Permit CITY OF TIGARD MECHANICAL PERMIT
NI
I . COMMUNITY DEVELOPMENT Permit#: MEC2014-00405
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/04/2014
Parcel: 2S 102CA00219
Jurisdiction: Tigard
Site address: 13145 SW ASH DR
Project: Sundance Investments Subdivision: VIEWCREST TERRACE Lot: 17
Project Description: Mini split ductless heat system.
Contractor: LEGACY HEATING AND COOLING Owner: SUNDANCE INVESTMENTS LLC
325 N 7TH AVE 17420 SW 110TH AVE
CORNELIUS,OR 97113 TUALATIN, OR 97062
PHONE: 503-367-4752 PHONE: 503-969-1233
FAX:
FEES
Specifics: Description Date Amount
Heat Pump 08/04/2014 $61.06
Type of Use: SF 12%State Surcharge-Mechanical 08/04/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/04/2014 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires y o follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 -009 You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1•c • :11.332.2344. 1./17/—
Issued By: 1.
Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Mechanical Permit Application �1` f� FOR OFFICE USE ONL},
City of Tigard ��� Date/By: �/�K � Permit No.: /1 � �I��00/1,_�t�
inril" 13125 SW Hall Blvd.,Tigard,OR 97 V i a=t- W
Phone: 503.718.2439 Fax: 503.598.1 +R Plan Review n
r1o1
Date/By: Other Permit: p gity . ]i.f 3
T I G A R D Inspection Line: 503.639.4175 P`\r 1. Date Ready/By: Juris r® See Page 2 for �C
Internet: www.tigard-or.gov 3 ����,�t1� �� Notified/Method: '7J Supplemental Information
TYPE OF WOIiii∎-1 �'���w�� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ,ddition/alteratiOt� tacement performed.Indicate the value(rounded to the nearest dollar)of all
ZDemolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
XI-and 2-family dwelling ❑Commercial/industrial ❑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:
Air conditioning 46.75
Job site address: 131 4-S 1-) A SIN Dr Furnace 100,000 BTU(ducts/vents) , 46.75
City/State/ZIP: T t 5 Fr('`-/ (3 2 7 7l S Furnace 100,000+BTU(ducts/vents) ,
Heat pump 0 61.06 6 i•(Xv
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
{� Residential boiler(radiator or
I J S L P‘U-e_ 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
m!1 t 1
O I S p1:'-t- 14e Pt S y S fireplace _ 23.32
buck-I�S f Log lighter(gas) 23.32
T 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: S 1A,.)eoN-4 LC._ f-1- 1 V e,3 T i‘Ae_v-S S L L L Range hood/other kitchen
equipment 33.39
• Address: 11 4-Z O S L.1 II 61-k— R Clothes dryer exhaust 33.39
City/State/ZIP: T u.P t fk1:,.J o (` Single duct exhaust(bathrooms,
p toilet compartments,utility rooms) 23.32
Phone:(g3) -t 61— ,'z 33 Fax:( ) Attic/crawlspace fans 23.32
, APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: "_ Fuel piping:
` $14.15 for first four;54.03 for each additional
v
Contact name: � Furnace,etc.
Address: Gas heat pump ç\-(Y\ Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
�y �j- Other:
Business name: Se-c,�- �(r,,ff-f111 I- ��C�U �y��T�[' MECHANICAL PERMIT FEES*
Address: 31.5_ ,! l�. Subtotal (,j,C (o
Minimum permit fee $90.00) 40 ,U
q o Ci /State/ZIP: � �G! (A S I q 711 Plan review(25%of permit fee)
Phone:c35'1) 3 2 f 23 Fax:( ) State surcharge(12%of permit fee) /p.
CCB lic.: zv t !1(.., 1131/ I(I TOTAL PERMIT FEE t/pi),80
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tr-County Building Industry Service Board
Print name: � l {t s Date: /c—/i 4_
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(1 I/02/COMJW EB)
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.
I:\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
13145 SW ASH DR, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00405
George Heimos
Violation Summary:
Inspector Contractor