Permit i ``Ir CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00242
Date Issued: 05/28/2010
TiGA)tD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102BD00600
Jurisdiction: Tigard
Site address: 12725 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Adrangi
Project Description: Installing (2) furnaces, gas piping, ductwork, and (2) A/C units.
Owner: FEES
ADRANGI, FARID Description Date Amount
4289 ORCHARD WAY Permit Fee 05/28/2010 $347.71
LAKE OSWEGO, OR 97035
Plan Review 05/26/2010 $86.93
PHONE: 503- 719 -2174 12% State Surcharge - Mechanical 05/28/2010 $41.73
Contractor:
SUNSHINE HEATING AIR CONDITIONING
14289 SE WYLER ST
HAPPY VALLEY, OR 97086
PHONE: 503 - 720 -8410
FAX: 503 - 762 -4311
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -2 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 2 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: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $476.37
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 2
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 • !cation Center. •ose rule are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a cop ,of the rules
or d questions to OUNC b - ng ' 03.246.6699 or 1.800.332.2344.
Iss ed By: / Permittee Signature: f j 42.
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.
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Mechanical Permit Application
ol� O l I ui ''
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Received
City of Tigard Date/By: � � Permit No. 00
13125 SW Hall Blvd., Tigard, OR 97223 �.�r 1 �-
® Plan Review SJ 1 Other Permit: ��y��^
= Phone: 503.639.4171 Fax: 503.5 cs Date/By: p'� i (4 �/ �IJLXJp �{/
li l c n K'ta Inspection Line: 503.639.4175 °� O Date Ready /: y: Juris: ® See Page 2 for
. . Internet: www.tigard- or.gov �0� Not 5 , 7/10 6 1 ) Supplemental Information
Mai a_ � RT 0 MttIN �' _ T YPE OF WO 6 COMMERCIAL FEE* SCHEDULE. - USE CHECKLIST
Ci ` ` ' Mechanical permit fees* are based on the value of the work
❑ New construction Addition /altera \- -- 1° Mechanical
performed. Indicate the value (rounded to the nearest dollar) of all
111 Demolition 11 Other: ��v \ \i 2 6 `t mechanical materials, equipment, la overhead, and profit.
CATEGORY OF CONSTRUCTION � ° W`9 Value: $ (J i }v
n A1G RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
'; 1- .n4 -fa • : , elli k Commercial /industrial ❑ Acce {t
G ►� 1 M �j0� 15, �� For special information use checklist.
'3W.D
• Multi- family • Master builder ❑ Othe Description I Qty. Ea. Total
JOB. SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: r /� ( r' �] c
�,� ��J �(/�' �Gt� � � �(�{I// ` (requires site plan showing placement) o!/ 46.75 1 � y (J
City /State /ZIP: � /� 0 ri Furnace 100,000 BTU (ducts /vents) 2 46.75 60
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: 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: I Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK • Water heater 23.32
1-'7417‘9, Gas fireplace 33.39
/ - 8 0 7 6s' :� 1 (*e- 4 Flue vent for water heater or gas
j a, 2' 1 ,��Q epees- Log fireplace 23.32
��// !� / � 09)9/,',v, v' /�' Log lighter (gas) 23.32
a4d a - 4/L an / s Wood/pellet stove 33.39
Wood fireplace /insert 23.32
It PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 46,(01
' • ❑ APPLICANT .. ❑. CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: /5 pte l�if I Arc L � � Clothes dryer (gas)
/ v Other
Address: / /`��� 57E MECHA NICAL PERMIT FEES* •
City /State /ZIP: � / ® 9?‘ Subtotal
Minimum permit fee ($90.00) _
Phone: (3D3 7 O � � i‘,. Fax: ( j3 76" Z 9 // Plan review (25% of permit fee) ,i
CCB lic.: /g 7 /y5- /}- State surcharge (12% of permit fee)
TOTAL PERMIT FEE 1 -1'76a < 7
T his permit application expires if a permit is not obtain d within 180
Authorized signature: days after it has been accepted as complete.
Print name: (1j k g / 344 77c0 , Date * F ee methodology set by Tri- County Building Industry Service Board
I: \ Building \Permits\MEC- PermitApp.doc 10/01/09 440- 4617T(11 /02 /COM/WEB) li 3r
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and •
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5;000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
•
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
l:\ Building \Permits \MEC- PermitApp.doc 10/01/09 2
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