Permit r �r CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2015-00630
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/15/2015
Parcel: 1S134BD07011
Jurisdiction: Tigard
Site address: 11490 SW SPRINGWOOD DR
Project: Smith Subdivision: ENGLEWOOD NO.3 Lot: 200
Project Description: Mechanical work for addition:duct work,range hood,dryer exhaust,(2)exhaust fans for utility and bath room,and
gas line for range.
Contractor: G L HEINTZ HEATING &COOLING Owner: SMITH, DAVID A
20871 SW 216TH PLACE 11490 SW SPRINGWOOD DR
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 503-625-6798 PHONE: 503-734-0899
FAX:
FEES
Specifics: Description Date Amount
Duct Work 09/15/2015 $23.32
Type of Use: SF Range Hood/Other Kitchen 09/15/2015 $33.39
Class of Work: ALT Type of Const: Clothes Dryer Exhaust 09/15/2015 $33.39
Occupancy Grp: Single Duct Exhaust(Bathrooms,Toilet, 09/15/2015 $46.64
Stories: Utility Rooms)
Fuel Piping 09/15/2015 $14.15
12%State Surcharge-Mechanical 09/15/2015 $18.11
Fuel
Fuel Types:
Gas Pressure:
Total $169.00
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ` ,/.941� Permittee Signature: _. ,s
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application RECEIVE I FOR OFFICE USE ONLY
City of Tigard DaC01Vy: 9 s /5 J. emit No
Date/By: /tlire020/5�Jo430
III 2 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 S E P 15 2015 015 Date/By: Other Perm` ..57- 04S(0042
FIG A R I> Inspection Line: 503.639.4175 Date Ready/By: Juris: HI See Page 2 for
Internet: www.tigard-or.gov CITY OF I i(>,A1tU Notified/Method: T/6--- Supplemental Information
Mechanical permit fees*are based on the value of the work
❑New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
-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:
Air conditioning 46.75
Job site address: Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ` (51.K Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: S"./( 77f Duct work 4 2332
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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPT ON OF WORK Gas fireplace/insert 33.39
�� i -ew � — Flue vent for water heater or gas
�� fireplace 23.32
(3} C 1 ,' /life 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: —C/ti/ 777' Range hood/other kitchen
/ equipment it 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) . 4.-. 23.32 _
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
Other: 23.32
Fuel piping:
Business name: ;fi M`A ' Ci 00 '`_Ai $14.15 for first four;$4.03 for each additional
Contact name: --311-re `(/ti Furnace,etc.
Address: i " 0, IU Gas heat pump
i f /� yd Wall/suspended/unit heater
City/State/ZIP: h eff�d oe �j-7 / Water heater
(5-b3) •3/ JIT 5� 2 3 "1 ( ) [ Fireplace
Phone: Fax:
Range
E-mail: Barbecue
Clothes dryer(gas)
ii,"( 64 Cy. _/ /!'U 6) I ,A�, Other
Business name:_ f/( 7_( �/ly
Address: 4 Subtotal
City/State/ZIP: e`, 0/'A 97 //d Minimum permit fee($90.00)
Phone:(53 _3/� % v(Fax:( ) _ Plan review(25%of permit fee)
State surcharge(12/o of permit fee)
CCB lic.: / V J, i - TOTAL PERMIT FEE 49,01
` '1. This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
• Fee metho
Authorized signature: • �� — methodology set by Tri-County Building Industry Service Board
Print name: `iSIf— Date:421msr
1:\Building\PermitsUMEC_PermitApp_040113.doc 440-46177(1 I/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil Fee Schedule:
r,�
$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
11490 SW SPRINGWOOD DR, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00630
David Young
Violation Summary:
Inspector Contractor