Permit CITY OF TIGARD MECHANICAL PERMIT
11/111 s COMMUNITY DEVELOPMENT Permit#: MEC2014-00184
T I G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/23/2014
Parcel: 1 S134DC09100
Jurisdiction: Tigard
Site address: 11454 SW TWIN PARK PL
Project: Amundson Subdivision: TIGARD PARK Lot: 7
Project Description: Replacing(1)range hood/microwave combo.
Contractor: STEIN CONSTRUCTION Owner: AMUNDSON, GERRAD& KELLY
5705 NE BOULDER CREEK RD 11454 SW TWIN PARK PL
CAMAS,WA 98607 TIGARD, OR 97223
PHONE: 503-735-5826 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 04/23/2014 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 04/23/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/23/2014 $56.61
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 may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: rmittee Signature: _ 1 J� 2 '
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.
04/23/2014 14:C7 NIP (TA)t}3666354900 P.002/004
Mechanical Permit Application , '',, '' , 11 1 I .11 ' , ,t
City of Tigard � w 6�1ed
13125 SW Ilan Blvd._Tienrd.OR 9 Zi � ® `� ��`selBy: .. OtherPamut
Phone: 503.7182439 Pax: 503.598.1 �/ 1� `3—
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Ia:ennot: .vrw.tiaoad or.�ov nndem�rsemoo: newcomer Iarot-mapoa
TYPE OF WORldi`V(-',`,� COMMLKC.IAL FEE- SCHEDULE — USE CHECKLIST
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❑1.Teav oono4'.+e4ea� Jldelikiea/atlbsnk:a�+N�, est! polonium.tiiw, ui We value;tWUUL L W We QpUeaL UUIHU)UI all
rl 1JeM011tlOn n tither' a r_ mechanleal mortals,equipoult,labor,ovemeae,ana prom.
v ue.
CATEGORY OF CONSTRUCTION RESIDENTIAL AL EQU1TMEN''/SYSTEMS FEES.
i and a fanaay d..ollmE El Comaao.v:a)r d .trio! ❑.1owa�.7-bvs11.11.6 rvr apecrw u IJurmwtun rte CI leaf
Multi-family U Master builder U Other. Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heat'ae coonatE:
Job site address: 1 14 S 4 5 t.J T W n Poch. el Air conditioning _ 46.75
City/State/ZIP: T0 -0 l d R. 17.113 Furnace 100,000 BTU(ducts/vents) , 4635
e..;,o/l.urly/opt ..n rhni..M o.....•• ol,,.,,,,.. So VI
•utnace Iw,wuH-is ru(ttucasrveats) 34.91
...aVJi.OLL....VULL....UUL.0 tV JuU alai.
Heat pump 61.06
"rum WWII 1.3S2
ilcdmnie belt luster curt0.00 11 21
Residential boiler(radiator or
D LJ:•;u:uu. I Lan nu.. 1.%•dYe�'4) =_an
Unit heaters(fuel-type,not electric),
Taw uauy/Isw wl tmV.. W-wall,to-UUta,tuspcutlal,cu:. 4o./7 - —
tmeicturttom of WORK Flue/vent for any of above 23.32
_
Q.re ct orG bocci M/ icvQvdovit COw)7O
Other. 23.32
Other fuel appliaaees:
Water heater 2'1 32
go (3as fireplace/msert 33.39
rnvrra-I I vni.r.IC Cl ielvnlrI Flue vent for water heater or gas
lvame: (�C aCrta 1Mu t r' �`°"�'°' sa.a1
A 50
Aaaress: }1 t.'5 L1 51n/ Tvvi Y1 fA,cn- P1 Lug Ia 2Lwt(get) 23.72
city/Stare/c.Ir: 1 1.5 Aro(, Ct 9 7 J�3 Wood/pellet stove 3339
Phone:( ) Fax ( ) Wood fireplace/insert 23.32
IX1 APPLICANT ❑ COINTACI rutwr ChimleY/lmer/Hnelveot 2332
Du c,,o uauac. .3}':C i v\ cogr tt c 1 Y 1 i-e-l r
wutnt4Ilaulc. �4e3 i11 C Rnler _
L7t>rl Faviraalnew�Mt Prbawtt and ventilation! IlliNj5:31
Arldrecq- _ C-'1/1C ._ .tG Qn..J r r-,-..AI f..I !,"L laid. Atherk'a en, ,ter
City/cwtc/Zrr: C G vm s w A. 4.6 t'ic�7 4 'b . _
1 .,,� .a .,.. -,
room:l JO Z 1 7Z3- b 2S_2(i rax::( ) ..
F-rratil 5�Zi n C OIrJ S �r�n 10 -�vvl r:f• Cp wt toile[compartments utility rooms) 2332
r ANTR A rillit Affiderawlen.anA fans 77'1')
`
Business name: 54/e,,, to,/.51-tvt e-a-C'UI^ I i_C Oa..., _ 23a2
A ddrecc• S 105 N& to0c.r c Iv e 14 P..01... Foe'doing:
iry/atare/w.tr: , LayT S Wf# `llsl,V / SldlS for tlratferr__Sd036remrltsddbtGtnal
a
rtlone:( 503 ) 7)55-0 r.1.(Q Nax:( ) Purnao','to.
1 Q 1 CM. l7m l.rat pump
GGD ltu.. r 1
Wallis lspendea/unfr heater
Authorized signature T
6tib*1n1 1 i33.3cl
w!wh t,,r.,7 cee : /9.
w►lW P
04/23/2014 14:5Q PnP (//003606354302 P.003/004
Fireplace
Range
Barbecue
Clothes dryer(gas)
Other:
IV.I:Ge.aeuv...ew rr.nr azi rasas^
Subtotal )3.1s
ns.�......Y,......IL..(m,o.00) 10•oO
Plan review(25%of permit fee) U.53
Slate surcharge(t L'90 or permit ree) ' i u.10
TOTAL PERMIT FEE 1%I q4,30
This permit application expires if a permit is not obtained within 180
day,after it Awl berm areewpt d as ra.oplwfw
Fee methodology set by Tri-County Building Industry Service Board
\)
AAf71f]A1A 1A•C7DnD $A1ADAR9CAIAI DAA1IAAA
Fax Cover Sheet
Pages (tint in—eqiirling Inver sheet). "4
To: City of Tigard Dv:41d121z Dort
503 598 1960
Attn: Brandon
From: Stein Construction
DI-I: sO2 72S sQ34
Note-- Draudon. this i5 the inct Zia kal ucrinit auulicatiuii 11 iat w c
discussed earlier today. It needs to be attached to the master
permit MST2O13-00250
Thanks
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11454 SW TWIN PARK PL, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
May 13, 2014 at 11:39:10 AM
MEC2014-00184
Jeff Grove
Violation Summary:
Inspector Contractor