Permit (56) ry CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2016-00258
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/14/2016
Parcel: 2S109DA09800
Jurisdiction: Tigard
Site address: 15288 SW OAK VALLEY TER
Project: Balakrishnan Subdivision: SUMMIT RIDGE NO.2 Lot: 87
Project Description: Extend gas line for range
Contractor: J&M CONTRACTOR SERVICES INC Owner: BALAKRISHNAN, SRIDHAR&LESLIE
15604 NE RUID RD 15288 SW OAK VALLEY TER
AMBOY,WA 98601 TIGARD, OR 97224
PHONE: PHONE: 503-227-2624
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 04/14/2016 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 04/14/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/14/2016 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance. • •• k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility lotification Cen : . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or•rect questions to OUNI b a g 503.232.1987 or 1.800.332.2344.
Is ued By: ,` :L Permittee Signature:
// /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application C Folz UI 1 1( 1 I. I.SO\l.l
City of Tigard RECEIVED Receivyd ���� �l6-Voa
Date'B I Permit No.:
alfA
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.19A1PR 14 2016Date/By: Other Permit:
I I(, \1:I) Inspection Line: 503.639.4175 Date Read B Juris:
Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
i t, B • 1
-, , ''' - ; ti.a t`, ° -' "' V t e. , +;,.., .. s value of the work
0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
'''''':.".1., -,:-..:'t'
E
Value:
alue:$
'C ....-....:.3‘.. ..,.-...i.-.tg i fqa+� 4 • i
i.-',.:- r..y. `,,,� <, . ,. . Yr � �' � '. 1gaVIp14
0 y? Y'0 ,
fl 447:'.
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
Multi-family 0 Master builder 0 Other: Description I Qty. Ea. I Total
` d( :t o rr tp) s 4' Heating/cooling:
,,. —. . ,,,,,.17.'7 . , �s � ' r �'4. "€ Air conditioning
46.75
Job site address: l C7a g5 6.U.—.) u a ( lri"ci
tFumace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 4.1C A q Furnace 100,000+BTU(ducts vents) 54.91
—1 Heat pump 61.06
Suite/bldg./apt.no.: Project name: �A LA pi.,‘&144. t31, Duct work 23.32
Cross street/directions to job site: So
mr,1 1 . R 1 CI Hydronic hot water system 23.32
�l 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
l)SCRIPTI• ON OF WORK :• Gas fireplace/insert 33.39
n Flue vent for water heater or gas
0., --zz yt et 1 A C'_ c-kr) \ t p C. / \<- fireplace 23.32
/v,` �"� 5 Log lighter(gas) 23.32
' 6d\IN Wood/pellet stove 33.39 .
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32 +
w, R Y oyei CJ,TEN ANP ;
Environmental exhaust and ventilation:
Name: L -G 11 a-- Q r 1„'� rta 1 n Range hood/other kitchen
r\ Y \ equipment 33.39
Address: -3�� `5 i 4►
. Clothes dryer exhaust 33.39
City/State/ZIP: 0\ 17T ci '1 1 Single-duct exhaust(bathrooms,
I ` toilet compartments,utility rooms) 23.32
Phone: ) a,Q--2 a( 4 Fax:( ) Attic/crawlspace fans 23.32
., ,,-, , ,,,,,I,Al c:j1-444-oit,i6r,',64,,,.74.. - 0 coNTAc'I< PERSON Other: 23.32
Fuel piping:
Business name:
$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:( ) I Fax: :( ) Fireplace
Range /1
E-mail: Barbecue
77 Ams to e, , R;' ` t Clothes dryer(gas)
Business name: a Other ,a,
Address: Subtotal
City/State/ZIP: � Minimum permit fee($90.00)
a 1 Plan review(25%of permit fee)
Phone:(5 3 /('c) —Q I 95 Fax:( )
J State surcharge(12%of permit fee)
CCB lie.: ( SS,) �G,� TOTAL PERMIT FEE LQQ.t°
CC) This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
Authorized signature: jr4p�i�_/r�'I... * Fee methodology set by Tri-County Building Industry Service Board
ril
Print name: � � . , Date: ,�,_ ,J
1:Building Permits MEC_PermitApp 040113.doc 440-417T(1I 02 COM WEB)
Mechanical Permit Application - City of Tigard
and
Page 2 - Supplemental Information
Commercial &IMulti-Family`Fee Schedule:
3't�
�l� atto>ri: ��.-��.��t 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.
1:A Building\Permits MEC_Pe7nitApp_0401 13.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
15288 SW OAK VALLEY TER, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00258
Jeff Grove
Violation Summary:
Inspector Contractor