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Permit (172) CITY OF TIGARD MECHANICAL PERMIT I COMMUNITY DEVELOPMENT Permit#: MEC2019-00292 T I G A R 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/09/2019 Parcel: 1 S136CB06000 Jurisdiction: Tigard Site address: 11200 SW 83RD AVE Project: Schafer Subdivision: STEVE&HUGHIE'S PLACE Lot: 32 Project Description: Installing gas safety shutoff valve. Contractor: OWNER Owner: SAS HOLDINGS#1 LLC STEVEN SCHAFER PO BOX 432 P 0 BOX 432 BEAVERTON, OR 97075 BEAVERTON, OR 97075 PHONE: 503-863-1593 PHONE: 503-863-1593 FAX: FEES Specifics: Description Date Amount Fuel Piping 05/09/2019 $14.15 Type of Use: SF 12%State Surcharge-Mechanical 05/09/2019 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/09/2019 $75.85 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. 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 O by calling 503. 2.1987 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 ' City of Tigard Date/ B d `T III ' 13125 SW Hall Blvd.,Tigard,OR 97223 y IPIIIRecei 91i S Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T 1 G A P.D Inspection Line: 503.639.4175 Date Ready/By: Juris: Fd See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information RECEIVED ty 'TYI1'E OF WOR r x cOMMERC AT FEE* s » tt ',tis** 512 ❑New construction .„V{CUM Mechanical permit fees*are based on the value of the work ®Addition/alteratior rep acement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: CITY OF TIGARD mechanical materials,equipment,labor,overhead,and profit. ©lV1 tON- Value:$$140.00 CA3 EGt3RY fl O1S t� 3y RESWENT 4L iJ1PPMENT/SYSTEMS FEES* >. , ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB STYE INFORMATION NAND LOCATION Heating/cooling: A :# . �� Air conditioning 46.75 Job site address:11200 SW 83rd Ave. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard OR 97223 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:83rd Ave&Pfaffle St. 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.:R283990 Water heater 23.32 "t `V Gas fireplace/insert 33.39 z riESC121PTMN 9F` W„O P Flue vent for water heater or gas Install gas safety shutoff valve fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ''''SV":' R u, Other: 23.32 PROPER O t I- ''''�� `”" � rx4 Environmental exhaust and ventilation: Name:Steven Schafer Range hood/other kitchen equipment 33.39 Address:PO Box 432 Clothes dryer exhaust 33.39 City/State/ZIP:Beaverton,OR 97075 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(503)863-1593 Fax:( ) Attic/crawlspace fans 23.32 {CONTAL PERSS0* �� PhI� �� vOther: 23.32 Fuel piping: Business name:SAS Holdings,LLC $14.15 for first four;$4.03 for each additional Contact name:Steven Schafer Furnace,etc. Address:PO Box 432 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Beaverton OR 97075 Water heater Phone:(503)863-1593 Fax::( ) Fireplace Range E-mail:steven@sasholdingsllc.com Barbecue ' CONTACTOR' Clothes dryer(gas) Other: Business name: l%�t�jj ci/-- rStw ill lvt Y cncfri i'1t ` MEC PERMITFEES`* 3 �.CA� . , .. Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) To,g) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) (d;70 CCB lic.: TOTAL PERMIT FEE `dj,8?) 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:Steven Date:5-8-19 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: ;Tot ' ,ttiti,froo $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 Tel: 503.718.2439 Location: Inspection Date: 11200 SW 83RD AVE, TIGARD, OR, 97223 May 22, 2019 at 12:53:29 PM Record Type: Record ID: Residential - Mechanical MEC2019-00292 Inspection Type: Inspector: 699 Mechanical final Jeremy Burrows Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor