Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
IIII
COMMUNITY DEVELOPMENT ,r Permit#: MEC2020-00041
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 //A' Date Issued: 01/20/2020
T I(-' - g �Y/�L Parcel: 2S110BB04700
/Is�� Jurisdiction: Tigard
Site address: 12329 SW CHANDLER DR
Project: Susan Chao Subdivision: ARLINGTON RIDGE Lot: 24
Project Description: Gas line to range. 2/26/20:REPRINT to add(1)range hood.
Contractor: J &M CONTRACTOR SERVICES INC Owner: CHAO, SUSAN
15604 NE RUID RD 12329 SW CHANDLER DR
AMBOY, WA 98601 TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: SF Range Hood/Other Kitchen 01/20/2020 $33.39
Class of Work: ADD Type of Const: Fuel Piping 01/20/2020 $14.15
Occupancy Grp: Occupancy Load: Minimum Fee Adjustment-Mechanical 01/20/2020 $42.46
Stories: 12%State Surcharge-Mechanical 01/20/2020 $10.80
Project Valuation: $0.00
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 0
Heat Pump: 0
Appliances
Vent Fans: Vent Systems: Total $100.80
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 0
Fire/Smoke Dampers:
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 a set forth in AR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by callin 03. 987 on-1. .332.234 .
Issued B
y:AIf Permittee Signature: ! /` �
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.
City of Tigard Received
Permit No.:
:1.f ' 13125 SW Hall Blvd.,Tigard.OR 9 ,� ni 1)am93): ( ,�� -
111 rem KC%ew
Phone: 503 71$2439 Fax 503 59R 1 1 'f r...=L: Otter Permit
. IOnic.td)t I U:Ah I t Inspection line 503 639.4175 Dale ReaderB lam. Ed see 1'a e 2 for _..
inlerhet, tau l%tigard-or.gov FEB 13 2020 Notilied•\letliod: Supplemental Information
kith ,°7 COMMERCIAL FC 8 ® t k , ,..... �.,.., s
Mechanical permit fees*are based on the value of the work
❑ New construction IN Addition/ajteration/replacement performed, Indicate tlw value(rounded to the nearest dollar)of ail
❑ Demo litinn her; mechanical mutertals.equipment.labor,overhead,and profit.
CATO st�y s+ h RE C"t1OiM Value $
A't"b
ftE;SiDEtouI;F.CjE11PhEEpl t'l- ssx`
I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building - For special informauan use theekAsr-
❑Multi-fnnilq ❑ Muster builder ❑ Other: Description Qty. Ea. Total
ifeatia cook
.108 S111E wi FOR •R AND LOCATION
"g'
oh site address Air conditioning 46.75
Furnace 100,000I3TU(ductieicoi-.1 r, 46.75
City/State/LIP: Trnn rel ("'2 9 7 g)-(-j FumaCe 100,000+B U idwaan ern t 54.9 i
/ f / Heat pump 61 06
Suite/bldg/apt.no: Project name: Duct work 23.32
Cross street/directions to job site: I lydronic hot water system 13 32
Residential boiler(radiator or
hydronie) 23,32
Unit heaters(fuel-type.not electric).
in-yc Il,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23,32
Subdivision: Other. 23,32
I of too.;
Other fuel appliances:
Tat map/parcel no.: Water heater 23,32
t` 3 `
,'_� � ')'ORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Tr addi-1-.Z.0/1 1"6 `/"yyham —Yi.44 ° aaS )t 1 v - r ( firepl:iee 23.32
J L.oal(gfttet(fip ) 23,32,
'cant- ,LItue( tAJr i i lris.h.4-1G,,l,, edit) Woodpelhtstove 33.39
e1 C.:k4 t .. "�'e[' 6 tI it.) f f• Wood tircplace/inscn 32
Chimney/liner/flue!,en: 23-32
0 0ther: 1 23.32
s 7 ❑ TENANT
Name: jf�5 (s`• ✓ RanEnvironmentaleIoer exhaust and ventilation:
Range Ixxidtother kitchen
Address: r"y [� t I i 33.39
of 3 D -4 31A) C• (-r - f.Clothes dryer exhaust 33.39
City/State/ZIP: 1T n •� Single-duct exhaust(bathrooms.
115c��C'�/ �1 ! �(� toilet compartments,utility rooms) 23,32
Phone:( ) Fax:( I Auic/crawlspace tans. 23.32
NI ; as - , 4` l Other 23-a2, , ;a
Business donne �} Fuel piping:
�� ''"to U ties SI4.1.5for first four;$4,O3 for each additional
Contact name: '3 p/j ...i iC s -------- Furnace.etc;
Address: c iJ"t d J t Gas heat pump
t y1 �� 1'v Ave, Wall/suspender/unit heater
City/State/ZIP: rQt t - J 65 1 S Water heater
Phone:(33CO) 43 "5(/o c Fax: :( ) Fireplace
[`-mail; ( Range
1 t_ _f 110 C {i„ , . ' 41 Barbecue
coy l('i Oit Clothes dryer(gas)
Business naive:- f P.- It, Other
Address: am e Subtotal
City/State/Z1P: „A-V)`yp Minimum permit tee($90d10)
Plan review(25%of permit fee)
Phone,( ) Fax:(- 1 State surcharge(12%of permit fee)
CCf3 tic.; I8e, . s TOTAL PERMIT FEE
- ---- lids permit application expires if a permit is not obtained within IN
days after it has been accepted as complete.
Authorized signature; y hoe lnethadalo set In-County att Building industry S<r ee Board
.q;.L _ n by y 4 ry
Print name'-Af'jC'e t' -2vrtct Date: 21 i
I'naddn tiPeraues'MtC_PernrApp 04001 t.doc 4440461 Ti i l 1 02 Ceu g/WEBI