Permit INCITY OF TIGARD MECHANICAL PERMIT
' ' COMMUNITY DEVELOPMENT Permit#: MEC2022-00908
Date Issued: 10/17/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S110AD12300
Jurisdiction: Tigard
Site address: 10873 SW ANNAND HILL CT
Project: Annand Hill,Lot 2,(2 of 2)ADUs Subdivision: ANNAND HILL CT PARTITION Lot: 2
Project Description: Mechanical for upper dwelling in a new multi-family building:(1)mini split heat pump, (1)range hood,(1)clothes
dryer exhaust,and(3)bathroom exhaust fans.
Contractor: TECHNIQUE HVAC INC Owner: BLUE PALOUSE PROPERTIES LLC
10316 SE 38TH AVE 333 S STATE ST STE V452
PORTLAND, OR 97222 LAKE OSWEGO,OR 97034
PHONE: 503-407-2448 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: MF Heat Pump 10/17/2022 $61.06
Class of Work: NEW Type of Const: VB Range Hood/Other Kitchen 10/17/2022 $33.39
Occupancy Grp: R-3 Occupancy Load: Clothes Dryer Exhaust 10/17/2022 $33.39
Stories: 1 Single Duct Exhaust(Bathrooms,Toilet, 10/17/2022 $69.96
Utility Rooms)
Project Valuation: $7,000.00 Plan Review 10/17/2022 $55.28
Duct Work 10/17/2022 $23.32
Fuel Air Handlers 12%State Surcharge-Mechanical 10/17/2022 $26.53
Fuel Types: Electricity 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: 1
Appliances
Vent Fans: 3 Vent Systems: Total $302.93
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
Issued By: At....„..„ve.„ Permutes Signature:
A�4
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.
Mechanial Permit A lit. •
Tigard E I tl 1. " Received
:/v u permit No.: W21Z l/ W U
Cityof T' and 12
Illira • 13125 S W Hall Bivd.,Tigard OR 97223 rvn Review
Phone: 503.718 2439 Fax: 503.598.19�EP 2 9 2022 ma y. i 0.) )- ZZ�i Other Permit: 64144'ai' 5
Inspection Line: 503.639.4175 pate Ready/By: IJII r ® pm 2 for
Internet: www.tigard-or.gav CITY OF TIGARD Notified/Method: ��/ Supplemental lotonusuos
TYPE OF WORK / C0.1OIERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
, 'iNew construction ❑Addition/al teration/replaarnent performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit
0 Demolition ❑Other Value:S ' QC) C c'c'
CATEGORY OF CONSTRUCTION RESI0ENTLAI.EQU1P3IENT/SYSTEMS FEES*
DI-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
p'Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
I..-c T '7 JOB SITE INFORMATION AND LOCATION Heating/cooling:
!y Air conditioning 46.75
Job site address: 1�l 3 4Jd�pJ A)0 )Ji L.T.. t1=� &. ' Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 11 7,..7...LI Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 31SIE Ductwork 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
/�, �-r �� ] p p Residential boiler(radiator or
(apt,, s i1i2 t�+-s t--R'( Y - i �t�Z- 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 beater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
l Flue vent for water heater or gas
IL) I S A(...C. otki
a NJ SP L-t j n) l- r i Fta51C,.... fireplace 23.32
VO Pion t .i� . Lnia +` o' ' '' e 01 -C. L Leg lighter(gas) 23.32
Wood/pellet stove 33.39
V$i•L j r2 lt'4 In 6 or 501-4.v Gre-f r t_ Wood fireplace/insert 23.32
U �
��T- �RN , As7 6,(, c�^AO l vvotit Chimnq/liner/tue/vent 23.32
0 PROPERTY OWNER ' 78NA111 f OthEnvironmental exhaust and ventilation: 23.32
Name: Range hood/other kitchen 7
equipment / 33.39
Address: Clothes dryer exhaust 1 33.39
City/State/ZIP: Single-duct exhaust(bathrooms, 'L
toilet compartments.utility rooms) '•J 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
' Business name: 514.15 for first four;S4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) FireplaceRange
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
-�-.a t Other:
Business name:
- Ocf f.�>q ea 1-E v C .l-/�C- MECHANICAL PERMIT FEES* ill
Address: `0-2 ((P S -z> r`}k toc}if( _ Subtotal -
: 'L- Minimum permit fee(S90.00)
City/State/ZIP: K 2-t- /!4N t') ct i 2 '
Plan review(25%of permit fee)
Phone: 5Q3 Ai 07. 7.1... t4,e, Fax:( ) State surcharge(12%of permit fee)
CCBfit.: al...%4� �q"�
TOTAL PERMIT FEE
This permit application expires H a permit is not obtained within IRO
days after it has been accepted as complete.
Authorized sigpa
• Fee methodology set by Tri-County Building Industry Service Board
Print name: yi'ie,;ha fie, it xvr504.+1 Date: 4lza(27
I:IBuilding\Permits:MEC_PermitApp 040113.doc 440461Tr(I 1/02/COM/WEB)