Permit N110,-' CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00222
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2010
7 I O AR 1J Parcel: 2S1 12 DD01600
Jurisdiction: Tigard
Site address: 15575 SW SEQUOIA PKWY 140
Subdivision: Lot: 0
Project: Winzler Kelly
Project Description: Provide and install with ductwork and grills. Modify existing supply & return ductwork.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 05/14/2010 $333.66
PORTLAND, OR 97224
Plan Review 05/14/2010 $83.42
PHONE: 503 - 624 -6300 12% State Surcharge - Mechanical 05/14/2010 $40.04
Contractor:
ARJAE SHEET METAL CO, INC.
5510 SE MCLOUGHLIN BLVD.
PORTLAND, OR 97202
PHONE: 503 - 231 -7717
FAX: 503 - 230 -4888
Type of Use: SF
Class of Work: ALT Type of Const: IIB
Occupancy Grp: B Occupancy Load:
Stories: 2
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 $457.12
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 2 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 r es adopted by the Oreg. __--
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You ay ob i - co. of the r I
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. � � 1 '
' I
Issued By --4100" Permittee Signature: /
. I PAL
Ca .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.
.,de)c /Iry
Mechanical Permit Applicatl „ 4CEIVE1P x FOR OFFICE USE ONLY
City of Tigard �A 1 3 % k Date/By: z... I d (' , 1 Permit No.: Ge o�010 -DOS.
1, . 13125 SW Hall Blvd., Tigard, OR 97223 MAY Plan Review
C Other Permit: 7
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: �� �3� K � �up aor0'" � �
TIGARD Inspection Line: 503.639 CITY OF TIGARD Date Read /B luris
Internet: www.tigard- or.gov Ready /By: ® See Page 2 for
BUILDING D1V1SION Notified/Me od: 5 - 0 Co Supplemental Information
TYPE OF WORK i OMMEEERR { CCIIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® 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: $ 59,500.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi-family ❑ Master builder 0 Other: Description 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15575 SW Sequoia Pkwy Air conditioning
(requires site plan showing placement) 46.75
City /State /ZIP: Portland Or Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: 140 I Project name: Winzler & Kelly 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
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Modify existing supply and Return ductwork, Flue vent for water heater or gas
Provide and install (1) 2 ton rooftop unit, and (1) 3 ton rooftop unit ductwork fireplace 23.32
Log lighter (gas) 23.32
and grills, re locate existing thermostats. Wood /pellet stove 33.39
Wood fireplace /insert 23.32
® PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Pac Trust Environmental exhaust and ventilation
Address: 15350 SW Sequia Parkway Ste #300 Range hood /other kitchen
equipment 33.39
City /State /ZIP: Portland Or Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503- )624 -3000 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Arjae Mechanical Services
Fuel piping
Contact name: Heath Burmeister $14.15 for first four; 54.03 for each additional
Address: 5510 Se Mcloughlin Blvd Furnace, etc.
Gas heat pump
City /State /ZIP: PORTLAND OR ?72-0 9— Wall /suspended/unit heater
Phone: (503) 231 -7717 Fax: : (503 -) 230 -4888 . Water heater
Fireplace
E -mail: HEATH @ARJAE.COM Range
CONTRACTOR Barbecue
Business name: ARJAE Mechanical services Clothes dryer (gas)
Other:
Address: 5510 se mcloughlin blvd MECHANICAL PERMIT FEES*
City /State /ZIP: portland 9 7J'.02 Subtot
Minimum permit fee ($90.00)
Phone: (503) 231 -7717 x: (50 Plan review (25% of permit fee)
CCB lie.: 60835 7(1 !gyp State surcharge (12% of permit fee)
TOTAL PERMIT FEE 1,5 (2.
Authorized sig lure: This permit application expires if a permit is not obtained within 180
�,D days after it has been accepted as complete.
Print name: vi ck r k- 1 R-r►,talye�'n— 0 Date: ‘ b * Fee methodology set by Tri- County Building Industry Service Board
1'\ Building \Permits \MEC PermitApp. doc 10/01/09 440 -4617T (11 /02 /CO61/WEB)