Permit Support Document (21) CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2018-00851
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 4 ' '�t• Date Issued: 10/26/2018
T t a 1=.Dg Parcel: 2S104AA06300
Jurisdiction: Tigard
Site address: 12725 SW WILLS PL
Project: Saldana/139776 Subdivision: BELLWOOD NO.2 Lot: 84
Project Description: replace gas furnace and add air conditioner. 11/1/18:REPRINT to add gas line to range.
Contractor: ROTH HEATING&COOLING Owner: SALDANA, CARLOS
PO BOX 1265 12725 SW WILLS PL
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503-266-1249 PHONE:
FAX: 503-266-3478
FEES
Specifics: Description Date Amount
Air Conditioning 10/26/2018 $46.75
Type of Use: SF Furnaces<100K BTU 10/26/2018 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/26/2018 $11.22
Occupancy Grp: Fuel Piping 11/01/2018 $14.15
Stories: 12%State Surcharge-Mechanical 11/01/2018 $1.70
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
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: i Permittee Signature:
5r/r
.01
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.
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wiecnantcat rermtt wppttc `"� FOR OFFICE ICI 1'S ONL1
City of Tigard EIVEE) Received l` tA
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13125 SW Hull Blvd.,Tigard,OR 972223,iPlan Review "—'W
Phone: 503.718.2439 Fax: 503.598.1961 'V L a $ Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Jurir El See Page 2 fur
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION ,
TYPE,OF'WORK COMMERCIAL FEE' SCIIEAULE `USE CHECKLIST s
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
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION _
Value:$
• RESIDENTIAL,EQUIPMENT/sYSTEh151:EE$' .., ,
® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Far special information use checklist:
0 Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION'AND LOCATION
Air conditioning 46.75
Job site address: 12725 SW WILLS PL Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:TIGARD Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:SALDANA/139776 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: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF`WORK" Gas fireplace/insert 33.39
Flue vent for water heater orgas
REFERENCE PERMIT MEC2018-00851 fireplace 23.32
EXTEND GAS LINE TO RANGE Log lighter(gas) 23.32
Wood/pellet stove 33.39
PLEASE SEE a ikct+ D c C31'Y OP oRtyOVAL Wood fireplace/insert 23.32
PE-ggt.j Chimney/liner/flue/vent 23.32
® PROPERTY OWNER <.❑ TENANT Other 23.32
Environmental exhaust and ventilation:
Name:CARL OS SALDANA Range hood/other kitchen
equipment 33.39
Address: 12725 SW MILLS PL Clothes dryer exhaust 33.39
City/State/ZIP:TIGARD,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)860-8474 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT ''. ❑ ER
CONTACT"PSON other': 23.32
Business name: Fuel piping:
514.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: ,,Gas heat pump
Wall/suspended/unit heater
City/Stale/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range 1 15.85
E-mail: 1/54/9 ((0-71_ --4?. .-f-e (-01,--t Barbecue
c� CONTRACTOR Clothes dryer(gas)
Business name: ROTII HEATING&COOLING Other:
:MECHANICAL PERMIT FEES*.
Address: PO BOX 1265 Subtotal
City/State/ZIP:CANBY,OR 97013 Minimum permit fee(590.00)
Plan review(25%of permit fee)
Phone:(503)266-1249 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:LISA PALMA Date:11/01/2018
19Jiuilding1Permits'MEC_PermitApp_040117.doe 440-4617r(I1/021COMIWEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12725 SW WILLS PL, TIGARD, OR, 97223 December 3, 2018 at
9:35:01 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00851
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Minor label # ELS 681221
Violation Summary:
Inspector Contractor