Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00225
T [ G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/30/2009
Parcel: 2S 102AA03100
Jurisdiction: Tigard
Site address: 8635 SW SCOFFINS ST
Subdivision: Lot: 0
Project: American Legion
Project Description: Replace RTU gaspack.
Owner: FEES
AMERICAN LEGION, THE Description Date Amount
TIGARD POST #158, PO BOX 23482
TIGARD, OR 97281 Permit Fee 06/25/2009 $199.10
Plan Review 06/25/2009 $49.78
PHONE: 12% State Surcharge - Mechanical 06/25/2009 $23.89
Contractor:
R &S HEATING INC
1123 MEADOWVIEW COURT
WEST LINN, OR 97068
PHONE: 503 - 657 -4137
FAX: 503 - 657 -4137
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -2 Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas 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 $272.77
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 -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: Unaty\Q_ � \ p Q A )� Permittee Signature: / 44 /Ad
Call 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.
t� .,' MECHANICAL PERMIT
CITY OF TIGARD
'. 11 a ' ,~ COMMUNITY DEVELOPMENT Permit #: MEC2009 -00225
, T f GA1 D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/30/2009
• 4 !4*.5.;z; r, Parcel: 2S102AA03100
Jurisdiction: Tigard
' Site address: 8635 SW SCOFFINS ST
Subdivision: Lot: 0
Project: American Legion
Project Description: Replace RTU gaspack.
Owner: FEES
AMERICAN LEGION, THE Description Date Amount
TIGARD POST #158, PO BOX 23482 Permit Fee 06/25/2009 $199.10
TIGARD, OR 97281 Plan Review 06/25/2009 $49.78
PHONE. 12% State Surcharge - Mechanical 06/25/2009 $23.89
Contractor:
R &S HEATING INC
1123 MEADOWVIEW COURT
WEST LINN, OR 97068
PHONE: 503 - 657 -4137
FAX: 503 - 657 -4137
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -2 Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas 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 $272.77
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 B I! f " r
By: - 1 t z f J Permittee Signature: cL • ��; i
Call 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.
Ai i mGa_ t-E.. 3 0 'J : _ 4.111x.,
M echanical Permit Application FOR OFFI ONLY
City of Tigard RECEIVED Received Permit No ,,c
111111 q 3125 SW Hall Blvd., Tigard, OR 97223 1 DDate/By: ®
I Cr 1 r`y • a G 22-S
1 2 009 DateB iJ
Phone: 503.639.4171 Fax: 503.598.1960 M Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready a y: f „ ® See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: ` i .-S Q-1 ` Supplemental Information
BI III DING DIVISION N
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction \❑/ 'Additio altra n/lieplacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, I bBr, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: W;;7.4)() . (cal
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address:
gsi_35' S , tz, • SG4.5 /PS (requires site plan showing placement) 14.00
City /State /ZIP: -/- t t / 1,",t d , Q r , Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: , c) rn 0 ir k C Cur\ h ion Gas heat pump 14.00
Cross street/directions to job site: SJ Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances .
k DESCRIPTION OF WORK Water heater 10.00
`� Gas fireplace 10.00
l � O A /'t C -� `e u / S 7 �i !4 n {'C i `erz, ' 4 ,5' Flue vent for water heater or gas
�7- fireplace 10.00
e � //R/ l � DI 0 (be( # '/ ' ../ Dog �"cf / t7 / Log lighter (gas) 10.00
/X/„p W C A- Jere / P12 C / S / 11 C fl d44P1 / Wood/pellet stove 10.00
4,77 07 0 o,7 /30711 to e (y I7 ,• g 1 ] 3 Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
t Other: 10.00
Business name: fp ?. S He J tr Fuel piping
• Contact name: R asS b 2 P it/ $5.40 for first four; $1.00 for each additional
Address: Q` Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Water heater
Phone: ( ) Fax: : ( ) -
Fireplace
E -mail: Range
CONTRACTOR Barbecue
. Clothes j( Business name: 7? 5-- S /71'e / / N� Other:
f dryer (gas)
! Other:
Address: /11.2 17 e d/7ua U � e to fir MECHANICAL PERMIT FEES*
City /State /ZIP: toes T X )NN r Q `e 9' /J Q 6 > Subtotal
Minimum permit fee ($72.50)
Phone: 6Q3) o L y3 j, Fax: ( ) Plan review (25% of permit fee)
1C CCB lic.: 1 /( a, 0 I ' l 0 • l' State surcharge (12% of permit fee)
TOTAL PERMIT FEE
/� This permit application expires if a permit is not obtained within 180
Y Authorized signature: ' 1 days after it has been accepted as complete.
r Print name: R (/ 5 d� /D i e e a,. Date: 3/a J/O r * Fee methodology set by Tri- County Building Industry Service Board
B \ '
I :\uildingPermitsNEC- PermitApp.doc 01/19/07 440- 4617T(I1/02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $1 0,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I: Buildin \Permits \MEC- PermitApp. 01/19/07 2
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