Permit (43) CITY OF TIGARD MECHANICAL PERMIT
I. ' COMMUNITY DEVELOPMENT Permit#: MEC2019 00163
TfGA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/19/2019
Parcel: 1 S 125DB00400
Jurisdiction: Tigard
Site address: 9305 SW 70TH AVE
Project: HIPPLER Subdivision: SHADY DELL Lot: 4
Project Description: Furnace replacement.
Contractor: VAN AIR&CONTROLS LLC Owner: HIPPLER, JARED P
13327 S GLENN DR GEMMET,TAYLOR R
MULINO, OR 97042 9305 SW 70TH AVE
TIGARD, OR 97223
PHONE: 503-632-5991 PHONE:
FAX: 503-632-8672
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 03/19/2019 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 03/19/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/19/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fo .the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- . You may obtain a c hof the rules
or direct questions to OUNC by calling 503.232.1987 20733272344.
Issued By: / ' _P`erml tures --- 7,- Z
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE LSE ON El
'I Received 3
City of Tigard �`��S Date/By: �L �; — Permit No.: �c _ 1
13125 SW Hall Blvd.,Tigard,OR 97223 �✓ 1 -
? • rO3 an Review Other Permit:
III 5 Phone: 503.718.2439 Fax: 503.598.1960 ` Date/By:
T I G A tt D Inspection Line: 503.639.4175 PR s ate Ready/By: WI See Page 2 for
Internet: www.tigard-or.gov M \GP• , •'fied/Method: Supplemental Information
L��� NGo,�>,_ • COMMERCIAL FEE* SCHEDULE - USE. CHECKLIST
TYPE OF WORK U�„v
Mechanical permit fees*are based on the value of the work
❑New construction jgAddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION liESIDENIDU,EQUIPMENT/SYSTEMS FEES"'
Ir1-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 AM) LOCATION Heating/cooling:
// �1 Air conditioning 46.75
Job site address: Q f 2.5 �J�v- y -. Furnace 100,000 BTU(ducts/vents) / 46.75 ti‘,,7_,;City/State/ZIP: / -5. Furnace 100,000+BTU(ducts/vents) 54.91
�`��� �I
`�� r Heat pump 61.06
Suite/bldg./apt.no.: Project name: �—
�0/'e 17/!7/ 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.: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
h },. :, "DE,SCRIPTI OF"'W#11j1IC Gas fireplace/insert 33.39
"`" Flue vent for water heater or gas
5 - „l - ,�— fireplace 23.32
, s " Log lighter(gas) . 23.32
''J'r`j �i' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
"'t PROPERTY OWNER 0 TENANT Other: 23.32
•, -- -�". _- -.--,." Environmental exhaust and ventilation:
Name:
V /..(1„.,� /v 7/, /c,� Range hood/other kitchen
equipment 33.39
Address: yyG� 5'" c�•aC/ Clothes dryer exhaust 33.39
L1/ Single-duct exhaust(bathrooms,City/State/ZII: Cyyy 9lgdy
toilet compartments,utility rooms) 23.32
Phone:(0_9) RX,,,. Sr.., Fax:( ) Attic/crawlspace fans 23.32
4'14
rl 'e:::14/...NP 0 cot Ac ; R$OIV Other: 23.32
Business name: /f Fuel piping:
/L�� 1,4",,.,
�/�1%Lf/"li/ $14.15 for first four;$4.03 for each additional
Contact name: p9�9 a 1/y zj� Furnace,etc.
��` �j i„,30e. Gas heat pump
Address: ,�yy (,,,
/J., /may. Wall/suspended/unit heater
City/State/ZIP: ,,,,, ' ex ,9,4'Z Water heater
Phone: 9) Q' 3 (5 Fax: :( 5) /7� Fireplace
�'' !' / ' !y Range
E-mail: �,/�,4�//�liV,l`Gier11Bj97�,/l i' - d Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: )/1 �y
�/�� r
Other:
(.9
L rem ''„' MECHANICAL PERMIT' FEES*
Address: ./..,j,77..."--• i��.„.4_, f� Subtotal 14, -7
City/State/ZIP: �+ // Minimum permit fee($90.00) Id....;10
/ �/ ��o- 4�` p7,92_ Plan review(25%of permit fee) —
Phone:5 ) /9 4 L'f Fax:(��%j) /y x3.472 State surcharge(12%of permit fee) A) ,
CCB lio,:/,,``ii77�/�17y' / ✓ TOTAL PERMIT FEE t!i2r)-rsi
// This permit application expires if a permit is not obt ined within 180
days after it has been accepted as complete.
Authorized signature: A.,...,......
* Fee methodology set by Tri-County Building Industry Service Board
Print name: ,i�p,,r�4e`#......00,9"7e," Date /9/!�'
I:\Building\Permits\ME`CC 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: 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\Permits\MEC_PermitApp_040113.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9305 SW 70TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00163
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
No minor label posted in panel or at equipment for furnace electrical re connect.
No electrical permit on file for furnace re connect.
Provide city of Tigard electrical permit for furnace re connect, permit and inspection
required prior to mechanical final inspection.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9305 SW 70TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00163
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Minor label ELS 709901
Violation Summary:
Inspector Contractor