Permit 111 CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT MECHANICAL
MEC2022-00903
Date Issued: 10/17/2022
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AD12200
Jurisdiction: Tigard
Site address: 10891 SW ANNAND HILL CT
Project: Annand Hill Partition,Lot 1,(2 of 2)ADUs Subdivision: ANNAND HILL CT PARTITION Lot: 1
Project Description: Mechanical for lower 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 Duct Work 10/17/2022 $23.32
Occupancy Grp: R-3 Occupancy Load: Range Hood/Other Kitchen 10/17/2022 $33.39
Stories: Clothes Dryer Exhaust 10/17/2022 $33.39
Project Valuation: $7,000.00 Single Duct Exhaust(Bathrooms,Toilet, 10/17/2022 $69.96
Utility Rooms)
Plan Review 10/17/2022 $55.28
Fuel Alr Handlers Info Process/Archiving-Lg$2.00 (over 10/17/2022 $4.00
Fuel Types: Electricity Units<10000 cfm: 11x17)
Gas Pressure: Units>10000 cfm: Info Process/Archiving-Sm$0.50(up to 10/17/2022 $2.50
11x17)
Furnaces Boilers&Compressors 12%State Surcharge-Mechanical 10/17/2022 $26.53
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: 2 Vent Systems: Total $309.43
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: Permittee Signature: " P ���r - _ '
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. P %�
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 Annlicati (�� FOR OFF ICL 1.`E ()NIL}
City of Tigard v 1®p� �< DaeCNCdBy: l0 b3 2022 "f PermitNo.:MeC 7f)�. 03
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: -v�
+ Phone: 503.718.2439 Fax; 503.598.1960 SEP 29 2022 Date/By: )p- ) 2Z �i-iA i1"r-293U"
t i_ \F,D Inspection torte: 503.639.4175 v Date Ready/By: Jurs: ® See Page 2 for
Internet: www.tigard-or.gov CITY 1 OF YIUMIiIJ Notified/Method: /// iir ) Supplemental taformaaon
BUILDING DIVISION, is i2pt�f COMMERCIAL TEE*SCHEDULE-USE CHECKLIST
TYPE OF WORK v4e C '
Mechanical permit fees'"are based on the value of the work
,Q:fNew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other. mechanical materials,equipment,labor,overhead,and profit.
Value:5 -700 Q
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMSFEES*
al. 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
Heating/cooling:
I�O- 1 JOB SITE INFORMATION AND LOCATION Air conditioning 46.75
lob site address: 10139 , 4,EINA A)Q ).'LL. r>R Lki2 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 117...7--L4 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump t 61.06
Suite/bldg./apt.no.: Project name: 3 Uj a. V at-c)i..ts g--- Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 2332
r Residential boiler(radiator or
( -T. lR .^r_ LAtt--R''( ck ck r hydranic) 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 Stzaludrnsert 33.39
Flue vent for water heater or gas
':..1)5!ACC ill y/V} SLR L I r ) (�'��i Ft-Co IC., lace (gas) 23.32
23.32
Log N f jt l i 0 a � ( )A > as t)�f f' ��' L Wood/pellet stove 33,39
NJ ir>1T In 7-4. [1 P 5/ q m Gfp-(.,L- Wood fireplace/insert 23.32
LYEn
fLST tx. -c1.4 -,4/v f, , of(p 6,n, 540.00...76, wolf/ Chimney/liner/flue/vent 23.32 Other: 23.32
0 PROPERTY OWNER Q Tim Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms, "1123.32
toilet compartments,utility moms) "'
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
Cl APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
' Business name: $14.15 for first fours 54.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: WalVsuspended/unit heater
City/State/ZIP: Water heater
Fax: :( ) Fireplace
Phone:( ) Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
/C•f.i -rt Other: �.s
Business name-Gd(,J/(?Ll0. H.if 44 C. _I--Ja u MECHANICAL PERMIT FEES* (7 s
Address: k0 ,4 s a_ "-4,pC'i,4L A t1(. _ Subtotal
r Minimum permit fee(S90.00)
City/State/ZIP: , %TIT- L),t}/%.) IQ. ej{'�_ ci1Z '1'_ Plan review(25%of permit fee)
Phone:(_rjO3 � Z0�" !"yt,(•g Fax:( )
State surcharge(12%of permit fee)
CCB lie.: C7 6.C ! TOTAL PERMIT FEE
�� -] r,� This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Authorized signs ( / • Fee methodology set by Tri-County Building Industry Service Board
Print name: J rt,irzts,rE, - 144.c5a✓ Date: gl2rj( _7
040113.4oe 440.4617r(l IN2KOM/WEB)
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