Permit CITY OF TIGARD MECHANICAL PERMIT
Si
COMMUNITY DEVELOPMENT Permit#: MEC2014-00265
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2014
Parcel: 1 S133DA08000
Jurisdiction: Tigard
Site address: 12660 SW SNOW BRUSH CT
Project: DEMARS Subdivision: AMART SUMMER LAKE NO.2 Lot: 140
Project Description: Gas piping for range.
Contractor: ADVANCED CONSTRUCTION& REPAIR LLC Owner: DEMARS,ANDREW W&STEPHANIE
14758 SW 79TH AVE 12660 SW SNOW BRUSH CT
TIGARD,OR 97224 TIGARD, OR 97223
PHONE: 503-841-1323 PHONE
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 06/02/2014 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 06/02/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 06/02/2014 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspe tion date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application [OR Of It 1. 1 til. 0\1.1
Received
City of Tigard �� Date/By: AA, Permit No.: b i ��
III i.
• 13125 SW Hall Blvd.,Tigard, 97223 v y '
Plan Review
Other Permit:
Phone: 503.718.2439 Fax: 503.598. Date/By:
I I c,;\R I) Inspection Line: 503.639.4175 Date Ready/By: 0 See Page 2 for
Internet: www.tigard-or.gov 0 Notified/Method: Supplemental Information
``\�
TYPE OF WORK Q► COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
t� INC 5`O� Mechanical permit fees*are based on the value of the work
❑New construction 1(�l Addition/altera��� performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: �' �`� mechanical materials,equipment,labor,overhead,and profit.
11, Value:$
CATEGORY OF COIUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
b9..1-and 2-family dwelling ❑CommerciaUindustrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating cooling:
Job site address: Z. Air conditioning 46.75
I rD�a SI/f Thvt,-/ /f i'v ih ('/. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: tad,, Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Ocer‘et.r 5 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator 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/insert 33.39 .
Flue vent for water heater or gas
1£ l // �a-1 /jP �p fireplace 23.32
(00 / /? Log lighter(gas) 23.32
IC Tom' 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: Ar'la r,f A��," 3�n Range hood/other kitchen
1 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
til APPLICANT ❑ CONTACT PERSON Other: 23.32
��� li (-r� / Fuel piping:
Business name: (OPT//tee' G*+
�� $14.15 for first four;S4.03 for each additional
Contact name: �G'L/ �l`7 / (-h-I. Furnace,etc.
v Gas heat pump
Address: / (174- `1�4 �`c Wall/suspended/unit heater
City/State/ZIP: 1- 4,11
Water heater
Phone:(50)) 7 `�:i 1(--(3 Z '3 Fax: :( ) Fireplace
Range I Pi,fs'
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
ratir Ile . Other:
Business name: l/��> * f l� MECHANICAL PERMIT FEES*
Address: / / 1t 7 I t-i/ ?1ti /91,.a Subtotal
City/State/ZIP: ! 1—). r,-.07 4/t. Minimum permit fee($90.00) ').(. )
/ Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) If .
CCB lic.: /7l 97 7 516/4., TOTAL PERMIT FEE I La). ik
This permit application expires if a permit is not obtained within 180
Authorized signature: JOr'a0 ,,/�� days after it has been accepted as complete.
a/"/Z`j t/71 • Fee methodology set by Tri County Building Industry Service Board
Print name: d� ( Date: V2 /2'(f
1:\Building\Permits C_PermitApp_0401I3.doc 440-4617T(t 1/02/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_040I 13.doc 2
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
12660 SW SNOW BRUSH CT, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00265
Jeff Grove
Standard pressure verified 10lbs 15 min
Violation Summary:
Inspector Contractor