Permit (20) CITY OF TIGARD MECHANICAL PERMIT
N -. COMMUNITY DEVELOPMENT Permit#: MEC2018-0028
3
TIC A i i) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/25/2018
Parcel: 2S 112C B 19200
Jurisdiction: Tigard
Site address: 8015 SW BARNUM ST
Project: Corbin Estates,Lot 9 Subdivision: CORBIN ESTATES Lot: 9
Project Description: Installing A/C unit. Placement of A/C unit must meet manufacturer's requirements.
Contractor: J T ROTH CONSTRUCTION Owner: JT ROTH CONSTRUCTION INC
12600 SW 72ND AVE#200 12600 SW 72ND AVE, STE 200
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-639-2639 PHONE:
FAX: 503-624-0239
FEES
Specifics: Description Date Amount
Air Conditioning 04/25/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 04/25/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/25/2018 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Ypu may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. l ✓
'
,(2, ...4.ew,..r/iiiee.
Issued By: ze �r - Permittee Signature:
I'
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application , - - -r., ----;) FOR OFFICE USE ONLY
rt F, „s , . ,-,
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 ADD c, :' '1.018
II Date/By: 4- ,
Plan Review
6 ,:.#1,am. Permit No.;:,,t2r f_C 0/„ --a,
' 2 Phone: 503.718.2439 Fax: 503.598.1960 ri I I' 4' " - Other Permit:
Date/By: 14
TIGARD Inspection Line: 503.639.4175
, ') Date Ready/By: Juns' 0 See Page 2 for
Internet: www.trgard-or.gov ,._ , Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 PKt New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION
Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
JOB SITE,INFORMATION AND LOCATION eating/cooling.
, e.- ' ' Air conditioning 46.75
Job site address: 0 , , 5„,, i>...,_ fa /
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1-13 0,....v-S ,ie ct 7..„0....4 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Ciwe-to,in E-3 6-4-1---1 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
Other: 23.32
Subdivision: Lot no.: I
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
:1)0 citirruji or:*:0,4 ' : : ,; 4, : -, , ::;tr 4 Gas fireplace/insert 33.39
7( Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
EJ-i*OrgRTY OWNER P 4 l'''' 1 r: ' '0 TENANT ' - ' ' Other:
' 4' * 't ' ' Environmental exhaust and ventilation:
Name:
Range hood/other kitchen
equipment 33.39
Address:
Clothes dryer exhaust 33.39
City/State/ZIP:
Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( )
Attic/crawlspace fans 23.32
0,
.„,, ,,, •,- -. ,Aril:1,6Ni4. : 0 coNTAci 4ptts' cw Other: 23.32
.------i---- i
Business name: i
\ ei,N. C.. Fuel piping:1Y1-4-41-06V\ $14.15 for first four;$4.03 for each additional
Contact name: --)n 1 Furnace,etc.
Address: tc:). C5b ,SL,,,$) .--f-c22,. .4ve c? --4e 4'(--) wGaavus
Gasheatpumpd
Pentmit heater '
City/State/ZIP: ()EA,.ff-C>--v‘j C4 9 Th p-.. --) Water heater
Phone:( cs) .L.3,.-..1i I Fax::( )6,,c34711- ...3 Fireplace
Range
E-mail: A\,L4..t.,,,,\,,, 1/4s.4-y,61-4,1\fl c, vi,\_
Barbecue
'CONOIACTOR .., . „ , ' ., - , ,,. Clothes dryer(gas)
Business name:
Other:
: '', ; *cukrricAL'Peo LITTEES:*
Address:
Subtotal
City/State/Z1P:
Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) I Fax:( )
State surcharge(12%of permit fee)
CCB lic.: 3 1 7a, / ..,/, t ,
TOTAL PERMIT FEE
/
Authorized signature: 0 .........4
if .ThFiesepmeremthiotdaopipolgiycasteiton expires if a permit is not obtained within Tab
days after it has been accepted as complete.
by Tri-County Building Industry Service Board
I Print name: '1 „ .4 fel „e.jrz I Date: -c2C--/'
1:1Building 1 Pennits 1 MEC_PermitApp_040113.doc 440-4617T(11/02/C0114/WEB)
1111111111111111IMIEMEM111............... ---__
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
-To a`l Narration:, - :Permit Fee
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 0.00 and
$3 076 for the first 7 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 $2. t 49 foreachandr the first$50,000.00
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:
8015 SW BARNUM ST, TIGARD, OR, 97224 April 26, 2018 at 9:07:33 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00283
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Ac installed.
Violation Summary:
Inspector Contractor