Permit u CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2015-00440
T i G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/06/2015
Parcel: 2S111 CC09900
Jurisdiction: Tigard
Site address: 15770 SW GREENS WAY
Project: BRUMBAUGH Subdivision: SUMMERFIELD NO.2 Lot: 126
Project Description: Installing(1)exhaust fan and(1)hood fan.
Contractor: DANNYS HEATING AND COOLING INC Owner: BRUMBAUGH, NANCY
16303 NE 36TH ST 15770 SW GREENS WAY
VANCOUVER,WA 98682 TIGARD, OR 97224
PHONE: 503-914-8058 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 07/06/2015 $33.39
Type of Use: SF Single Duct Exhaust(Bathrooms,Toilet, 07/06/2015 $23.32
Class of Work: ALT Type of Const: Utility Rooms)
Occupancy Grp: Minimum Fee Adjustment-Mechanical 07/06/2015 $33.29
Stories: 12%State Surcharge-Mechanical 07/06/2015 $10.80
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 181 •• ENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are se orth in OAR 952-"" -0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 0
Issued By: Permittee Signature:
...011110-'100/'-
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit App
IVEP ,„ „ ,
City of Tigard lei ` !S-
Date/By. �j 617— Permit No.: ._-11 l 0■111
• 13125 SW Hall Blvd.,Tigard OR, 23
Phone: 503.718.2439 Fax: 503.E 4960 6 2015 Plan Re w
Date/13y: Other Permit:
I (. It I) Inspection Line: 503w .639.4175 OF Date Ready/By: M See Page 2 for
Internet: ww.tigard-or.gov ( I f 'OF AG AR]) Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE" SCHEDULE— USE CHEC'KLiST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 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 Ileating/cooling:
Job site address: 15770 SW.GFeensWay (1 -�I;S (,.,t'� Air conditioning 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: pact 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
Other: 23.32
Subdivision: Lot no.: -
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 exhaust fans,1 hood fan fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Nancy Brumbaugh Range hood/other kitchen
equipment I 33.39
Address:15770 SW Greensway Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 1 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ® CONTACT PERSON Other: _ 23.32
Business name:TL Remodel&Construction Inc
Fuel piping:
$14.15 for first four,$4.03 for each additional
Contact name:Tim Labunsky Fumacc,etc.
Address:PO Box 1996 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Lake Oswego,OR 97035 Water heater
Phone:(503)9842783 Fax::( ) Fireplace
Range
E-mail:TLRemodel @ yahoo.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Dannys Heating and Cooling Other:
MECHANICAL PERMIT FEES*
Address:16303 NE 36Th st.Vancouver WA 98682 Subtotal
City/State/ZIP:Vancouver,WA 98682 Minimum permit fee($90.00) GO
Plan review(25%of permit fee)
Phone:(503)9148058 Fax:( ) State surcharge(12%of permit fee) ja_ j
CCB lic.: 197549 TOTAL PERMIT FEE /j>j_
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 Tri-County Building Industry Service Board
Print name:Danny Zubanov I Date:7/6/15
1\Building\Permit6MEC_PermitApp_340113.doc 440-4617T(11/02/COM/WEB)
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
15770 SW GREENS WAY, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00440
David Young
Violation Summary:
Inspector Contractor