Permit (2) CITY OF TIGARD MECHANICAL PERMIT
IN • COMMUNITY DEVELOPMENT MECHANICAL
MEC2020-00063
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/30/2020
TIGARf7 g Parcel: 1S134BD13200
Jurisdiction: Tigard
Site address: 12074 SW SUMMERBROOK LN
Project: Summerbrook,Lot 15 Subdivision: SUMMERBROOK SUBDIVISION Lot: 15
Project Description: Adding NC unit. Placement of NC unit must comply with manufacturers placement requirements.
Contractor: WEEKLEY HOMES Owner: WILLOW CREEK LAND LLC
1905 NW 169TH PLACE SUITE 102 PO BOX 1060
BEAVERTON, OR 97006 WOODBURN, OR 97071
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 01/30/2020 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 01/30/2020 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/30/2020 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
1
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: 5rr l/e--GC C--
1
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.
A
Mechanical Permit Application FOR OFFICE USE ONLY
1Date,By City of Tigard Received
/4
• 13125 SW Gall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 41i11�► , 2/C� U5-
DatelBy !s'/� !J`C/L L
Inspection Line. 503.639.4175 [d See Page 2 for
TIGARU Date Ready By: tuns
Internet: www tigard-or gov Notified Method:
Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
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.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: 12074 SW Summerbrook En Furnace 100,000 BTU(ductstvents) ,.F-- 46.75
City/State/ZIP:Tigard/Oft/97223 Furnace 100,000+BTU(ducts/vents) 5491
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Sum merbrook Duct work 23.32
Cross street/directions to job site:SW 121"Ave and Sun;rnerbrook Lane 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:Summerbrook Lot no.:15 Other 23.32
Other fuel appliances:
Tax map/parcel no.:TBD Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert '1 33.39
Flue vent for water heater or gas
o e m t- sq e h fireplace 23.32
� ' A /l/I / 1" ` Log lighter(gas} 3339
L /mil Ci Wood pellet stave 3339
Wood fireplace/insert 23.32
Chimney/I finer/flue/vent 23.32
® PROPERTY OWNER 0 TENANT Other. 23.32
Environmental exhaust and ventilation:
Name:David Weekley Homes Range hood/other kitchen
equipment " 33.39
Address:1905 NW 169'h Place Suite 102
Clothes dryer exhaust 33.39
City/State/ZIP:Beaverton,OR 97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) ' 23.32
Phone:(503)213-4415 Fax:( ) Attie/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 2332
Fuel piping:
Business name:David Weekley Homes
$14.15 for first four;S4.03 for each additional
Contact name:Michele Schiedler Furnace,etc. /Y'
Address:1905 NW 169th Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Beaverton/Oft/97006 Water heater II'
Phone:(503)213-4415 Fax::( ) Fireplace er
Range X
E-mail:mschiedler!adwhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:David Weekley Homes Other
;MECHANICAL:PERMIT FEES*
Address: 1905 NW 169th Place Suite 102 Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)213-4415 Fax:( ) - State surcharge(12%of permit fee)
CCB lie.:213653 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: # Fee methodology set by Tri-County Building Industry Serviee Board
((//}Print name:Ken Puttman Date: �(' '' — 'Z 2() II/I)
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