Permit (146) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00673
Tf ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2019
Parcel: 1 S 134C B01800
Jurisdiction: Tigard
Site address: 12130 SW SUMMER ST
Project: Lamb Subdivision: SUMMER HILLS PARK Lot: 21
Project Description: NC installation. Placement of NC unit must comply with manufacturer's installation requirements.
Contractor: OWNER Owner: LAMB, RICHARD PIERCE
RICHARD&JAN NA MAE LAMB BOREN, JANNA MAE MARTIN
12130 SW SUMMER ST 12130 SW SUMMER ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 541-840-5537 PHONE: 541-840-5537
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 09/19/2019 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 09/19/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/19/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You m- o.t. n a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
{
Issued By: Permittee Signature: r
.01
Call 503.639.4175 by 7:00 a.m.for the next availabl in .ection date.
This permit card shall be kept in a conspicuous place on the job, • until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONE) ,
City of Tigard Received
g Date/B : Permit No.:
II "I 13125 SW Hall Blvd.,Tigard,OR 9722 E E 1V E Plan Review
D y 1 iii 1
_
Phone: 503.718.2439 Fax: 503.598.19Date/By: Other Permit: a ca)i r_
TIGARD Inspection Line: 503.639.4175 SEP y ( 20 1 g Date Read/B Lffir
Internet: www.ti and-or. ov i I y y' See Page 2 for
g g Notified/Method: Supplementallnformation
,ITY OF TIGARD
...- ' TYPF of wcpatiLDING pIVIStU coMl�lz+cInl<.'FEE •:;`a D =.� UsE, 0c-I.isT
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATE ORY OF,CONSTRUCTION Value:$
Value: ,.
RESIDE1 TIAL EQ I4IENI4I`SYSTEMS FEES*
1-514-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
'" Heating/cooling:
J4;E3.'rSITE INF RMA ry N AND ?CATION'.
~ . ~ "` Air conditioning I 46.75 ' 7S
Job site address: �1 3 5� Ky Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1` Gi,ir�l 0i�. 4 Il "7 3 Furnace 100,000+BTU(ducts/vents) 54.91
+` _` /(� Heat pump 61.06
Suite/bldg./apt.no.: Project name: �l/ul') Duct work 23.32
Cross street/directions to job si 5 �yt,44w S.1- -.b 1'2,1 54 S , 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: `� /y/7/6 P,A,//' Lot no.: 2' Other: 23.32
Other fuel appliances:
Tax map/parcel no.: 1 t ( 3 Li D I 5 ) Water heater 23.32
.DES O WORK .r, Gas fireplace/insert 33.39
1j Flue vent for water heater or gas
ifial�/4 ' /J l Glcfj-p bit'7177 .fsj, /aia_.1 fireplace 23.32
a�fki' �. este Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
' Chimney/liner/flue/vent 23.32
Other: 23.32
... ' L ''OPERTY �►VNER F~~._' U. ,I,E1V
�:' Environmental exhaust and ventilation:
Name: �-,v,t/ i,�I 6 Range hood/other kitchen
y,� equipment 33.39
Address: /Z// .50 ,5-4/ ,...5L„,.1 avv. L Clothes dryer exhaust 33.39
City/State/ZIP: 7-liafri t) , 97Z z 3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(510 ) 5.5-3-7 Fax:( ) Attic/crawlspace fans 23.32
7FI.IC .7` 3 co PE' 'N Y Other: 23.32
Fuel piping:Business name: '4-0L 60(Wygk-YZ_
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
r ,,City/State1ZIP,. _ _ .: iaterheater
Phone:(LTR' ) go --5-5--7 Fax::( ) Fireplace
Range
Barbecue
E-mail: ONrIG! 'M.oQ hfJh+'/iC�J �Plf
M
r 604
r ..Q1 '''' Clothes dryer(gas)
Business name: /V o Other: PXc%/75/vv? cf//ruP
„, w,r 4., 11
Address: Subtotal 4i .7 5-
City/State/ZIP: Minimum permit fee($90.00) 4t0„`
41
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee) ,V,TV
CCB lic.: TOTAL PERMIT FEE Lit!'Ft)
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ems` * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,/ f Z6y1_J Date:7// /f
I:\Building\Permits1 MEC_PermitApp_040113.doc 440-4 171(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
To l Valuation: :rmit Fee'
$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\Pernvts\MEC_PermitApp_040113.doc 2
44 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00673
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439Date Issued: 09/19/2019
TIGARD
Parcel: 1S134CB01800
PMr ' Jurisdiction: Tigard
Site address: 12130 SW SUMMER ST
Project: Lamb Subdivision: SUMMER HILLS PARK Lot: 21
Project Description: NC installation. Placement of NC unit must comply with manufacturer's installation requirements. 10/7/19:
REPRINTED permit to include(1)bathroom exhaust fan and fuel piping for meter relocation.
Contractor: OWNER Owner: LAMB,RICHARD PIERCE
RICHARD&JANNA MAE LAMB BOREN, JANNA MAE MARTIN
12130 SW SUMMER ST 12130 SW SUMMER ST
TIGARD,OR 97223 TIGARD, OR 97223
PHONE: 541-840-5537
PHONE: 541-840-5537
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 09/19/2019 $46.75
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 09/19/2019 $23.32
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: Fuel Piping 09/19/2019 $14.15
Stories: Minimum Fee Adjustment-Mechanical 09/19/2019 $5.78
12%State Surcharge-Mechanical 09/19/2019 $10.80
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.19; • :#1.332.2344.
Issued By: Permittee Signature:
,/e'er v�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard ,E IN/ED Date/B : a Permit No.:illi Ill _ _
Cy f.� ..a, - 2.
13125 SW Halt Blvd.,Tigard,OR 9722 Plan Review
Phone: 503.718.2439 Fax: 503.598.19 Other Permit: t_
n Date/By: S
T 1 G A R D Inspection Line: 503.639.4175 cC 27 1 Date Ready/By: in
0 See Page 2 for
Internet: www.tigard-or.gov JCP LO 3 Notified/Method: Supplemental Information
I;ITY OF TIGARD
_ SIMMER I'Ai.'1E`EE , 61•E.. t3I x:„sE.
__ `�'YP]E OF wc�1'i�i)ItVG i�tVJGN. .. co
-.__--_ � ...__ OCI-45T:.:
Mechanical permit fees*are based on the value of the work
0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other: .-' 4.I,,`:;h fh+
e' g . mechanical materials,equipment,labor,overhead,and profit.
�,;r Value:$
CATEGORY OF QONSTRU I . '
J RESIDENTIAL EQiJIPMEN 1f ISYSTEMS FEES*
5.1-and 2-family dwelling ❑ Commercial/industrial i i ccessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE JI ORMAT QN AND WCATIOTY Heating/cooling:
( Air conditioning I 46.75 k�.7S
Job site address: 1 2.13 0 5,A) S K rH 4404/ S 7'- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 11-34v4 toe_ Q-i i 1 3 Furnace 100,000+BTU(ducts/vents) 54.91
L- t Heat pump 61.06
- L
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job sit£ 0.4,411,144J4/ S•i- -0. I'Z-j s+ S 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: ,5 rn i f/,,/l!�- /6,4 Kt Lot no.: 2' Other: 23.32
�' Other fuel appliances:
Tax map/parcel no.: I t ( ..."6/-t 14:1.50-0 Water heater 23.32
.4".1/4V. :(' .'"--° . DES I O_ WQRK ::. � Gas fireplace/insert 33.39
- Flue vent for water heater or gas
_al %/;/7 Askr b/'//lflG "Lia.. fireplace 23.32
/_r / i-Irdie Log lighter(gas) 23.32
/ r( r/
tWood/pellet stove 33.39
rd/7 l`l .
/)1_4-J s L, -4..4 . r,,.- , a Nil Wood fireplace/insert 23.32
�/ Chimney/liner/flue/vent 23.32
?.� d(Jl{nr - -4.-/? -►r i. J,.•�7Ce-. ��/„r i Other: 23.32
*, C o' 'OIr hRT'.t NER y, ... . . TEN pL+-c.
• Environmental exhaust and ventilation:
Name: ti:4r/i/211 /i/49 /4/16 ,g! Range hood/other kitchen
l equipment 33.39
Address:
7/ .j(7 ‘.574,2„,/ ,541./.17~ c51- Clothes dryer exhaust 33.39
City/State/ZIP: ! i.-4 6� 7 7Z 7 3 Single-duct exhaust(bathrooms,
Gr toilet compartments,utility rooms) j 23.32 )-3)-„
Phone:(51// ) p4 6)5-_5-3-7 Fax:( ) Attic/crawlspace fans 23.32
m "F iCAN " ,. ;K.ta< fl CO!T PERR9N ", '; Other: 23.32
Fuel piping:
Business name: (.� o(,t:.� }2
514.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
Ci LS1alr.ZJP: .. .. • Wateffteeter
Fireplace
Phone:(C i ) ,fl,u0 --SS 21-7 Fax: : ( )
Range
E-mail: ioyin ! .*& ,bere,C"J frielr • Ll�t Barbecue
lCQN rC`I QRS 'c
Clothes dryer gas)
Business name:
Other: e74O',an ci/ix. 1 (. a S
/lip/ire der Iry .MEcscals
Address: Subtotal 46/.7 5'"
Minimum permit fee($90.00) ctt,..c
City/State/ZIP: Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
.0 Sv
CCB lie.: TOTAL PERMIT FEE iof...?-6
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: i / • Fee methodology set by Tri-County Building Industry Service Board
Print name: f /./ LIZ 6 Dater/if9 /f
IaBuildin¢1Permits\MEC PermitApp 040113.dac 440-4 I7T(tl/02/COMAVEBI