Permit CITY OF TIGARD MECHANICAL PERMIT
11...„
COMMUNITY DEVELOPMENT Permit#: MEC2018-00702
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/05/2018
TIGARD Parcel: 2S102DC00501
Jurisdiction: Tigard
Site address: 9085 SW EDGEWOOD ST
Project: SULLIVAN Subdivision: EDGEWOOD Lot: PTS 12
Project Description: Wood stove replacement.
Contractor: OWNER Owner: SULLIVAN, RICHARD A&SUZANNE P
RICK SULLIVAN 9085 SW EDGEWOOD
9085 SW EDGEWOOD ST. TIGARD, OR 97224
TIGARD, OR 97223
PHONE: 503-620-1261 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Wood/Pellet Stove 09/05/2018 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 09/05/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/05/2018 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. S.- .-Ity Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if wore of started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foil. ' the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090./ You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.80!. • . •-.
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Issued By: 6c—ze....„}„L.2.06... • 1.nature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
14 City of Tigard ReceivedDate/By: Permit No.: - . , 1
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• i Phone: 503.718.2439 Fax: 503.598 1964.l ,, 4 , .' Date/By: Other Permit:
TI G n R U Inspection Line: 503.639.4175 »'•
t .. '` °. at Date Ready/By: lei VI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
16, di - TY QF WORK ( � ' CQlt\ R��AL FEE a....,.,...
SCHEDULE.—"ITSE'-IiECKLIST v
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alter4tionirepl'aJemeil , i it:'a performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: t.i ` `" ii., a i,1 a, mechanical materials,equipment,labor,overhead,and profit.
,F Value:$
r ;CATEGO1 Y OF`C;()NSTRUCTIOI►1 : ,', hj RESIDENTIAL EQUII'MEI ' `� .LL A ES*
❑ 1-and 2-family dwelling Af Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
1} ITE INFORMATION AND'WCATION t'• Heating/cooling:
Air conditioning 46.75
Job site address: 4 V Dr; '3 t,„,l [,'i C AJOO(L Si- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: `` D C1.-,' 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: t
S u vE^,,\ 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), 11
in-wall,in-duct,suspended,etc. 46.75 1
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances: —
Tax map/parcel no.: Water heater 23.32
; Gas fireplace/insert 33.39
Flue vent for water heater or gas
�.t1 ::1 ive, fl4 rte- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove / 33.39 3).3i
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
.. t 'r* v * Other: 23.32
r PROI EIITY' ar y •' '� }'' v, Environmental exhaust and ventilation: _
Name: `-R;"• S�r i t ,A Range hood/other kitchen
`` equipment 33.39
Address: 0 t5 5 odLS d' UJOO i S C Clothes dryer exhaust 33.39
City/State/ZIP: �')2 23
Single-duct exhaust(bathrooms,
`� toilet compartments,utility rooms) 23.32
Phone:(S43) (0 20 - i Z(Q , Fax:( ) Attic/crawlspace fans 23.32
u a-4 - =.' Other: 23.32
DANT `.4.Z.',' ' NTA I'EILSON ..
Fuel piping:
Business name: { et
3r�xe. 1e4✓ K1t! $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: —
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
i= fi
® , o :7 , y Clothes dryer(gas)
Business name: Other:
,
Address:
Subtotal 33.�
City/State/ZIP: Minimum permit fee($90.00) ' a-Cb
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: TOTAL PERMIT FEE j,a). au
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ` * Fee methodology set by Tri-County Building Industry Service Board
Print name: .2:� i M,,,,,,,\ ate: 9/5-/(S
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
total Valuation: „T..$P ittntit 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_PennitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9085 SW EDGEWOOD ST, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2018-00702
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor