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Permit
CITY OF TIGARD MECHANICAL PERMIT 11- COMMUNITY DEVELOPMENT Permit#: MEC2020-00135 T!GA R D 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 03/10/2020 Parcel: 2S110BA11700 Jurisdiction: Tigard Site address: 14248 SW 118TH CT Project: CORICA Subdivision: MEDALLION MEADOWS Lot: 10 Project Description: Adding supply and return air to new addition. Contractor: FORD FOUNDATION LLC Owner: CORICA, CRAIG&MELISSA 13810 SW 100TH AVE 14248 SW 118TH CT TIGARD, OR 97223 TIGARD, OR 97224 PHONE: 503-680-0471 PHONE: FAX: FEES Specifics: Description Date Amount Duct Work 03/10/2020 $23.32 Type of Use: SF Minimum Fee Adjustment-Mechanical 03/10/2020 $66.68 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 03/10/2020 $10.80 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow tI'e rules adopted by the Oregon Utility Notification Center. Those rules ar set forth in OAR 952-001-0010 through OAR 952-001-0090. Y u may obtain a copy of the rules or direct questions to OU calli 503.2 87 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Annl n;EIVED lop.OIl i( I 1 .1 U'.l 1 City of Tigard y 10 , /i :�,' _ r,��g-- n 13125 SW Hall Blvd.,Tigard,OR 9' R O 1 2020 y i Phone: 503.718.2439 Fax: 503.598.1960 Dan By""^` Other Permit: T 1 G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By. kris: lid See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE*SCHEDULE=USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ( 2ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT!SYSTEMS FEES* '`and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special informadon use checklist Multi-family ❑Master builder ❑Other: Description Qty. 1 Ea. i Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 / Job site address: l /2.91 s t.J /:/5 e-i Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: —7";.r�p � c+ Furnace 100,000+BTU(ducts/ - `-- 7'1 ' rr Heat pump 61.06 Suite/bldg./apt.no.: I Project name: Duet work / 23.32 / Cross street/directions to job site: ' �;� /l II_ hydronic hot waters 23. 2_/ Residential boiler(mdiato 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: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insec 33.39 d� �I Flue vent for water heater or gas TT � /'le .-•ti� mac_%(.,'�'' Ar /n� fireplace 23.32 ��, AI'��' i1A 4,ti LoA titer(pas) 23.32 / • Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chitmtey/tiner/tlue/vent 23.32 I © PRO OWNER f 0 TENANT Other: 1 23.32 Environmental exhaust and ventilation: Name: - .,/27 J ` A._- Range hood/other kitchen Address: equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone'.( ) Fax:( ) Anic)crawlspace fans 23.32 ❑ APPLICANT. ID CONTACTPERSON Other: 23.32 Business name: / ,t� a / fDt;-, i 'h%^i LZC'. ��i A- {r'E'r'�"11Ffi"Y i l�'z/ ` Fuel fMPirS1 /� �.J J 510.15 for first four;S4.0.3 for each additional Contact name: `//i4o.�7 Furnace,etc. Address: ( 3 7, S J 7 . 'c) —(7� Gas/ s pump �L�._ WalUsuspende d/unitkeater City/State/ZIP: '7., `,%-: }Z_. . 7 'Z Water heater Phone:6- ) D yr / Flax`::( / ) Fireplace E-mail: M�i)'1f, �('`"``'''' 6r J 1. G4LC i:.1f�� Barbece ue ` CONTRACTOR Clothes dryer(gas) Business name: filam' ' � ! - C.. \ �'4+'n 4, / �i" 7mi J Other: MECHANICAL PERMIT FEES* Address: 4J Subtotal City/State/ZIP: Minimum permit fee($90.00) Phone:6:5 ) 6O v(.r( ?/ Fax:( ) Plan review(25%of pis unit fee) LC- / /� � �� State surcharge( PERMIT fee) CCB Iic.: ) (/ / 0 TOTAL PERMIT FEE This permit application a if■permit b not obtained within 180 IK PPlka expires days after It by been accepted a complete. Authorized signature: • Fee methodology set by Tri-County B.lding Industry Senice Board Print name: ;i .^' Date:5//2 0 c1 j I:lnwldmg1P rmitslMEC_PetntitApp_040t 13.doc 440-4617T(1 1/o2/COM/WEB)