Permit (185) CITY OF TIGARD MECHANICAL PERMIT
" 2 COMMUNITY DEVELOPMENT Permit#: MEC2018-00169
T(CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/13/2018
Parcel: 2S102DB08900
Site address: 9058 SW HILL ST Jurisdiction: Tigard
Project: Feack Subdivision: CHELSEA HILL NO.2
Project Description: Adding(1)gas line to fireP lace insert, 1 Lot: 66
( )gas line to Range,and ductwork.
Contractor: THOMAS LEE SCHMITT
Owner: FEACK, EDLON C
555 EDGEWATER RD
GLADSTONE, OR 97027 058
9 S NG, DIANE D
9058 SW HILL ST
TIGARD, OR 97223
PHONE: 503-657-4431 PHONE: 503-490-6294
FAX:
FEES
Specifics: Description
Date Amount
Duct Work
Type of Use: SF Gas Fireplace 03/13/2018 $23.32
03/13/2018 $33.39
Class of Work: ALT Type of Const: Range Hood/Other Kitchen 03/13/2018 $33.39
Occupancy Grp: Fuel Piping
Stories: 03/13/2018 $14.15
12%State Surcharge-Mechanical 03/13/2018 $12.51
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $116.76
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC y calling 503. 2.1987 or 1.800.332.2344. 9
: C '
Issued By: `/ %/
—� "�
` �.► Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
FOR OFFICE: list 01L1
III • City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: /till,. Permit No
S Plan Review
D
Phone: 503.718.2439 Fax: 503.598.1960
Inspection Line: 503.639.4175 Date/By: Other Permit:
TI G A R D p Date Ready/By: Ju s: .t.. ,e 'It . 1
Internet: www.tigard-or.govH See 'age 2 for
Notified Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHI±,DULE ,- ((ISE CHECKLIST
❑New construction Addition/alteration/replacementMechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial
0 Accessory building
For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description I Qty. I Ea. I Total
u. JOB SITE INFORMATION AND LOC TION Heating/cooling:
c.Job site address: 6/..5— �../' . 1Air conditioning 46.75
i...r (...(J A/�nl _Cr.' Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1 SL) I ` O/C Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: 1 f Project name: Heat pump 61.06
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: I Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
,PESCR1 TION OF Woo x Gas fireplace/insert / 33.39
h� / (e hFlue vent for water heater or gas
..c.0..51/ i!( c c Cif._/I� fireplace 23.32
�/ Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OYiER _ Other:
° ', x «;: ' 1... ❑;TENANT'` f 23.32
Name: �`D j C� • Environmental exhaust and ventilation:
1l N JQ' 0 C A-) Range hood/other kitchen
Address: �t� "CL j' / 5 equipment /1 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: I c(3 r-d a,l' Single-duct exhaust(bathrooms,
Phone:( ) toilet compartments,utility rooms) 23.32
Fax ( ) Attic/crawlspace fans 23.32
k APPLICAIIT': '''" 7 ❑'•CQNir4' ' 1 E N ` Other: 23.32
Business name: 7-111)/4-70/55 .�"L)1t /Y')( Q oily Fuel piping:
Contact name: %)i�� ["�_,_ % .>e 2( $14.15 for first four;$4.03 for each additional
� (J J L,f7 /'/ Furnace,etc.
Address: 5 ,5"-'5-14 � K, /D Gas heat pump
City/State/ZIP: / Wall/suspended/unit heater
O i'� S / J./ ' d 9 ?C.2 7 Water heater
Phone:(5'63) 973----0 e D I Fax::633) :�e 2 „33 l/- Fireplace
Range i
E-mail: Sc moi / '7-.)4"-Z,,/--,476) / x „ 7 Barb
�Q/�CC��j/ '' Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: �S 46v Other:y�7
Address: MECHANICAL PERMIT FEES* '`
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) I Fax:( )
CCB lic.: /t/ R E- - State surcharge(12%of permit fee)
TOTAL PERMIT FEE
RThis permit application expires if a permit is not obtained within 180
aP
Authorized signature: days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: /..,�C 17-7/>47( I Date:/3/' ,Vti 0,24/ ^
I:\Building\Permits\MEC_PermitApp_0401 13.doc
440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: > v 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\ EC_PermitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9058 SW HILL ST, TIGARD, OR, 97223 June 8, 2018 at 9:29:37 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00169
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor