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Permit Support Document CITY OF TIGARD /2 -) 4240 MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2020-00158 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/24/2020 Parcel: 2S111AB06400 Jurisdiction: Tigard Site address: 9280 SW VIEW TER Project: CLV Innovations Subdivision: PENROSE TERRACE Lot: 9 Project Description: Gas line to range,fireplace and BBQ. 4/17/2020: REPRINT permit to add range hood. Contractor: J& M CONTRACTOR SERVICES INC Owner: GORMAN, MEGAN L 15604 NE RUID RD 9280 SW VIEW TER AMBOY, WA 98601 TIGARD, OR 97224 PHONE: PHONE: FAX: FEES Specifics: Description Date Amount Mechanical Permit-RES 03/24/2020 $90.00 Type of Use: SF 12%State Surcharge-Mechanical 03/24/2020 $10.80 Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: .,?1 it„__ � � Permittee Signature: QR/ /�-�76/�. 77� L / �'��..YYv /1 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 'l/ This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applicatiolrt ECE V Received . City of Tigard DA1e,lly y Permit NOm E( 1Q�o a 1 3123 SW Ilan Blvd..Tigard,OR 97223 APR 1 6 2020 �� '�� _ Plan Review Phone: 303.718.2439 Fax: 503.598..1%0 Datedlly.. Other Permit Inspection Line: 503.639.4175 CITY ice 'TIGARD DateRrrd �BY TIGARD ®lice Page 2 for Internet: www,tigard-ocgov BUILDING DIVISIONNaiificdMethed: 'uppkmentat lnfurtnalion TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Much:I n:al pennt I Iles'are based on the value of the work 0 New construction ©Addition/alteration/replacement pertarmed Indicate the value(rounded to the nearest dollar)or all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead.and profit Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES` ,I-and 2-lamily dwelling ❑Commercial/industrial ❑ACCCssor). building For.rpec!ul information use eheclllsi. ❑Multi-family 0 Master builder 0 Other: Description I Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 lob site address: a`l ° J Vi,� TF�-- Furnace 1(10.000 BTU(ductsrvents) 46.75 City/State/Z1P: l`1 3a Qn i-7)`)L) Pomace 100,000+BTU lductyvcntal 54.9) t t !L !cat pump 61.06 Suite/bldg./apt.no.: Project name: hurt vrork 23.32 Cross slrectldireetions to job site: lydronir hot water system 23.32 Residential boiler(radiator or hydronicl 23.32 (Inh 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/insert 33.39 -VI /`` ll I _ Flue vent for water heater or gas rP-3 J UPiY1Tt/I -Ono_ fart ood) TCJ P h fireplace 23.32 Log lighter t 33.39 Q.X I i"iYJ ePCYh1ef1F P 0 -(0158 Woodpellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/i1ue%vent 23.32 El PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: CLV 'hooua1-ic.As Range hood/other kitchen t Address: � Slx1 equipment 33.39 t P.C+J TPA Clothes dryer exhaust 33.39 City/State2IP: Ti ota4- , 02 93 aaL-L Single-duct exhaust(bathrooms, toilet compartments.utility rooms) 23.32 Phone:( ) ` Fax:( ) Attic/crawlspacc falls 23.32 ❑ APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: Td M ,,P-f-11. C P S $11.15 for first four:S4.03 for each additional Contact name: a-..AA V C.A0 S Furnace,etc Gas heat pump Address: 35 bG , M %j+r 5) re- Wall/suspended/unit S't-` healer City/StateJZIP: Y c4i—/ LA q -15 Water heater Phone:(;3(,,p) 3.5)- Fax::( ) Fireplace A� Range E-mail: Tan /'\ a 5_, ; i e-i l r� G�n'1`r1.,L C o✓1') Barbecue CONTRACTOR Li Clothes dryer(;gas) Business name d,,v\ S V (. , - Other MECHANICAL PERMIT FEES* Address: Sam e Subtotal _ Plan Minreviimum eit fee($911.00) City/State/ZIP: ja(m a (25%of permit feel Phone:( ) 5�-iy t. - Fax:( I State surcharge(12%of permit fee) CY'B lie.: ( 8,4SQ S TOT:�1,PERNII'C FEE l( '1'hia permit application expires if a permit is not obtained within ISO ��,��1p�� days after it has been accepted as complete. Authorized signature: J��^Jv'�"_ ' fee methodology set by Tn{County Building Industry Service Board Print name BkJP f La L Date:313(/90 I i5nitmgPenn,i'rti('_Pnml Am W_ OI 13.doe J 440-1617111.02,C0M/WEB)