Permit (52) CITY OF TIGARD MECHANICAL PERMIT
�111 g.'' COMMUNITY DEVELOPMENT Permit#: MEC2019 00462
Date Issued: 07/03/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104CC03000
Jurisdiction: Tigard
Site address: 13999 SW HILLSHIRE DR
Project: Aube Subdivision: HILLSHIRE ESTATES NO.2 Lot: 136
Project Description: Addin NC unit. Placement of A/C unit must comply withh manufacturers requirements.
Contractor: K S HEATING&AIR CONDITIONING INC Owner: AUBE, GREGORY R&KAREN H
14925 BAKER CREEK RD 13999 SW HILLSHIRE DR
MCMINNVILLE, OR 97128 TIGARD, OR 97223
PHONE: 503-602-8283 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 07/03/2019 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 07/03/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 07/03/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if ork is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you yIlow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1.l,.VO' You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r
Issued B y, .„..„e...,: Pernilftee Si nature: k
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application r i, ,,,, FOR OFFICE I. OyLv
City g of Tigard Received
,
13125 SW Hall Blvd.,Tigard,OR 97223 I j E, y 41 Date/By:
t)t-'L "--,' t-t.,I Plan Review111111 /� f�I -�._
Il Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: _
T 1 G A R D Inspection Line: 503.639.4175 Ry ,;s ate Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov . .. ., ptified/Method: Supplemental Information
GOMMERCL!►L,FEE* SCHEDULE-USE CHECKLIST
'''''',:_%--
, ._ --- _z_a.. - „-.,'----. E - n t
-- ' � " Mechanical permit fees*are based on the value of the work
❑New construction IN Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF C01115TRUCTION RESIDENTIAL EQUIPMENT/SYSTEM FEES*
III -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
t , O Heating/cooling:
d STIE INFOIiMATI1rA1Vl1 ) CAN
t" Air conditioning I 46.75
Job site address: I Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: L 39 19_ <sv(' fA 1 l l H ( 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
T , {4 D N,.OF t t Gas fireplace/insert 33.39
h. ' " x . -�, , - Flue vent for water heater or gas
fireplace 23.32
///\ (C,.
ne-DfD .-Ci\- Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0 PROPERTY OwNtitxXi fl .:t .=ANTxi' Environmental exhaust and ventilation:
Name: l� : G V Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
C APPI AN)i': . CON'ACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/Statex Wates heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CON TRACTOR Clothes dryer(gas)
Business name: ,S --;,^- 1 Hilf Other: MECHANICA,i.PERMIT FEES ,..
Address: 1 �"/c„2s . "`-
Subtotal
City/State/ZIPP �7 /IA(/I�lit' ,' 97/,J,8 Minimum permit fee($90.00)
�1, �„.3 Plan review(25%of permit fee)
Phone: ) /Vp( ����j`--'�' Fax:( ) State surcharge(12%of permit fee)
CCB lit..: / � ` I /
TOTAL PERMIT FEE
Tr �✓ i;'j. This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: i gig- 114164i * Fee methodology set by Tri-County Building Industry Service Board
Print name: (,' Date:—C—3 / '
\ \ \ME
I:BuildingPermitsC_PermitApp_040113.doc 440-4617T(11/02//CCOM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee r ,
$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:
13999 SW HILLSHIRE DR, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00462
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
No answer at door, no one home 3:38 pm
Provide access for inspections.
Violation Summary:
Inspector Contractor