Permit (254) CITY OF TIGARD MECHANICAL PERMIT
111 1:." COMMUNITY DEVELOPMENT Permit#: MEC2019-00622
Date Issued: 08/22/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 133DA00600
Jurisdiction: Tigard
Site address: 11050 SW SUMMER LAKE DR
Project: WOOLDRIDGE Subdivision: AMART SUMMER LAKE Lot: 28
Project Description: (1)range hood for kitchen remodel.
Contractor: VALIANT CONSTRUCTION INC Owner: SHIELDS, BRENT
6107 SW MURRAY BLVD 243 WOOLDRIDGE, SHERI
BEAVERTON, OR 97008 11050 SW SUMMER LAKE DR
TIGARD, OR 97223
PHONE: 503-515-9613 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 08/22/2019 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 08/22/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/22/2019 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Bermittee Signature: Gam✓
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE l SE Oy1_1
City of Tigard Received
Permit No.:
III
13125 SW Hall Blvd.,Tigard,OR 97 Date/By: , ,�� ®Pr- — / J
S Phone: ` rED PlanReview
503.718.2439 Fax: 503.598 ECEIV Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Fa See Page 2 for
Internet: www.tigard-or.gov AUG Notified/Method: Supplemental Information
22 2019
TYPE OF Qiiii OF TIGARD FEE* SCHEDULE— USE CHECKLIST
Stihl: DIVISION_._ Mechanical permit fees*are based on the value of the work
❑New construction XAddition/alteration/replaceme performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-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 AND LOCATION Heating/cooling:
�� Air conditioning 46.75
Job site address: 110 5 O .(-J sL(.✓K✓�t er (/.-Gc f Bt Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -7--
1gArot OR 9723 Furnace 100,000+BTU(ducts/vents) 54.91
/ Heat pump 61.06
Suite/bldg./apt.no.: Project name:
L'Al-x tors i.�.,c 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
DESCRIPTION OF WORK Gas fireplace/insert 33.39
c1 Flue vent for water heater or gas
K I-1-ckte#1 R.e.M od e_( fireplace 23.32
f-E,�v� Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name: S h t-Joo ici r'a Range hood/other kitchen • 39
I J equipment 1 33.39r
Address:
So(s CU c.� rG Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(53) 5 y-C G0.4/6 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
j ,� J Fuel piping:
Business name: Val(an+ Cons4(C(CG±layt / .21L, $14.15 for first four;$4.03 for each additional
Contact name: Not..f-h a i4 Furnace,etc.
Address: O 7 Si---) Mu fe4 , Blvd A - 2 L/-3 Gas heat pump
T Wall/suspended/unit heater
q7090 Water herder . --'
Phone:sog) .c S_l b 12 Fax::( ) Fireplace
Range
E-mail: ria. 'I ( va.I rc,t(I`tcr t.t t7 vi . C tryvl Barbecue
CONTRACTOR Clothes dryer(gas)
. Other:name: o Ifan- Cfru� ;�yli �C
MECHANICAL PERMIT FEES*
Address: Subtotal 332,
J i
City/State/ZIP: vAAR- ets LeNi-e_ Minimum permit fee($90.00) V,.&
Plan review(25%of permit fee) ---
Phone:(
--Phone:( ) Fax:( ) o
State surcharge(12%of permit fee) /0,
CCB lic.: 1 1 3 Li Ci TOTAL PERMIT FEE it.,,,,)_
permit on iif a mit not taid win
/•Authorized signature: �)/ • FeeThis methodology setapplicatiby Tri-Counexpres typerBraidingis IndustryobServiceneBoard days after it has been accepted as complete.'
Print name: ,k% 4 9 )Q Date: S.Zt?
I:\Building\Permits\MEC PermitApp_040113.doc 440-4617T(71/02/COM/WEB)