ZIP: � Wall/suspended/unit heater
�cZ/Il% ( ���� Water heater
Phone:(" ) -, �, ` >, .v44- I Fax::( ) Fireplace
E-mail: Range
' Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:
� Other:
s/�� MECHANICAL PERMIT FEES*
Address:
Subtotal igo.75--
City/State/ZIP: Minimum permit fee($90.00) 4d,tC
Plan review(25%of permit fee)
Phone:( ) I Fax:( )
State surcharge(12%of permit fee) ;I)
CCB lic.: 6?", (G eL TOTAL PERMIT FEE jilt)
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: ` � ^� G
%�3 r,:�% G],-'1-1.C... . Date: j
I:\Building\Permits\MEC_PermitApp_040113.doc 4 440-4617T(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:
16465 SW 93RD AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Mechanical MEC2018-00199
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor