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Permit
J!1 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2010 -00369 Date Issued: 07/28/2010 4 IdAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110DC01000 Jurisdiction: Tigard Site address: 11165 SW SUMMERFIELD DR 8 Subdivision: SUMMERFIELD APARTMENTS Lot: 0 Project: Summerfield Apartments Project Description: (1) clothes dryer exhaust. Owner: FEES SUMMERFIELD ASSOCIATES, LLC Description Date Amount BY HSC REAL ESTATE, 1500 SW FIRST AVE STE 1020 Mechanical Permit - COM 07/28/2010 $90.00 12% State Surcharge - Mechanical 07/28/2010 $10.80 PHONE: Contractor: SKYWARD CONSTRUCTION INC 15908 NE 10TH AVE RIDGEFIELD, WA 98642 PHONE: 360- 546 -1625 FAX: 360- 546 -1630 Type of Use: COM 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 $100.80 Hoods: Comm Incinerators: Required Items and Reports (Conditions) Woodstoves: Gas Fireplaces: Clothes Dryers: Other Meth 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 .2344. Issued By: - Permittee Signature: J , / 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 _ K(5) t)Irorl Ic.I.usl “Ni,) City of Tigard *),\I DatePlan By: Permit No.: ° 13 SW Hall Blvd., Tigard, OR 97223 �\ \ ) M � `� 063•6, Review Phone: 503.639.4171 Fax: 503.598. , Date : : Other Permit: r i c n It r1 Inspection Line: 503.639.4175 y r � Q� ■ ��!adyBy: ® See Page 2 for Internet: www.tigard- or.gov \ � ��G ified/Method: IIM Supplemental Information F WORK s COMMERCIAL . FEE* SCHEDULE — USE CHECKLIST ❑ New construction Addition/alteratio m ent 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. CATEGORY F CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT /SYSTEMS FEES* ❑ 1- and 2- family dwelling ommercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total . JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: Su Id /�_n � � Air (requires conditioning rt /. / requires site Ian showing placement) 46.75 City /State /ZIP: i 1 / b5 ` j ( �J S') ,L/4) Furnace 100,000 BTU (ducts /vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: 'F Project name: Sct4 � n 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 f Gas fireplace 33.39 y— k ,S ,> � d� , ac. i W cL.5Aeit Otye.IQ, 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 [$ . PROPERTY.:OWNER� i '❑ TENANT �^ Other: 23.32 Name: SG itkv, e C1.acA >4G L LC. Environmental exhaust and ventilation © S W .C� �- Range hood/other kitchen Address: 1 C De) NI/E (U s �� I t Z equipment _ 33.39 City /State /ZIP: Clothes dryer exhaust 1 33.39 3 3 ,31 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: Fuel piping Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E- mail: Range CONTRACTOR Barbecue • U/ , 1 ?1/4)C- Ot dryer (gas) Business name: 9 T Other: Address: /5908r A C /0 +k A OE . MECHANICAL PERMIT FEES* • City /State /ZIP: #0Gcj e,4�(.0\ `xi- e l e6,liC/ Subtotal Minimum permit fee ($90.00) 4 d Q Phone: (3i 0)�[f-6 t 2 c Fax: ( ) Plan review (25% of permit fee) CCB lic.: 6 't5 g z_ a q State surcharge (12% of permit fee) 10. w 1 TOTAL PERMIT FEE i a This permit application expires if a permit is not obtained within 180 Authorized signature: J / days after it has been accepted as complete. Print name: P da I fl,Cifc ltil,C A. � ' Z Q D 2 2. f * Fee methodology set by Tri- County Building Industry Service Board :\ Building \Permits\MEC- PermitApp.doc 10/01/09 440- 4617T(11 /02/COM/WEB) 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. I:\ Building \Permits\MEC- PennitApp.doc 10/01/09 2