Permit (52) CITY OF TIGARD MECHANICAL PERMIT
11111 11. COMMUNITY DEVELOPMENT Permit#: MEC2019-00413
T l AR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/19/2019
Parcel: 2S110CB08400
Jurisdiction: Tigard
Site address: 12467 SW ST ANDREWS LN
Project: McDonald Subdivision: MOUNTAIN VIEW ESTATES Lot: 9
Project Description: Installing(1)approx.45'gas line for fire pit.
Contractor: NATURAL GAS CUSTOM PIPING INC Owner: MCDONALD, MIKEL S
1014 NE 177TH AVE 12467 SW ST ANDREWS LN
PORTLAND, OR 97230 TIGARD, OR 97224
•
PHONE: 503-319-6557 PHONE: 503-758-8695
FAX: 503-335-9950
FEES
Specifics: Description Date Amount
Fuel Piping 06/19/2019 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 06/19/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 06/19/2019 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
411
Issued By: Permittee Signatur =
Call 503.639.4175 by 7:00 a.m.for the next available i ,pection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic o rr FOR OFFICEUSE ONLY
City of Tigard R uEIVED Received k� t^ Permit
' al 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: C S �(\�� ��- (�j
Phone: 503.718.2439 Fax: 503.598JIM 1 9 2019 Plan Review
Date/By: Other Permit:
I I(i\R I) Inspection Line: 503.639.4175 Date Ready/By: 3u is: BI See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
r` n t rrs r: t,ti,at t :i�'+ at azy a m � (w
Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit.
VII:malue:$
:. .. ..,...::„ - ..,. ....,,,. cz :;exam....,,. E, ...., ..."_ :. _'` '?„_' i1tF.,M 11 ]t','.!Im i „, a e
.'4 i
Xi-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
ti I Sr a , ! t Heating/cooling:
.. 24' }a ...,e i i ,... < ..y=46 �\'..,..!a .,:" �i Air conditioning 46.75
Job site address: i, 7 "w)V V` .
1 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: `1 1u cx c ✓I�2� Furnace 100,000+BTU(ducts/vents) 54.91
v l 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
ellf� `A) ��! i� (� Residential boiler(radiator or
t'V �ZE f k/m� lC,A U4- ``'` I ZZ' '� hydronic) 23.32
�11�]� `' r� ) I Unit heaters(fuel-type,not electric),
k1v ' YY V I C,/A/ ST s - in-wall,in-duct,suspended,etc. 46.75
S-) ,,l'�6>�-^Ac \ 1 \ Flue/vent for any of above 23.32
"'N' s :J l�V Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
4 i fl I R ' I 11 E re a ! =i= Gas fireplace/insert 33.39
t` � pm
e ue vent for water heater or gas
F1'.1' � /� e j"� fireplace 23.32
1-15, T , ' y Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
# ' r .' x flier: 23.32
i y O
LI:. �- _. _. . ,, _ 'm
�A -- -� Environmental exhaust and ventilation:
Name: I i\,1[ 4, ��Q��1/ �A f b/�, Range hood/other kitchen
\�W// l'"�t 1�4J�� "b equipment 33.39
Address: \'DA 5\A C23 - �N Clothes dryer exhaust 33.39
City/State/ZIPr��1/> I OQ IP 2 (.A Single-duct exhaust(bathrooms,
toilet Phone ( 4 Y / L ) �� i Attic/craw space fans utility rooms) 23.32
r ms23.32
€ 4 Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
. , it .. i iii. .z . . a.: s. 'a> Clothes dryer(gas)
Business name: �t• U(p bit„ i) I�� c ci,,1\� Other a .}. k
Address: 10(y i` t, Subtotal
City/State/ZIP: �Efl , cv 2 Minimum permit fee($90.00)
Phone:50 311 . 1) , Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.: 12503�/ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatture:: A * Fee methodology set by Tri-County Building Industry Service Board
Print name: 1kkt IV>tk glk Date:
_lft i m-T
I:\Building\Permits\MEC PerndtApp_040113.doc 440-46171'(11/02/COM/WEB)
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12467 SW ST ANDREWS LN, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Mechanical MEC2019-00413
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Keyed shut off at fire pit.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12467 SW ST ANDREWS LN, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Mechanical MEC2019-00413
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Keyed shut off at fire pit.
Violation Summary:
Inspector Contractor