Permit Support Document (5) CITY OF TIGARD MECHANICAL PERMIT
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NI COMMUNITY DEVELOPMENTPermit#: MEC2019-00160
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 4 ?‘ Date Issued: 03/15/2019
Tri;;�rp g Parcel: 25111 BC00400
Jurisdiction: Tigard
Site address: 14485 SW 100TH AVE
Project: UNTALAN Subdivision: TIGARDVILLE HEIGHTS Lot: 19
Project Description: GAS PIPE(1)LOCATION,OIL TO GAS FURNACE,REPLACE AIR CONDITIONER. 3/25/19:REPRINT to add(1)
gas pipe.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: UNTALAN TRUST
13150 S CLACKAMAS RIVER DR BY JOSE&CHRISTINE UNTALAN TRS
OREGON CITY, OR 97045 14485 SW 100TH AVE
TIGARD, OR 97224
PHONE: (503)557-2220 PHONE:
FAX: 503-557-0919
FEES
Specifics: Description Date Amount
Air Conditioning 03/15/2019 $46.75
Type of Use: SF Furnaces<100K BTU 03/15/2019 $46.75
Class of Work: ALT Type of Const: Flue/Vent For Any of Above 03/15/2019 $23.32
Occupancy Grp: 12%State Surcharge-Mechanical 03/15/2019 $14.02
Stories: Fuel Piping 03/25/2019 $14.15
12%State Surcharge-Mechanical 03/25/2019 $1.70
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $146.69
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 UNC b coffin,' 03.232.1987 or 1.800.332.2344.
Issued By: ^/// 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.
Methanical Permit Application
City of TigardDate/By: , 4) Pilb:
111 13125 SW Hall Blvd.,Tigard,OR 97223
MAR 2 Z019 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TI(, Inspection Line: 503.639.4175 k, Date Ready/By: Jaris. Fa See Page 2 for
Internet: www.tigard-or.gov Supplemental Information
04-411 .ai• • 111.'1Mechanical y: ic,:rtt•-•a.,:: ,414=‘;
permit fees* based on the'vlre-Oithe'Work'
0 New construction CA Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
4*.ao 4'‘.(1 'IV• stri, ty,
0 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
1:3 Multi-family 0 Master builder 0 Other Description Qty. Ea. Total
"/ Heating/cooling:
Air conditioning 46.75
Job site address:14485 SW 100th Avenue 1 Furnace 100,000 BTU(ductsivents) 46,75
City/State/ZIP:Tigard,97224 Furnace 100,000+BTU(duets/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
c, -' 4-ttift,,,,6-44114-4 Gas fireplace/insert 33.39
;4>,, ifPoi'rf ,,PRIVW.Y• t4.At "664,t
Flue vent for water heater or gas
Add fixture to existing permit#MEC2019-00160 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:PflIV ,4 ,A111,41.A/` 23.32
4 •• -1„*. tx4-AC - Environmental exhaust and ventilation;
Name:Jose lUntalan Range hood/other kitchen
equipment 33.39
Address:14485 sw 100th Avenue Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)799-2286 Fax:( ) Attic/crawlspace fans 23.32
23.32
Fuel piping:
Business name:Tri County Temp Control
$14.15 for first four;$4.03 for each additional
Contact name:Diane Mason Furnace,etc. 1 ,
Gas heat pump
Address: 13150 S Clackamas River Drive
Walt/suspended/unit heater
City/State/ZIP:Oregon City,OR 97045 Water heater
Phone:(503)231-3311 Fax::(503)557-0919 Fireplace
Range
E-mail:dmason(iefirsteallheat.com Barbecue
CONTRACTOR . Clothes dryer(gas)
Other:
Business name:Same As Applicant
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.:72626 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
t ' days after it has been accepted as complete.
Authorized signature: AI( .r...42-i1.2,,,,r77/242.07%..---" • Fee methodology set by Tri-County Building industry Service Board
Print name:Diane Mason Date:3/25/2019
1 Building Pcrinos Mt-C'_PermitApp_.04011?doc 440-46171(11 02 COM WEB)
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
14485 SW 100TH AVE, TIGARD, OR, 97224 March 27, 2019 at
11 :34:50 AM
Record Type: Record ID:
Residential - Mechanical MEC2019-00160
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Minor label #'s ELS704885, ELS706336
Violation Summary:
Inspector Contractor