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Permit (198) CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2018-00988 Date Issued: 12/20/2018 -f f GAR.O, 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S125DD08700 Jurisdiction: Tigard Site address: 9690 SW VENTURA CT Project: PANGBORN, Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 95 Project Description: (1)gas line for range,(1)range hood installation,and relocation of duct work. Contractor: ROSE CITY REFRIGERATION HEATING&AIR LLC Owner: PANGBORN, JEFFREY L&CANDACE L PO BOX 19207 9690 SW VENTURA CT PORTLAND, OR 97280 PORTLAND, OR 97223 PHONE: 503-636-5371 PHONE: 503-807-6064 FAX: 503-655-4669 FEES Specifics: Description Date Amount Duct Work 12/20/2018 $23.32 Type of Use: SF Range Hood/Other Kitchen 12/20/2018 $33.39 Class of Work: ALT Type of Const: Fuel Piping 12/20/2018 $14.15 Occupancy Grp: 12%State Surcharge-Mechanical 12/20/2018 $10.80 Stories: Minimum Fee Adjustment-Mechanical 12/20/2018 $19.14 Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: /ice Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY Received City of Tigard `� Permit No.: si 13125 SW Hall Blvd.,Tigard,OR 97223 rCE1V 2:;./By: ,/ , ivl, r ._.._ I t .. t); A �n Review Other Permit Phone: 503.718.2439 Fax: 503.598.1960 Date/By: !/ 't _r ) , 7.1 GAR D Inspection Line: 503.639.4175 Date Ready/By: See Page 2 for Internet: www.tigard-or.gov DEC 0 Notified Method: IMISupplemental Information rimer. l ARD .., fi-p. -< C( CIAE,FES* SCII D -" E CHECI tST a Mechanical permit fees*are based on the value of the work El New construction m Addition/alterat 1 Ifljl DIS 3 SIGN performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF""CO NSTB,-,,..„..9,,,,,,,„v72,1,,, `` A Value:$ ri., ..�. "'_ .: n�.: I2ESIDENTIAi� :"alt `FE)�$* 1 ] 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder El Other: Description Qty. Ea. Total v 4--m X11 „67,2,41„,,,,,,,,T,- {4 1 '` r,r Heating/cooling: ,. k. a t .IOB SITE INFORMATION ANS s i°, 4 .., .,.., , ;, ._ Air conditioning 46.75 Job site address: 17690 Ste/ v eel tvtZ! Gt Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: r/q4/� 87023 Furnace 100,000+BTU(ducts/vents) 54.91 Cl j� Heat pump 61.06 Suite/bldg./apt.no.: Project name: / � `1yb i'P) Ductwork 1 23.32 23 . 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 r> D `v ' " O ` Gas fireplace/insert 33.39 ` Flue vent for water heater or gas `t--l�f' 54,s �/erC- e--e--c, /7-i fe fireplace 23.32 Log lighter(gas) 23.32 v/tilt-/'7y )/--- 7`¢,ri� 40©ci Wood/pellet stove 33.39 /77 44 C c//67 47,/r S .Sif-s"27 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 { ' Other: 23.32 " .!. ; *Z Environmental exhaust and ventilation: Name: Range hood/other kitchen Address: equipment / 33.39 19. 1 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 23.324 $* a _ ❑ CONTACT P �.s" Other: st �3.� ' '-i ( Fuel piping: Business name: t/SC .'je-ie r/7 S f/-r) $14.15 for first four;$4.03 for each additional Contact name: ,C f,� iO/� Furnace,etc. / , / Gas heat pump Address: . 6 pa 5‘..1.-} (/ �/t' Cit- Wall/suspended/unit heater City/State/ZIP: -77:f Gt'_ f7ZzJ Water heater Phone: 8.) 7--54)Z-. - Fax::( ) Fireplace / Range Iy"/ E-mail: Barbecue •. z. ACTOI4 ," 41 '4 µ w Clothes dryer(gas) Business name: D' 1 Other' F-�c,'C r, y /-,....rAj'1//' * , ,..i---**At,PERMIT FEES*'' t., 't74 v y Address: ✓ Subtotal )(.1 �(,, Minimum permit fee($90.00) 10:(.4)City/State/ZIP: Plan review(25%of permit fee) - Phone:( ) Fax:( ) State surcharge(12%of permit fee) /O.- TOTAL PERMIT FEE CCB lic.: /6'13,0 �diJ., This permit application expires if a permit is not obtained within 180 4. �.- days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: ./T:.-.1-1- /" rly /�/ Date: /2/247/9 440-4617T(11/02/COM/WEB) I:\Building\Permits\MEC_PermitApp_040113.doe/ Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & MultiFamily Fee Schedule: $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: 9690 SW VENTURA CT, TIGARD, OR, 97223 April 9, 2019 at 9:47:29 AM Record Type: Record ID: Residential - Mechanical MEC2018-00988 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor