Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00727
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2019
Parcel: 1S125DD08300
Jurisdiction: Tigard
Site address: 6925 SW BARBARA LN
Project: Davis Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 91
Project Description: Venting for range hood and duct work.
Contractor: GARDEN HOME INTERIORS Owner: DAVIS, TYLER B&AUTUMN E
8409 SW 57TH AVE 6925 SW BARBARA LN
PORTLAND, OR 97219 TIGARD, OR 97223
PHONE: 503-780-4010 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 10/14/2019 $23.32
Type of Use: SF Range Hood/Other Kitchen 10/14/2019 $33.39
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/14/2019 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 10/14/2019 $33.29
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center, Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: Permittee Signature: - �r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY 1
F �7 Received
City of Tigard
Permit No.: _
III
" 13125 SW Hall Blvd.,Tigard,OR 97223N403 Date/By:
/0 �j�f�j i � _ 11120 dyj�
_ Plan Review
Phone: 503.718.2439 Fax: 503.598 1Other Permit: /1.5 7 se-2
Date/By: / 7$ [.�L�r/_co
T I G A R D Inspection Line: 503.639.4175 0N9 Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov OG\ + 4 Notified/Method: -..-7.7 _,, Supplemental Information
�� ` k! �kn Y— cOMMEIRCIA1 LEE* SCIF�D
IULE UNE CIIECKI IST
�+ Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alter �v m nt performed.Indicate the value(rounded to the nearest dollar)of all
ElDemolition ❑Other: as mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF-C°1*** ,,,,g,,,4, RESIDENTIAL EQUIPMENT/Sl'S7 EDIS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
IIP °y�� ;;' €'SITE INF() IIT`LOGAATI T
Heating/cooling:
n� d - u Edi„ ,�-- ,,:_. sem. , . ' 7i..,:6 0,ro Air conditioning 46.75
Job site address:6925 SW Barbara Lane Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,Oregon 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work ( 23.32 ;-7 3)‘
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.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK IOyNoAliib Gas fireplace/insert 33.39
Flue vent for water heater or gas
Install vent for down draft for cooktop and move two HVAC dudts 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: 23.32
- ® PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name:Autumn and Tyler Davis Range hood/other kitchen
equipment I 33.39 33 31
Address:6925 SW Barbara Lane Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,Oregon 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax: ( ) Attic/crawlspace fans 23.32
® APPLicANT ❑ cONTA T PERSON „,
Other: 23.32
Fuel piping:
• Business name:Garden Home Interiors
514.15 for first four;$4.03 for each additional
Contact name: Bill Fletcher Furnace,etc.
Address:8409 SW 57th Ave. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland,Oregon 97219 Water heater
Phone:(503-)780-4010 Fax: :(503)292-6660 Fireplace
Range
L-mail:ghibill a hotmail.com Barbecue
CONT'RA(1'OI2 Clothes dryer(gas)
Business name:Garden Hoime Interiors Other:
.,
MECHANICAL PERMIT FEES* ,
Address:8409 SW 57th Ave. Subtotal
City/State/ZIP:Portland,Oregon 97219 Minimum permit fee($90.00) . etc)uJ
Plan review(25%of permit fee)
Phone:(503)780-4010 Fax:(503)292-6660 State surcharge(12%of permit fee) LU -g71
CCB lie.:162912 TOTAL PERMIT FEE j ) F(f
This permit application expires if a permit is not obtained within 180
t.
f� days after it has been accepted as complete.
Authorized signature:
Print name:Bill Fletcher ` ,// * Fee methodology set by Tri-County Building Industry Service Board
Date: 10-14-2019
1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)