Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2019-00219
T i LI A i;1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 * Date Issued: 04/05/2019
I,., Parcel: 2S102DB01900
7 Jurisdiction: Tigard
Site address: 13245 SW BURNHAM CT
Project: Lewis Subdivision: BURNHAM PARK Lot: 13,PT 8
Project Description: A/C and Ductwork. 7/1/19:REPRINT to add(1)gas line for new stove.
Contractor: LAKESIDE HEATING&COOLING Owner: LEWIS, EVAN W&KAREN E
PO BOX 327 13245 SW BURNHAM CT
LAKE OSWEGO, OR 97034 TIGARD, OR 97223
PHONE: 503-635-5253 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 04/05/2019 $46.75
Type of Use: SF Duct Work 04/05/2019 $23.32
Class of Work: ADD Type of Const: Range Hood/Other Kitchen 04/05/2019 $33.39
Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 04/05/2019 $23.32
Stories: Utility Rooms)
12%State Surcharge-Mechanical 04/05/2019 $15.21
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $141.99
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: ermittee Signature.
sc G �e/����
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 lint 01 1 R 1,t t° (Po N
Cis of T4 - igard RECEIVED Plan ce 7 7 //_ Pc /}f J
x 13125 SW Hall Blvd.,Tigard,OR 9722
Phone: 503.7182439 Fax: 503.598.1960 A other Permit:
1 i Inspection Line: 503.639.4175 JUN 2 '7 2019 ��Date/By:
edy/By: ,w;,; ® Page 2 for
Internet: www.tigand-01%80* Notified/Method: Supplemental Information
CITY OF TIGARD
MeChanical permit fees*are based on the value the work
New construction (4 Additionfalterationlre)lactanent performed.Indicate the value(mtmded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
0 Demolition ❑Other:
Value:
Mi
Farspedal ir�onnatdoruse chectiisr.[41-and 2-family dwelling 0 Commercial/industrial 0 Accessorybuildin
Qty. 1 Ea. Total
❑Multi-family 0 Master builder 0 Other: Description
-WC ' li' f� iiii litN, , Heating/cooling:
r tt Air conditioning 46.75
Job site address;
t•3.�(43l..� Bur yt t16 m C4 Furnace 100,000 BTU(ducts/vents) . 46.75
City/StateIZIP: ---q S al 0 ?) Furnace 100,000+BTU(ducts/venta) 54.91
CEJ Heat pump 61.06_
Suite/bldg/apt.no.: I Project name: 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: yl f A�✓h
r, l Lot no.: /3 Other: 23.32
Other fuel appliances: _
Tax rnapiparcel no.: '�5 �'7r jy -Water heater 23.32
bl i! 0'744 ,,,,,,,z7,1447614 T Dlt,:, J Hu '' Gas fireplacelinsest 33.39
�� _ '` Flue vent for water heater or gas
4 Iv1PJ Dns V rno i, ec yteast)taei e9,•kr ri4 a tie. .�A t.,e5 fireplace 23.32
a _ Log lighter(gas) 23.32
Nan scd r7 1 At-i s% 1 Mir`'f"%a 4 oil k(a?.Dl -rio,919. Wood/pelletstove 33.39
1,3n0 i a 2re: ea/' Aro llC al A-k.s Alb Ctires 24- op., Wood fireplace/insert 23.32
t�Dv 4111
ra, {d ASS
Chimney/liner/flue/vent 23.32
k .,, o n� Other: 23.32
PROIPERTX,D'W 'jlil I ''. 11° r ' Environmental exhaust and ventilation:
Name: �� P> 15
Range hood/other kitchen
equipment 33.39
Address: )3.944 6 c(..x) 3 ico f et Ianrel. 1414
Clothes dryer exhaust 33.39
City/State/ZIP: '�--� r o q--)2, Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Fax ( ) Attic/crawlspace fans 23.32 .
? ' l�IICNNCN11'111400i. . Other 23.32
Fuel piping:
Business name: 1ST Pinrs4-r-0,4 i 0"..- _
Contact name: rn� f $14.15 for first four;S4.03 for each additional
ghtP�(nil ��1,�dr'"t Furnace,etc.
Address: i 5 24 0 S l to 4,, D trGas heat pump
Wall/suspended/unit heater
City/State": Jo,k�tM�° r (i_ 9-14)15
-1p 15_ water heater
Phone:(5t�3)1.4 5 j.. q q9/ Fax::( ) Fireplace
yb Range
E-mail cut ro el 1 1 1 ..Wm- Barbecue
.,. T " . Clothes
s dryer(gas)l}, 4 O - . b Other.name: Ld ke accje, Ape 4,t r,r P gt,��
, ���'; :r 1;1'1V1 CHANICALPEPOT B *, '„. ,a- �i Pm4,
Address: P 3 fl Subtotal
City/State/ZIP: L >4L p t /7
p-P Minimum permit fes($90.00)
Plan review(25%of permit fee)
Phone:(50,2) 3'5 eg2s3Fax:
( State surcharge(12%of permit fee)
CCB lic.: ® TOTAL PERMIT FEE
This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: �- * P.O methodology set by Tri-County Building Industry Service Board
Print1181210t A✓Un t JD a^ Date: 62-.97-/ 1
I:lBuIIding\Permits\MEC PermitApp 040113.doc 440-4617r(11/02/COM/WEB)
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13245 SW BURNHAM CT, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00219
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13245 SW BURNHAM CT, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00219
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Gas range not installed at this time.
Bath fan to be on timer or de- humidistat. M1507.4
Violation Summary:
Inspector Contractor