Permit CITY OF TIGARD MECHANICAL PERMIT
.1111111
COMMUNITY DEVELOPMENT Permit#: MEC2019-00660
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/16/2019
Parcel: 2S 103C D04401
Jurisdiction: Tigard
Site address: 11675 SW TERRACE TRAILS DR
Project: SIEG Subdivision: TERRACE TRAILS Lot: PT 16, F
Project Description: (1)gas fireplace insert with a flue vent and gas piping.
Contractor: OWNER Owner: SIEG, GARY&JULIE A
GARY&JULIE SIEG 11675 SW TERRACE TRAILS
11675 SW TERRACE TRAILS DR TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-310-3614 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 09/16/2019 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 09/16/2019 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: Fuel Piping 09/16/2019 $14.15
Stories: 12%State Surcharge-Mechanical 09/16/2019 $10.80
Minimum Fee Adjustment-Mechanical 09/16/2019 $19.14
Fuel
Fuel Types: Natural Gas
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:
all 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.
f
Mechanical Permit Application i of o1r1( 1 t S Oyi.1
Received _
1114City of Tigard Date/By: L Permit No.:
■ 13125 SW Hall Blvd.,Tigard,OR 97223 . Wil '> �� ' �`
• Plan Review
" p Phone: 503.7182439 Fax: 503.598.190 - Date/By: OtherPennit:
t 1,‘,t rt 11 InspectionLine: 503.639.4175 Date Ready/By: H See Page 2 for
Internet: www.tigard-or.govNotified/Method: FM. Supplemental Information
,. '4y r ',7,"•-;, :;'--we 2p ...A: , .r .vat s e,. 9 r i� $,," 4 1 4' s# i i,
s ....r,7''''I'''''"-''''''''''''-77 ..... _ v.. Mechanical permit fees are based on_ _ "
, * the value of the work
❑New construction ® Addition/alter'a nt/4'ep18CCinent performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,andprofit.
Value:$
f
Y 1, r ; �_ . ,5 w Wt Lt
V
Eg 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. I Total
.. ,"':-..,:;1,-..4.,0 .",-if - .,;*':, 0: 4 ...,.. ; err Heating/cooling:
Air conditioning 46.75
Job site address:11675 SW Terrace Trails Dr 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.: I Project name:
Duct work 23.32
Cross street/directions to job site: 115th Hydronichot 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 forany of above 23.32
Subdivision: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
w ±�^ � �� Gas fireplace/insert 1 33.39 33.39
_� ,. ..-. - Flue vent for water heater or gas
Installation of free standing gas fireplace stove fireplace 1 23.32 23.32
Installation of flue vent Log lighter(gas) 23.32
•
Wood/pellet stove 33.39
Installation of gas fuel piping Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
..4 -' 'i-,.,,,� ,.. s ,U .. N`� � " -4-:n1",:',"- -. Other: 23.32
.n W 4, Environmental exhaust and ventilation:
Name:Gary and Julie Sieg Range hood/otherkitchen
equipment 33.39
Address:11675 SW Terrace Trails Dr
Clothes dryer exhaust 33.39
City/State/ZIP: Tigard,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)939-2036 Fax:( ) Attic/crawlspace fans 23.32
� i F t fm' y t Other: 23.32
, ,.
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Julie Sieg Furnace,etc.
Gas heat pump
Address:11675 SW Terrace Trails Dr
Wall/suspended/unit heater
_ .� _
,_...._w.: _ ...�.�__ -- _._...�- Waferheater -- _ -
Phone:(503)310-3614 I Fax::( ) Fireplace 1 iff 4.03
Range
E-mail:jgsieg@msn.com Barbecue
r
4 f y. � w ";
' , � Clothes dryer(gas)
Business name: (' v.-4„,t Other:
b t„i.-.:c h i a# S H "1 k. L p
Address: Subtotal ....J.1-1-rte i6.,
City/State/ZIP: Minimum permit fee($90.00) t''
Plan review(25%of permit fee) ,.2- 79"----.
Phone:( ) Fax:( ) State surcharge(12%ofpemritfee) _L3-34--1';::"iyj
CCB lie.: TOTAL PERMIT FEE ..,. r2 ?'t<(Gcf,Jy
This permit application expires if a permit is not obtained within 180
.o-A) after it has been accepted as complete.
Authorized signature: plit-A 1'/O'.23!1 * Fee methodology set by Tri-County Building Industry Service Board
Print name:Julie Sieg Date:9/16/2019/
I:wilding\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application-City of Tigard
Page 2'-Supplemental Information
Commercial & MultiFamily Fee Schedule:
"44A'
r
{F µ 6 E11Cy
$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:\Buik1ing\ mmils\MEC_PamitApp 040113.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11675 SW TERRACE TRAILS DR, TIGARD,
OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00660
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Installation appears ok per manufacturer installation instructions.
Violation Summary:
Inspector Contractor