Permit CITY OF TIGARD MECHANICAL PERMIT
n Permit#: MEC2015 00542
8 COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/10/2015
Parcel: 1 S 133AC 11600
Jurisdiction: Tigard
Site address: 10835 SW BRIARWOOD PL
Project: Sass Subdivision: HAWK'S BEARD TOWNHOMES Lot: 34
Project Description: Install a/c. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: DONS AIR CARE INC Owner: SASS,AARON D&MELISSA H NGUYEN
PO BOX 6408 14871 SW 164TH AVE
ALOHA, OR 97007 TIGARD, OR 97224
PHONE: 503-642-5844 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 08/10/2015 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/10/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/10/2015 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. •• ay,obtain a copy of the rules
or dir questions to NC by c • 3.232.1987 or 1.800.332.2344.
Is ued By: Permittee Signature: _I
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the proje
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Appli R FOR OFFICE I SE ONLI'
City of Tigard � ��� Date/By: 0 �G �� Permit{lo.:i-4 al
11
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
503.718.2439 Fax: 503.59 . Plan Review
Date/By: Other Permit:
I 1 t,A R I Inspection Line: 503.639.4175 1 2015 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY UN t'ft1ARLJ
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
i is .,
1 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
Heating/cooling:
CA ' p Air conditioning f 46.75
Job site address: f D 8 3 S d'^) l'Q,Y w� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
y � O1� 7 2.,7 Heat pump 61.06
Suite/bldg./apt.no.: I Project name: 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
Other: 23.32
Subdivision: I 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
A I • it. ` arm : / 10 ___ fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 _
Chimney/liner/flue/vent 23.32
Other: 23.32
Environmental exhaust and ventilation:
Name: S.-..-6 Z 5 Range hood/other kitchen
,Q / equipment 33.39
Address:
d 3 S r i f / t/'/iq-U b iS Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
�y nr� 7 Z.0?-2 toilet compartments,utility rooms) 23.32
Phone:( ) J Fax:( ) Attic/crawlspace fans 23.32
' Other: _ 23.32
Fuel piping:
Business name: '
�S �7 v' a Y'42 514.15 for first four;54.03 for each additional
Contact name: 7: uct Furnace,etc.
Address: [� f� Gas heat pump
(- I C < �t'°T Wall/suspended/unit heater
City/State/ZIP: q d?bk.c._ E, Q 70,P1 Water heater ,
(��) y ,— s-g�y I I ( ) Fireplace
Phone: �f Fax::
Range
E-mail: Barbecue
Clothes dryer(gas) .
Business name: cieii/ ^ , Other:
Address: �/ Subtotal
City/State/ZIP: Minimum permit fee($90.00) 0•t,0
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee) /,0.ff()
CCB lic.: 6 2./ 89' /0/3//S-- TOTAL PERMIT FEE /40, kG
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: ,tw tV .0 yl,t I Date: 3//0 5--
I:\Building\Permits\MEC_PennitApp_040113.doc 440-4617r(11/021COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil Fee Schedule:
$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.
1:1Buildingl 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
10835 SW BRIARWOOD PL, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00542
George Heimos
Electrical minor label number ELS481879
donsaircare@yahoo.com
Violation Summary:
Inspector Contractor