Permit IL CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2020-00655
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/8/2020
TIGARD Parcel: 2S112AD00301
Jurisdiction: Tigard
Site address: 14610 SW SEQUOIA PKWY
Project: John Barleycorns Subdivision: BONITA GARDENS Lot: 4
Project Description: Replace grease fan,same curb like for like,same model
Contractor: HVAC INC Owner: STEMLYCORNS LLC
5188 SE INTERNATIONAL WAY BY SMETS, JOHN E
MILWAUKIE, OR 97222 PO BOX 560
AURORA, OR 97002
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/06/2020 $182.65
Class of Work: ALT Type of Const: Plan Review 10/06/2020 $45.66
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/06/2020 $21.92
Stories: Info Process/Archiving-Sm$0.50(up to 10/06/2020 $2.50
11x17)
Project Valuation: $4,160.00
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>= 100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $252.73
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: � `
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application . _y`B
City of Tigard ! y Received/0 O/ O O CV r
g RecDateive: VW'�� Permit No.: �Z Z l�,/�
III u 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 S E P 2 4 2020 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: kris: Ed See Page 2 for
Internet: www.tigard-or.gov CITY OF'TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
Mechanical permit fees*arc based on the value of the work
❑New construction J Addition/alteratioe lacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overh d,andoofit.
\i Value:$ LI ' V , 0�1
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT)SYSTEMS FEES*
❑ 1-and 2-family dwelling ,W Commerciallindustrial 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:
kJ t„ < ��„ 'C p Y)W P Air conditioning 46.75
Job site address: v t> > , Furnace ace 100,000
000 BTU(ducts/vents) 46.75
City/State/DP: 1; CA R. t C\ _3 I Furnace 100,000+BTU(ducts/vents) 54.91
t '^ R y p' Heat pump 61.06
Suite/bldg./apt.no.: Project namej G v y 1 t'i W' t D V� Duct work 23.32
Cross street/directions t�b site: l Hydronic hot water system 23.32
IBPA
Residential boiler(radiator or
*✓ `S 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 Gas fireplace/insert 33.39
cfn� r (� C p r Flue vent for water heater or gas
�4• t� r '�I VI 1 ,)C�IA't' LA't IJ fireplace 23.32
�, . - 1 Log lighter(gas) 23.32
ko 1 P; 4�✓t
L S�vt� ., ece
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIl': Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
21 APPLICANT M CONTACT PERSON Other: 23.32
Business name: 1„1\il A j C,/ Fuel piping:
$14.15 for first four;S4A3 for each additional
Contact name: _ $ p d v1 Furnace,etc.
SF' �Y• 1 p telr l �1 Gas heat pump
Address: ��/ 1 r I �C �
tY i,`_l 11 W DAAA�' (An�„ Wall/suspended/uniterea heater
Ci /StateJZIP: ` , , / •�- Water heater
Phone:(03) L{W? .l g�� Fax::0)3) t.4 1:12,-- bccT Fireplace
' Range
E-mail: .it `j C\1 n V of s (.4 Y w
p t Ca \ Barbecue
!! CONTRACTOR Clothes dryer(gas)
Business name: 1--1V 'f � Other:
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee(S90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 5 0 7.°\n TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: nn t j� • Fee methodology set by Tri-County Building Industry Service Board
Print name 0 Date: "t Iw ,a n}-0
I:1BuildingWemsio\MEC_Pmr tApp_a4a113.doc 4444617E(II COM/WEB)