Permit 1111 q
CITY OF TIGARD MECHANICAL PERMIT
' • COMMUNITY DEVELOPMENT Permit#: MEC2015-00356
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2015
TIGARD Parcel: 1 S125DB08700
Jurisdiction: Tigard
Site address: 7167 SW LOLA LN
Project: Subdivision: RAZBERRY PATCH,THE Lot: 7
Project Description: Install(2)mini-split heat pumps outdoors with(5)indoor heads.
Contractor: AIR-TRIX Owner: SORENSEN, RONALD B& BARBARA A
2330 SE 156TH AVE 7167 SW LOLA LN
PORTLAND, OR 97233 TIGARD, OR 97223
PHONE: 971-563-9426 PHONE: 503-475-2430
FAX:
FEES
Specifics: Description Date Amount
Heat Pump 06/09/2015 $122.12
Type of Use: SF 12%State Surcharge-Mechanical 06/09/2015 $14.65
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $136.77
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow he rules ado. -d by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. .0 may obtai• a copy of the rules
or direct questions to OUNC�by calling 503.232.1987 or 1.800.332.2344.
—.war
Issued By: ;- Permittee Signature:
.Atop��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application' CEIV EP
pp FOR OFFICE USE ONLY
City of Tigard Received .r:��
;� - • 13125 SW Hall Blvd.,Tigard,OR 97223 JUN - 9 2015 Date/By: 9 /�S �/�/� . itNo.:„, aO/✓r/0,3 .
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Other Penttiftc7 /s 19 OQa?
Inspection Line: 503.639.4175 tl�i L il� tt1 U T 1 G A R D
Date Ready/By: 3uris: VI See Page 2 for
Internet: www.tigard-or.gov G^q Ill iviSlOi Notified/Method: Supplemental Information
RITILDIN !
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction KAddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
4,1-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: -7/ 6,7 46 k (:-1 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 7 'S ,,4 - n Furnace 100,000+BTU(ducts/vents) 54.91
/ Heat pump 61.06
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
5 �„ /V_ 4-- 4°/� ('f' 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/\/1.S..4-4,_ ( I Y _ t1 S -t- fireplace 23.32
1/1 C-C ( 2 /l n U fici.o v /^ Log lighter(gas) 23.32
Wood/pellet stove 33.39
1..J _ - 6 1 v i r- N-r_,-..ck 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
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
•
- Wall/suspended/unit heater _
City/State/ZIP: Water heater _
Phone:( ) Fax::( ) Fireplace _ ,
Range _
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: -.
<r r. �` MECHANICAL PERMIT FEES*
Address: (2. 3 ?l7 & 9 /16 Subtotal 4R 2 ,4,2_
City/State/ZIP: p,,, ,, ir. O rl� 4172_ 3 3 Minimum permit fee($90.00)
Phone:67/) S6`� ,_��7 6 Fax:( )
Plan surcharge(25%1 %of permit fee)
J State surcharge(12/o of permit fee) /V,(�
CCB lic.: /r e5 4.j /Q/s/� TOTAL PERMIT FEE _ /16,77
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: -VW; �/ * Fee methodology set by Tri-County Building Industry Service Board
Print name: /1 ycr f- Date: 8 ,
I:'Building\Permits\MEC_PermitApp_040113.dos / -461 (11/02/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.
I:\Building\P ennits\MEC_PennitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7167 SW LOLA LN, TIGARD, OR, 97223 May 25, 2017 at 10:29:58 AM
Record Type: Record ID:
Residential - Mechanical MEC2015-00356
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor