Permit Support Document (41) CITY OF TIGARD111
MECHANICAL PERMIT
"� ':;, Permit#: MEC2018-00568
COMMUNITY DEVELOPMENT x
Date Issued: 07/24/2018
T i O A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
?..k Parcel: 1S133DD10800
Jurisdiction: Tigard
Site address: 11958 SW 125TH CT
Project: Anderson Remodel Subdivision:'ILLAGE AT SUMMER LAKE PARK NO. Lot: 145
Project Description: Install a 1 ton daikin slim ducted heat pump system in attic with all ductwork,lineset&condo drain,3 supply air
ducts&1 12inch return air duct with filter grill;extend supply ducts in crawl space,extend gas line to kitchen range,
install kitchen hood vent&venting for master bath fan. 8/30/2018:REPRINT to add gas piping for barbecue.
Contractor: ENERGY SAVERS INC Owner: ANDERSON,JESSICA L
PO BOX 2829 11958 SW 125TH CT
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-679-1724 PHONE:
FAX: 503-512-5339
FEES
Specifics: Description Date Amount
Heat Pump 07/24/2018 $61.06
Type of Use: SF Duct Work 07/24/2018 $93.28
Class of Work: ALT Type of Const: Range Hood/Other Kitchen 07/24/2018 $33.39
Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 07/24/2018 $23.32
Stories: Utility Rooms)
12%State Surcharge-Mechanical 07/24/2018 $27.02
Fuel Piping 07/24/2018 $14.15
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $252.22
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: G'7/(/ /44,/ €1-17e7,1,/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application F,(dr,. v
7"1 FOR OFF10E USE ONLS
7". ived -
City of Tigard Date/By: Cf;-_1i / :lb:a eanitNoHte.2tric -a -4
* 13125 SW Hall Blvd.,Tigard,OR 97223 ,i,,
S Phone: 503.718.2439 Fax: 503.598.1960 Auti 3 0 2,018 Date/By:
,:iew
illi Other Permit:
Inspection Line: 503.639.4175
Date Ready/By: Axis: 65 See Page 2 for
flCiARD
Internet: www.tigard-or.gov CITY()f,' riGA rt'PliWfiediMethed: Supplemental Information
.•
al yr 1 rtn,-. nil isr,,,
:'-:-•',`'-. ;:.' '.7:i::''2f:7,0,,n'Ai'Vg.3n:'•:r-.'ftpilizii.:;i#431(4PY„ ,4„., V:',:„ViniMitil,N;'.:;'..•.:' '''. ''•:GoMM•ltRelAi:'''.0t*.'. 4.gt:.4.4*Carecic*E-',
;,.•,.,,,.,,,,,,..;;;',,,'',.*.t,MA :,."':'`e.c'':'''-'' ' ''''-,','''''''' '‘'''''":-.‘' '''' ' '' '' ''''-' '' ''- Mechanical permit fees*are based on the value of the work
0 New construction . Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit
0 Demolition 0 Other:
Value:$
:;:',..,1.,,.::',..'.;;;''.•4%.;:',':-:';''::'''.'rfrV15- 60:1.45-fiiiI41k*IiiSiliAIOtoN:',.:'•;•'::-.:':::•.: '-•-ifg0,.Q. :' ,2:i:•-;, .--,',:,,,,. iiii".„iii4. 0'itiiliOt.ist-tig-txkg,1*-a-e,
0 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 Qty. I Ea. Total
jog,.s.ifieit00;'''•'.1 i•64,e.41,46.4.666,,i,.isji,4: :f ;;; ,::-:,.:.-::':.:.-• :, :i-,;. Heating/cooling:
Air conditioning 46.75
Job site address: t V9)5:ic c-ovi ‘25-V. ,ck
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: --ct.06irkt o'cL c-).)23 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: J Project name: ( r.„ekoxur\AZeirvvrial
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.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
Gas fireplace/insert 33.39
,;.:'.::,',:'''•'.:,',,:'...':2,---•-::''':';'::', ..: g'KWI.V.14:PF 1.v... , '-,i'' ,:.:fT,'''''.A,' '•(''' '''''''"''''''' Flue vent for water heater or gas
Q-Y•i.C\VA\Csk.0 (“\-3,* kiVEC,2,-6\kka)511A. fireplace 23.32
Log fighter(gas) 23.32
33.39
Wood/pellet stove
(*N., _ _
Nob, t..t.k3 \Ji.w. roc otM,.cor .1.k_le Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
:;T•.::','if'c'.''"::.•:,14:::*41)-f..;ERTY:9****3 ;ignjgt::,:':.'':'-'':'0:17'4047-':':il',' 'n'N'' 1 Environmental exhaust and ventilation:
Name.
•:SeGfaM- NiAb,O.Alt(Y\ Range hood/other kitchen
equipment 33.39
Address: \,C\s‹:k ,bN tALF)-3\-1 rA.
Clothes dryer exhaust 3339
City/State/ZIP [ Z.... 1;Y-- Single-duct exhaust(bathrooms,
k toilet compartments,utility rooms) 23.32
Phone:( ) k3 Fax:( ) At6c/crawlspace fans 23.32
00*:, .0-Pt*.s?'amt:i' 23.32
Fuel piping:
Business name: .EiRet-.9cof, same,,r . ae_.
$14.15 for first four;$4.03 for each additional
Contact name: -co ,' R
U s(bic-mo,-1 Furnace,etc.
Address: . !lib 1
Atry'vs
WalVsuspGas heat pump
ended/unit heater
City/State/ZIP:()(eAdA pe)/ 9f..--... el 1 C4 Water heater
Phone:67)3)(j--) - (- Fax::(55).57:2... 5-3,S*:, Fireplace
Range
E-rnail:opergq-00woirVi.,0 t 6/viai(,, (.:0„,,,,A, , Barbecue
.1 "..•.''.,:::J..,1, ,,:?,V4,,,f44:::?,,-.,.,::;i:',:•..,,V.:::3q0.1i*140,4*(A,;.,A4,;;;:, .:i<,,, ..„,•-!'i::;8:q::,.,005A1P3A •i•":: Clothes dryer(gas)
Business name: i--^-reL ,le SOlAireirS ,e,t,!1•7',,,,,,,
,,,,,,,,,,,y,..,:,„v,;!,.:,,,,<:=1,1gcumecALPFAINnT,414.1. •,-.-:,--,,,,,,,''
„ „ ..
Address: bk.A6
Subtotal
Cit)/State/ZIP: C-0.A14.4 Minimum permit fee($90.00)
_.....-- Plan review(25%of permit fee)
Phone:(517;) (i9C-i - t\t)' K Fax:( ) cokw....„,
State surcharge(12%of permit fee)
CCB lie.: 10-01 el 9. , TOTAL PERMIT FEE
......-
This permit applicationtpermittehas been ptl
expires if a is not obtainedltwithin 180
days after
as
.
e.
Authorized signature: iv,' 1, - _. ••& . . Fee methodology set by Tri-County Building Industry Service Board
Print name:, 4.4.4 1 - , i9,,Feyt, Date: V2.4ilig
I:\BuildiugTerroits\NIEC_FtrmitApp_040113.doc 440-46I7T(I 1/02/COM/WEB)
1
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11958 SW 125TH CT, TIGARD, OR, 97223 December 14, 2018 at
10:27:08 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00568
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11958 SW 125TH CT, TIGARD, OR, 97223 December 21 , 2018 at
8:57:48 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00568
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Note: inspection completed at building final.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11958 SW 125TH CT, TIGARD, OR, 97223 August 30, 2018 at
9:34:53 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00568
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
No access for inspection, no one home. 9:30 am
Gas line not supported under cantilever right side of house and not listed on permit. 1
branch on permit to range. Add new branch to permit and schedule gas line test to new
branch.
No vent installed for hood.
No hood vent installed.
Electrical to exterior mini split unit not complete.
Not ready for final inspection, Work not complete. R109.3
Violation Summary:
Inspector Contractor