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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2016-00563 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/04/2016 Parcel: 2S 104CA07900 Site address: 13231 SW HILLSHIRE DR Jurisdiction: Tigard Project: Steinfield Project Description: Installation of gas piping for cooktop Subdivision: HILLSHIRE Lot: 79 Contractor: HOLMES INSTALLATION SERVICE 33535 NW VADIS RD Owner: STEINFELD,JEFFREY RICHARD 33535 NIUS, OR 97113 STEINFELD, VANESSA MARIE 13231 SW HILLSHIRE DR TIGARD, OR 97223 PHONE: 503-647-9320 PHONE: FAX: FEES Specifics: Description Date Amount Fuel Piping 08/04/2016 Type of Use: SF 12%State Surcharge-Mechanical $14.15 Class of Work: 08/04/2016 $10.80 ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/04/2016 $75.85 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notif on Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or• -ct questions to S, C b all g 03.232.1987 or 1.800.332.2344. Issued By: k / Permittee Signature: ` Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application /'� FOR OFFICE USE ONLY City of Tigard R E - +�I VED Received al 13125 SW Hall Blvd.,Tigard,OR 97223 �JI�..1 Date/By: gA �:� PermitNo.: ME 0/1 .a05103 s Phone: 503.718.2439 Fax: 503.598.1960 AUGPlan Review l T I G A It l� Inspection Line: 503.639.4175 G 2 016 Date/By: Other Permit: Internet: www.tigard-or.gov S Date Ready/By: auris: See Page 2 for :(}�JCITY OF�� n�� Notified/Method: Supplemental Information :: c x`.µ 7, .,A x, ./i i pEttl:a. 19.110 1 ` 1 r'1P14.1%.,,, ". ",. z r'.., „ I'°&_,`*46 !,,, ❑New construction ddition/alteration/replacement�` Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ , T GC 4 xfi 4444 e i 1 I � 1' �l SE *�i4,,,,,lit, ' T V� � irf , KJ r-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 OtherDescription I Qty. Ea. I Total ry JWr ►l ?ilt 'I1 .01 `IL1r VV '- fr Heating/cooling: Job site address: I3 Air conditioning 46.75 Tx s ���- Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: l �j 0.v ''Q 5-7� 7 -LZ Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: I Project name: Heat pump 61.06 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 Tax map/parcel no.: Other fuel appliances: Water heater e 23.32 DECRIPtION OF„wO Gas fireplace/insert 33.39 v. Flue vent for water heater or gas G� G,.. L- .t.,.3 ‘ vim) :: .6 , fireplace 23.32 cr��11� le. n� Log lighter(gas) 23.32 . 9 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 'ROPFR' OA ER r , .sI, Other: 23.32 Environmental exhaust and ventilation: Name iv �-t e 1 Range hood/other kitchen Address: 132...3 ) /A/is.L i v e equipment 33.39 J� //�� Clothes dryer exhaust 33.39 rCity/State/ZIP:' L aV EJ Q) l Z.Z Single-duct exhaust(bathrooms, t Phone: / toilet compartments,utility rooms) 23.32 3) 3 z_Q ,b Fax:( ) Attic/crawlspace fans 23.32 'at AP,PL CANT . : ". t" t1 C rt C .� ;���.;7.:- 1 1' , Other: 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax::( ) Fireplace E-mail: Range r- 7 ; r G° CtO '4.1! )1 ‘1.41 ,1111 - rx r: �,, Barbecue N. Clothes dryer(gas) Business namt(Me S /V� ( 5e/(_ Other: P. I /V./Y` Address: 3 5-2 S AAA) �/)Q,,{c,S' . . t. . x.i I' '., " r .) l ,1J Subtotal City/State/ZIP:Cb V� L� O v� 9 Minimum permit fee($90.00) ��.Q© Phone:( c.O. 1)-.b 7, 7s-7tf Fax:( ) Plan review(25%of permit fee) -- State surcharge(12%of permit fee) 4D,gt� CCB lie.: o -73 TOTAL PERMIT FEE /p. $d � �'x/"✓ 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: J c. (� e S Date: R t/ ) ,, 1:\Building\Permits\MEC_Pennil(App_040113.doc"''J (444-4617T I I/022/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family 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_PennitApp_040113.doc 2