Permit CITY TIGARD MECHANICAL PERMIT
M I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00277
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/26/2005
PARCEL: 2S 101 AB -01606
SITE ADDRESS: 07357 SW BEVELAND RD ZONING: MUE
SUBDIVISION: HERMOSO PARK LOT: 017 JURISDICTION: TIG
Project Description: Gas line. Valuation $ 3000.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMM. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
SLOAN, DAVID MARTIN Description Date Amount
SLOAN, KAREN MARIE [MECH] Permit Fee 5/26/200E $95.50
7355 SW BEVELAND RD [TAX] 8% State Surchar€ 5/26/200: $7.69
TIGARD, OR 97223 -
Total $103.19
Phone:
Contractor:
SURE FLOW HVAC INC.
16209 SE WEBSTER RD REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97267
Phone: 503 653 - 1636
Reg #: LIC 109777
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: ■ Permittee Signature
Call 503 - 639 -4175 by 7:00 a.m. for inspections 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 tla,I / FOR OFFICE U
A► SE ONLY
City of Tigard C IU NI E LJ Received / / Pit No.' 1 13125 SW Hall Blvd., Tigard, OR 97223 DatDate/By: e rm ( 7
Phone: 503.639.4171 Fax: 503.598.1960 : %; Other Permit:
n �� Plan Review
D ate/By:
Inspection Line: 503.639.4175 ' j ? 2005 ■.! 1 e� ' I Date Ready/By: luris: E1 S ee Page 2 for
g
Internet: www.ci.tigard.or.us �± " f/6.. CITY OF T�k7J��® Notified/Method: Supplemental Information
8111) OIN.G DP 'BSiO .. , _
TYPE. OF WORK" coKvIERCIAL. FEE *:'SCHEDULE - "USE CHECKLIST
IR New construction ❑ Addition/alteration/replacement 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, labor, overhead, and profit.
..
Value: $ p (17 C
" ' CATEGORY. OF ,CONSTRUCTION . - - • _
:RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1 - and 2 family dwelling IR Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
. I.. JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 7 zJ e i r e _t- Air conditioning or heat pump
/J' � it/ !? (requires site plan showing placement) 14.00
City/State /ZIP: , t �. � _U Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Or Project name: / ,�
Ch 7r G G fJ1t iZ Gas heat pump 14.00
Cross street/directions to job site: h Duct work 14.00
�� Hydronic hot water system 14.00
Residential boiler (radiator or
II 0S hydronic) 14.00
Sy Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc" 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
Water heater 10.00
•
DESCRLPT[ON °:OF .WORK...
//// t ,/ Gas fireplace 10.00
/ d �T fa �f e� � ef Y Flue vent for water heater or gas
fireplace 10.00
''t A ' "e ` " h Log lighter (gas) 10.00
Aei_ f �!/J //9' , ff- X % IP Wood /pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER TENANT Chimney /liner /flue /vent 10.00
.,0
0, 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
: :.5' •APPLICANT' ' i > ❑" CONTACT PERSON Attic /crawlspace fans 10.00
/ /f / , / /. Other: 10.00
Business name:
fu re_ 7 ,, at,.....--" ff :L�/70 [ Fuel piping
Contact name: X G `i G 4 $5.40 for first four; $1.00 for each additional
N.." !/ ~ ' / Furnace, etc.
Address: ,4-Z t� ...$C 4/4 4s - - ��
Gas heat pump
C City/State /ZIP: / te � e-
C t/de" 972 C 7 Wall /suspended/unit heater
`\ Phone: do)) - S� _/63 Fax: (it ?) ,�`� -S / � �`� Water heater
4
Fireplace
E -mail: �Ll l�/ 4.... — 7` 6t ht L !c / 17 e 1 Range
CONTRACTOR . • Barbecue
Business name: �� Clothes dryer (gas)
Other:
Address: , MECHANICAL PERMIT FEES* • " '
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee) 2, 4
TOTAL PERMIT FEE 63, /
Authorized signature. This permit application expires if a permit is not obtained within 180
�� days after it has been accepted as complete.
Print name: X. 'o L Y`a K o 4 Date: f/2 • 4 - 4j' * Fee methodology set by Tri- County Building Industry Service Board
i:\Building \Permits \MEC- PermitApp.doc 12/03 440-46I7T (I I/02/COM/WEB)
•
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation ,Perm><t Fee;`... :. y .
$ 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 $10,000.00 $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 D
$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 J
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:\Building\Permits\MEC- PermitApp.doc 12/03 2