Permit (174) CITY OF TIGARD MECHANICAL PERMIT
71 COMMUNITY DEVELOPMENT Permit#: MEC2019-00312
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/15/2019
Parcel: 1S 135DB09500
Jurisdiction: Tigard
Site address: 11175 SW 93RD AVE
Project: Lacan Subdivision: REEL ACRES Lot: 1
Project Description: (1)gas furnace,(1)ductless heat pump,(1)A/C unit,with fuel piping for furnace,water heater,and range.
Placement of A/C unit must comply with manufacturer's installation requirements.
Contractor: PACIFIC NW HEATING &COOLING INC Owner: LACAN, MANUEL ALVARO
14790 SE 232ND DR 11175 SW 93RD AVE
DAMASCUS, OR 97089 TIGARD, OR 97223
PHONE: 503-425-9013 PHONE: 503-432-6191
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 05/15/2019 $46.75
Type of Use: SF Furnaces<100K BTU 05/15/2019 $46.75
Class of Work: ALT Type of Const: Heat Pump 05/15/2019 $61.06
Occupancy Grp: Fuel Piping 05/15/2019 $14.15
Stories: 12%State Surcharge-Mechanical 05/15/2019 $20.25
Fuel
Fuel Types:
Gas Pressure:
Total $188.96
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 ado.ted b the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9 e -•• = You may .: .in a copy o the rules
or direct questions to OUNC by calling 503.232.1.: - 44.
Issued By: Permittee Signature:
AM-
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 plane are required-en-the Iola site at the Mme of each inspection
Mechanical Permit Application F•OR OFFICE t SE O\I.I
City of Tigard Received
Date/By: 5m f 1 Permit No.: _ - _ �`/_
;� is 13125 SW Hall Blvd.,Tigard,OR 9722 $$$$
Plan Review
111 Phone: 503.718.2439 Fax: 503.598.196 Q Date/By: Other Permit: _
T 1 G A R D Inspection Line: 503.639.4175 p\t 1 �,� J Date Ready/By: ® See Page 2 for /� ,
Internet: www.tigard-or.gov H 1 Notified/Method: Supplemental Information
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i-tw C -0A4KERCIAL FEE' SufirmULE-USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction i a dition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
o Demolition • Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
s..
CATEGORY OF CONSTRUCTION - RESIDENTIAL EQUIPMENT 1 SYSTEMS FEES*
ti-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 SITE INFORMATION,AND LOCATION Heating/cooling:
Job site address: 1 1 1 �^ S'� 3 ry AirFurnace conditioning0 ,0L 46.75 ixgiti„. 1j
100,000 BTU(ducts/vents) l 46.75 1(�y,. 1_5-
City/State/ZIP:
jCity/State/ZIP: c-r-\64-�-� '311__ Furnace 100,000+BTU(ducts/vents) 54.91
v Heat pump 1 61.06 6.1..0.0
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
T, 1Residential boiler(radiator or
C 413 ,fz) Cp CkNkS1--Cti4r)() ( - N D \ hydronic) 23.32
1 _ ` Unit heaters(fuel-type,not electric),
G�p L, V�r_ ( 1 e rr ‘,-).QQ r.y )v /) in-wall,in-duct,suspended,etc. 46.75
`(' Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
,. � ��- .. ES ION OF a, ,,'-
h t Gas fireplace/insert 33.39
`-� A / � � i Fluep vent for water heater or gas
JT_`"��`��- fireplace 23.32
�.�`,,U I" r Log lighte (gas) 23.32
0 C'+1 PP( � , 1V/ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
a R - Other: 23.32
.N ° e,,, ,... v '- ----- ,m1 Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
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
0 APPLICANT '0'CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: {�J (ZSte._
Furnace,etc.T Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP:
IP:: Water heater I /4/ r 5
Phone:(s)l.. t-f 2s--901? Fax::( ) Fireplace
Range t
E-mail: Barbecue
" CONTRACTOR Clothes dryer(gas)
Business name: ',/� ° n Other:
/�-c A 3 c ,,:.e ,MEC'1ETA111i+ AL PERMITFEES*
Address: ( S a 3 2 ^� Subtotal /6, '7/
City/State/ZIP: c541 0 p 9 D 0 t,$-.1 Minimum permit fee($90.00)
Pj r Fax: Plan review(25%of permit fee)
Phone:
(��i l ? 0� ( ) State surcharge(12%of permit fee) ?ef._a5
CCB lic.: 21 SNr"") I r AliTOTAL PERMIT FEE .*74
�� This permit application expires if a permit is not obtained within 18�0G
days after it has been accepted as complete.
Authorized sign tore .i....i * Fee methodology set by Tri-County Buildin l Industry Service Board
n
Print name: NA_k,)r `()'f(, Ate: ( c 9
C\Building\Permits\MEC_PermitApp_040113.doc -f` 440-4617T(11/02/ OM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Pere ee:
$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
Tel: 503.718.2439
Location: Inspection Date:
11175 SW 93RD AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00312
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Contractor on site sealing around line set penetration to crawl.
Violation Summary:
Inspector Contractor