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Permit CITY OF TIGARD MECHANICAL PERMIT '.' COMMUNITY DEVELOPMENT Permit#: MEC2016-00402 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/06/2016 T i A.P. 9 Parcel: 25111 DC13900 Jurisdiction: Tigard Site address: 15805 SW OAK MEADOW LN Project: Gerson Subdivision: SUMMERFIELD NO.11 Lot: 635 Project Description: (1)vent fan for bath remodel Contractor: JBW ENTERPRISES LLC Owner: GERSON, EVELYN 14808 SE RUPERT DR 15805 SW OAK MEADOW LN MILWAUKIE, OR 97267 TIGARD, OR 97224 PHONE: 503-309-8740 PHONE: FAX: FEES Specifics: Description Date Amount Single Duct Exhaust(Bathrooms,Toilet, 06/06/2016 $23.32 Type of Use: SF Utility Rooms) Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/06/2016 $10.80 Occupancy Grp: Minimum Fee Adjustment-Mechanical 06/06/2016 $66.68 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 : ''cation : ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 -0090. Y may obt in of the rules or dir ct questions to O C b 'ng 503.232.1987 or 1.800.332.2344. Iss ed By: � Permittee Signature: X 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 FOR OFFICE USE ONLY Received / /6 j City of Tigard (� ( I tmi,n,,. Date/By:ive • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 211 = Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: loris. I ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information Vis; a'Z k* I� t', r oda:` + l COMMERCIAL FEE* SCHEDULE - USE 7' , .. s0°. ., -. $-�A..J w ,k ek .. s '':- - Mechanical permit tees*are based on the value of the work D New construction [Addition/alteration/replacement perfonned.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I S1&J E.i± '' _ ` G ipI-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building For special information use checklist. li Multi-family ❑ Master builder 11 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: s S` C uj c,:k M S � � �h� Furnace 100.000 BTU(ducts/vents) 46.75 City/State/ZIP: (:,4„..11. b y 9...1 9- Furnace 100,000+BTU(ducts/vents) 54.91 1111 Heat pump 61.06 Suite/bldg./apt.no.: f 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 Subdivision: SU .fY-CS VI4 L`k Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 j 0 Flue vent for water heater or gas 4.040.-(^ kl“-• r.GO,t,S etAL - P\ 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 lg PROPERTY OWNER 'gfi - 0 TENANT Environmental exhaust and ventilation: Name: %)•-f. rSQ h Range hood/other kitchen j equipment 33.39 Address: Sgo ©atC /� Clothes dryer exhaust 33.39 City/State/ZIP: �clard ©g �7` _).� Single-duct exhaust(bathrooms, pq( 1 toilet compartments,utility rooms) I 23.32 Phone:(1.'63) (Q q 0,, (-I U Q Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: ``..`` Fuel piping: W a*1��Cpv w .ttet �LL $14.15 for first four;$4.03 for each additional Keo t OA Contact name: I(���„ Furnace,etc. iLk`q0 3 C E R ?r D r f Gas heat pump Address: l5 J �,J Wall/suspended/unit heater City/State/ZIP: Pk('Low w fit p C•('-l_4 1 Water heater Phone:(SpX) .&A,... $l l'O r Fax: :( ) Fireplace Range E-mail: - to W. H r 0 tr tk.0 T # e jK ' WA I, Can—, Barbecue CONT' ••CTOR 't � Clothes dryer(gas) Other Business name: c ?/ -H€. it�- AIL,pv ;, } Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Phone: Plan review(25%of permit fee) ( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.:y ti'/S00 16'/151 4TOTAL PERMIT FEE PO. 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:( 14to W FI,1-.-e Date: 4/U / 1 (.,t I:,Building,Permas,MEC_PennitApp_040I13.doc 440-4617T(11,02 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. I:\Building\Permits\MEC_PermitApp_040113.doc 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15805 SW OAK MEADOW LN, TIGARD, December 6, 2017 at OR, 97224 11 :39:38 AM Record Type: Record ID: Residential - Mechanical MEC2016-00402 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor