Permit CITY OF TIGARD MECHANICAL PERMIT
'i COMMUNITY DEVELOPMENT MECHANICAL
MEC2016-00251
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016
T r C;,4 A n g Parcel: 2S114BB12000
Jurisdiction: Tigard
Site address: 10463 SW TITAN LN
Project: MENDENHALL Subdivision: SWANSON'S GLEN NO.2 Lot: 61
Project Description: A/C installation. Placement of NC unit must comply with manufacturer's installation requirements.
Contractor: OWNER Owner: MENDENHALL, LAUREN N
LAUREN MENDENHALL 10463 SW TITAN LN
10463 SW TITAN LN TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 541-643-2249 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 04/13/2016 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 04/13/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 04/13/2016 $43.25
Occupancy Grp:
p Y P
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. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
C /
Issued By: ermittee Signature: �,���/���///
‘........e........,....6Call 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 Applitg. 9 1-oR Orel( t. 1 sI.Oy1 1
City of Tigard Received Permit No.:
`5 g Q�0 DatelBy: K , / AIL——i! .I. I
13125 SW Hall Blvd.,Tigard,OR 97223 1�J
+�i), Plan Review
Phone: 503.718.2439 Fax: 503.598.196V(� 7+x, Date/By: Other Permit:
Inspection Line: 503.639.4175 s��-�`
1 I l.ARI) ! {; , Date Ready/By: BI See Page 2 for
Internet: www.tigard-or.gov tykry". '.� \,* Notified/Method: MilSupplemental Information
It
TYPE OF W0)\)11‘'
V� '- COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
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 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 (
Job site address:10463 SW Titan Lane � -��
��
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: riirAdt,bij het,it 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
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
installing an AC 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 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Lauren Mendenhall Range hood/other kitchen
equipment 33.39
Address:10463 SW Titan Lane Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(541)643-2249 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Shrti 41S- A bdX $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
E-mail: Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: 14),v-[� MECHANICAL PERMIT FEES*
Address:
Subtotal I(p-
City/State/ZIP: Minimum permit fee($90.00) C 4v
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee) 10
CCB lic.: TOTAL PERMIT FEE 84/)
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: veel }1 1 11 Date: 1-03//6
1\Building\PermitsUMEC_PermitApp_040113 doc 440-4617T(1 1/02/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\'ermits\MEC_PermitApp_040113.doc 2
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
10463 SW TITAN LN, TIGARD, OR, 97224
Record Type:
Residential - Mechanical
Inspection Type:
699 Mechanical final
Result:
FA I L
Comments:
Provide tamper resistant access port caps. M1411.6
Insulate line set per manufacturer requirements.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 30, 2016 at
12:15:10 PM
Record ID:
MEC2016-00251
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
10463 SW TITAN LN, TIGARD, OR, 97224
Record Type:
Residential - Mechanical
Inspection Type:
699 Mechanical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
MEC2016-00251
Inspector:
Jeff Grove
Contractor