Permit (200) CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2018-00694
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/30/2018
T I t ;k I=.t_, g Parcel: 2S111AA10900
Jurisdiction: Tigard
Site address: 8970 SW INEZ ST
Project: HURD Subdivision: GREENSWARD SOUTH Lot: 3
Project Description: Installing new gas line for tankless water heater.
Contractor: CENTRAL AIR LLC Owner: HURD,ANDRE L
PO BOX 433 8970 SW INEZ ST
CLACKAMAS, OR 97015 TIGARD, OR 97224
PHONE: 503-656-1908 PHONE:
FAX: 503-650-3898
FEES
Specifics: Description Date Amount
Water Heater 08/30/2018 $23.32
Type of Use: SF Fuel Piping 08/30/2018 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/30/2018 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 08/30/2018 $52.53
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00• Yo / ay o. in - opy o
the r -s
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
' Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
` :1 f Received W 1 4i,
City of Tigard :7.., „ ' * ' '' -3 Date/By: et"pet 0 4111r Permit
13125 SW Hall Blvd.,Tigard,OR 97223
3 Phone: 503.718.2439 Fax: 503.598.1960 AUG 3 fl 2.013
Ili Plan Review
Date/By: Other Permit:
T
i i,A,z, Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
.- '-- Internet: www.tigard-or.gov „ „
l Notified/Method: Supplemental Information
TYPE O. WORK '
i CIAL rEE*S_CI1EDFLt - lt..' DRCRUST
--'
Mechanical permit fees*are based on the value of the work
0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CTE9941(
OF CONSTKLICTION ''''5:.',:;' 'P RESIDE • EQuipmENT iM-M
SFSTEES
j
• • ' use checklist.
fX1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Te,„ „ ., .:` Heating/cooling:
,,H)Di*E :INFORNIATION AND LOCATION 4,' %,
Air conditioning 46.75
Job site address: -1.-7 CD 5, L ) r/Li Ca....., Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1---, L,A.,..vuO 014,-- 91 z 2 'I Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
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
4-1 p Li__ 13 Lki 0 — C. ti2.,-e-c--s-4-.4)\-10 LAI / hydronic) 23.32
Unit heaters(fuel-type,not electric),
ei 0 I-1, _ ::riv C:::Z-- in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: 6 gep„,v-34L, Lot no.: 3
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
.,, ri - wistroj ,,, irte ' S.e: 5: 74 Gas fireplace/insert 33.39
-, At 14;'4:Iffli 4, '-''..i...:-.4.. ,...”MI-A 7-141.7.:17.- ',' ' Flue vent for water heater or gas
— 11---1l.)5 TA.L..-1.._ K.)6-C-J .s>AS 4--I A-)("1” fireplace I 23.32
Log lighter(gas) 23.32
-CC vz_ or-) 0 -A Px.i'0 LA./A.1"ER-(-4 E:_--1:4?-'11 Wood/pellet stove 33.39
-r-Ax..)K.c_c_-,ss Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
.7-.
I-2-r' 0 TE-.14...-4 -
-, - - ' Environmental exhaust and ventilation:
Name: Range hood/other kitchen 33.39
equipment
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
ff&NTA-•.„TE Other:,,„. 23.32 Fuel piping:
Business name: .,ci1,2_ D co,,,s-ne,c,t-,0 A)
$14.15 for first four;$4.03 for each additional
Contact name: t-')tiasu i c' D c........lal&itpptivt_t- Furnace,etc.
Gas heat pump
Address: Fit 0 .='>( i S 7 _) Wall/suspended/unit heater
City/State/ZIP: 2)1,:-_-1,,,,,,,,..:...,,,,..„0 A..., 0 IL cr707S. Water heater
Phone:(53) 72 0 V__-7 Li 5 Fax::( ) Fireplace
Range
E-mail: "r---(...)LA it- 41.) (45N-5TClothes rbeciidrye er(gas)
CO '.:•..-':1 TO:iC :„:. ''..:f :.k'„, 1.4..,4-:. Other:.
Business name: e),...j-ritia (..... ,r) ,, /2_
1 4, 7'ti+VIECHANI4L PERNIFT FEES
Address: 0,0 0-6-1( 933 Subtotal
Minimum permit fee($90.00)
City/State/ZIP: _
6 e....pic ky.k fil fk 5 6 (a-, 970 ) s
Plan review(25%of permit fee)
Phone:( ._S--) &56 - 1 1 ) < Fax:( ) State surcharge(12%of permit fee)
CCB lie.: /7 0(2'2-9TOTAL PERMIT FEE /00 ph
-
This permit application expires if a permit is not obtained within 1 80
days after it has been accepted as complete.
Authorized signature: /...)1
* Fee methodology set by Tri-County Building Industry Service Board
Print name: Q1)l0 (Sct___7-_-,4,t",„4-- Date: g -50 - 1 „ '
I.\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Tota'SIT ivation•
$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:
8970 SW INEZ ST, TIGARD, OR, 97224 September 5, 2018 at
12:54:55 PM
Record Type: Record ID:
Residential - Mechanical MEC2018-00694
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Leak test letter from HVAC company received. Gas line final approved.
Violation Summary:
Inspector Contractor