Permit (189) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
.111 4Permit#: MEC2018-00945
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2018
T t t A R.t� g Parcel: 2S103BB10700
Jurisdiction: Tigard
Site address: 12110 SW 123RD CT
Project: Lee Subdivision: YE-OLDE WINDMILL Lot: 27
Project Description: Moving gas range and hood vent for kitchen remodel.
Contractor: SUPREME COMFORT HEATING Owner: LEE, MARTIN L&CAROL A LEE TRUS
9425 SW COMMERCE CIRCLE#16 12110 SW 123RD CT
WILSONVILLE, OR 97070 TIGARD,OR 97223
PHONE: 503-682-1985
PHONE: 503-590-7341
FAX: 503-682-1018
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 12/06/2018 $33.39
Type of Use: SF Fuel Piping 12/06/2018 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 12/06/2018 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 12/06/2018 $42.46
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 95 :1 -0.•i You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
A.
Issued By: �� r,,,sA. ./-... �� Permittee Signature: $ •�-
1�
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 , oject.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application . .. , FOR OFFICE USE ONLY
City of Tigard Received
Date/By: ,,,,.. illifirilliarEMMENIT° --MI
13125 SW Hall Blvd.,Tigard,OR 97223 ' F, '1)15 Plan Review
:1111 I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 ' pate Ready/By: Juris: EZI See Page 2 for
Internet: www.tigard-or.gov ', 'Notified/Method: Supplemental Information
TYPE qp worm COMMERCIAUIFEE* SCHEDULE,-. USE cniadikr
Mechanical permit fees*are based on the value of the work
0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
11 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
'CATEGORY OF C*TRUC*10* 1:' := ''.5., ' REsipg:sTIAL EQUIPMENT/SYSTEMS TEES*
A1-and 2-family dwelling 0 Commercial/industrial D Accessory building For special information use checklist.
0 Multi-family P Master builder 0 Other: Description Qty. Ea. Total
__•r_..'" • ...—• _.P...' ..tt'•• ' Heating/cooling:
JOB SITE Irq'ORMATIOr4,AND WOTIOI,t, :"''''
-' Air conditioning 46.75
Job site address: 12110 SW 123rd Ct. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRTFION 0GAIC,...4 A ,, 1.:::4),4<" Gas fireplace/insert 33.39
Flue vent for water heater or gas
Kitchen remodel fireplace 23.32
Log lighter(gas) 23.32
M b\re 6, A-5 P-A-A(je i— kAvoN UQ-nl-- Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
.0:#1445PERtie"NER '''' '' ' ''''r''''','-"' 1:3 TENANT Other:';"1. 7Environmental exhaust and ventilation:
Name: Martin and Carol Lee Range hood/other kitchen
equipment X 33.39
Address: 12110 SW 123rd Ct. Clothes dryer exhaust 33.39
City/State/ZIP: Tigard, OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 503) 590-7341 Fax:( ) Attic/crawlspace fans 23.32
PLIC ',,,,, i....: I V I,, i •c'T*RSON Other: 23.32
Fuel piping:
Business name: Douq Ziebart Construction, Inc. $14.15 for first four;$4.03 for each additional
Contact name: PO Box 80402 Doug Ziebart Furnace,etc.
Gas heat pump
Address: Portland., OR 97280 Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( 503) 307-4114 Fax: :( 503) 245-5433 Fireplace
)f••
E-mail: zbart3@comcast.net Barbecue ,
Clothes dryer(gas)
Other:
Business name:
Supreme Comfort Heating & Air Conditioning ,,, . MECHANICA'''
Address: 9425 SW Commerce Circle #16 Subtotal
City/State/ZIP: W i lsonville, OR 97070 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 503) 682-1985 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 2189 2co TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: 64-) * Fee methodology set by Tri-County Building Industry Service Board
Print name: Douglas G. Lie rt, Pres. Date: 12/3/18
I:\Budding\Permits\MEC_PermitApp_040113 doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: �' rmit Fee:
44'$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_PemiitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12110 SW 123RD CT, TIGARD, OR, 97223 January 17, 2019 at
9:58:43 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00945
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor