Permit CITY OF TIGARD MECHANICAL PERMIT
= COMMUNITY DEVELOPMENT Permit#: MEC2014-00193
T f G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2014
Parcel: 2S 1138000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Replacing 30 ft.of gas piping.
Contractor: LYNCH MECHANICAL CONSTRUCTION LLC Owner: CLEAN WATER SERVICES
19305 SW TETON AVE 2550 SW HILLSBORO HWY
TUALATIN, OR 97062 HILLSBORO,OR 97123
PHONE: 503-545-6466 PHONE:
FAX: 503-218-1120
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/01/2014 $145.81
Class of Work: ALT Type of Const: Plan Review 05/01/2014 $36.45
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 05/01/2014 $17.50
Stories: Info Process/Archiving-Sm$0.50(up to 05/01/2014 $2.00
11x17)
Project Valuation: $2,989.00
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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $201.76
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 Other Desc:
Duct Work:
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 are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questio• to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B : / 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 Application FOR OFFICE USE ONLY
Received
City of Tigard Permit No
nip 13125 SW Hall Blvd.,Tigard,OR 97223
Date/By: I ∎6 i-/ , 1f "'"' •/ - • (q
Phone: 503.718.2439 Fax: 503.598.19�i01 EtE1VFD DateBy1 EI E�
Other Permit:
Inspection Line: 503.639.4175
T I G A R D Date R :
y: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov i'20-'R 2 8 2014 Notified/Method: /jo/(� / r V.' Supplemental Information
, 1 +I_ F mil( ��
TYPE OF WO �Y Ur I iblAHO ` COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
�� �/ Mechanical permit fees*are based on the value of the work
❑New construction Addition/altera performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:• ?��-1 `i, y
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address:J�aS0 Si„...) Tu Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 7-10„ p ) Cr Z7---ii Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: -r� Project name:
Heat pump 61.06
<��4 �/1/U ��rdCFlM�- � Duct work 23.32
Cross street/directions to job site:(1 , <T .4124,4„,16,16,_ go., Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
� in-wall,in-duct,sus pended,etc. 46.75
Flue/vent for any of above 23.32 Subdivision: ✓� Other. 23.32
Other fuel appliances:
Tax map/parcel no.: �� Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas p fireplace 23.32
-'�� At�• �(`� � ��. �!�1�i�� Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39 _
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32 _
Phone:( ) Fax:( ) Attic/crawlspace fans _ 23.32 _
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: -
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( )
Fireplace
Range _
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
•
Other:
Business name:(..Yo-cAl I v Vt-sui_iv,A[sue
MECHANICAL PERMIT FEES*
Address: )3i'2)Uc- 51....) -1? T t/,J— AVE: . Subtotal
City/State/ZIP:�+ t �A TI•N �� �� /-----/ Minimum permit fee($90.00)
Phone:(S-C 3 ) Fax: ) )��) Plan review(25%of permit fee)
SYfc (4(, V �3 z_/ State surcharge(12%of permit fee)
CCB lic.16lfll(,i ,/NI,s,--- 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: l �� * Fee methodology set by Tri-County Building Industry Service Board
Print name: rL/l s G TG ti1iZ li Date:.2.-/-Z5--Al -
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/2/COM WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\Building\Permits\MEC_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16580 SW 85TH AVE, TIGARD, OR, 97224
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
May 2, 2014 at 8:15:46 AM
MEC2014-00193
Chip Barnett
Gas line 80# for 30 minutes
Violation Summary:
Inspector Contractor