Permit CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC2010 -00145
T { G ARQ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/06/2010
Parcel: 2S110DC01000
Jurisdiction: Tigard
Site address: 11255 SW SUMMERFIELD DR 1
Subdivision: SUMMERFIELD APARTMENTS Lot: 0
Project: HSC Real Estate
Project Description: Install dryer exhaust.
Owner: FEES
SUMMERFIELD ASSOCIATES, LLC Description Date Amount
BY HSC REAL ESTATE, 1500 SW FIRST AVE
Permit Fee 04/06/2010 $69.06
STE 1020 12% State Surcharge - Mechanical 04/06/2010 $8.29
PHONE:
Contractor:
SKYWARD CONSTRUCTION INC
15908 NE 10TH AVE
RIDGEFIELD, WA 98642
PHONE: 360 - 546 -1625
FAX: 360 - 546 -1630
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $77.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: n (/� , Permittee Signature:
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CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 ' ,* ut . ,,,,, ' , '4 ,,, q=-,t ,, 1(;)�z c"I y:r l �l 1 ( - > '"
r 1 T / a :, p , , t�Jtiis hl !IS u4tt>e.1M4 to l�1 . tr# u' ' ..
rd �'' + . . 1 Received
Date
CI of Tigard i. �j c Plan Review
Permit No.: (I /�� ^'� ! n a �s
`J g . r , k . �ld Date/By:
1 v�` A) (In
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1 13125 SW Hall Blvd Tigard, OR 97223
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*gy Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
el +u+ Internet: Inspection Line:
ti and 503.639.4175 APR 0.6 201Q DateReadyBy: Juris: ® See Page 2 for
g g Notified/Method: Supplemental Information
C! Y O F: TIGARD
TYPE OF WORKS- V°Nl:t UfVISIUN COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction jg Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2-family g ❑ Commercial/industrial ❑ Accessory building
ID Multi-family 0 Master builder For special information use checklist.
❑ Other: Description I Qty. I Ea. I Total
JOB SITE II,[FORMATION AND LOCATION Heating/cooling
Job site address: , .A Air conditioning
// �s� , r..r *_tjJrat. (requires site plan showing placement) 46.75
City /State /ZIP: / i o 9 7 Furnace 100,000 BTU (ducts/vents) 46.75
�czc^ t~ aZ� Y r Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: 4 7 Project name: �
name: p'1, 161"- i-t r lief/! 5: Heat pump 61.06
Cross street/directions to job site: / Duct work 23.32
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
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
/� 1 Gas fireplace 33.39
ei / TG d` .S 7 Gt r w/i? Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
7[] PROPERTY OWNER ❑ TENANT Other: 23.32
•
Name: )-/5G / (/ P ,( Fs is A Environmental exhaust and ventilation
Address: p p 5 � 5 - Range hood/other kitchen
owe Si JO 0 equipment 33.39
City /State /ZIP: p ,,:f / L A 0 ' ?� O 1 Clothes dryer exhaust 1 33.39
_ Single -duct exhaust (bathrooms,
Phone: (3 5 /G S 30 / Fax: (5i). ) SA, - 36 / toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: /
rS ��/ -err d G /I .a1 1 Fuel piping
C
Contact name: h a �A j , / $14.15 for first four; $4.03 for each additional
"`��+ Fumace, etc.
Address: ! 5 p N E /„.-/- au, Gas heat pump
City /State /ZIP: / ,.. � ` 6i ,, /j j, y�Cq 2 Wall/suspended/unit heater
Phone: (3( ) 544, / /6.2 S d Fax: : (yea ) S - 9 `C jr-,e, Water heater
Fireplace
E -mail:
Range
CONTRACTOR . Barbecue
Clothes dryer (gas)
Business name: S k t/ t j a ,4 C �', Other:
Address: 1 ‘-- S 0 `t MECHANICAL PERMIT.FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: / 51 2, 2 Cr State surcharge (12% of permit fee)
TOTAL PERMIT FEE (7- s
Authorized signatu : - 4_
This permit application expires if a permit is not obtained within 180
,/ days after it has been accepted as complete.
Print name: X F E • 5 4 , Date: -oC -i. Ut • Fee methodology set by Tri-County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 10/01/09 440-46I7T(1I /02/COM/WEB)