Permit Proi q CITY OF TIGARD MECHANICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: MEC2010 -00375
T 1 G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/04/2010
Parcel: 251136000600
Jurisdiction: Tigard
Site address: 16060 SW 85TH AVE
Subdivision: SEWER TREATMENT PLANT Lot: 0
Project: Clean Water Services
Project Description: Replace existing rooftop unit. For server room in Service Bldg.
Owner: FEES
CLEAN WATER SERVICES Description Date Amount
2550 SW HILLSBORO HWY Permit Fee 08/04/2010 $161.16
HILLSBORO, OR 97123 Plan Review 08/04/2010 $40.29
PHONE: 503 -681 -5100 12% State Surcharge - Mechanical 08/04/2010 $19.34
Contractor: •
VAN AIR & CONTROLS LLC
13327 S GLENN DR
MULINO, OR 97042
PHONE: 503 - 632 -5991
FAX: 503 - 632 -8672
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 1
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $220.79
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 riot 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 No ' •1 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 dir: questions t. •U - , y calling 503.246.6699 or 1.800.332.2344.
Iss ed By: /, �1 A Permittee Signat e � �
`mi " ! Lc
Call 503.639.4175 by 7:00 a.m. for an inspection that bus 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.
Jul 27 10 06:52a Greg Van Damme 503- 632 -8672 p.3
Mechanical Permit Applicati 0 l i ■ ' F oR c Hrlc k,� �r o f ,,
Q �/
City of Tigard Received
r q ��� Date.B>: p 5Y , p�, Q A PennitNo.: I , �ftCe�alo-co 375
• 13125 SW Halt Blvd., Tigard, OR 97223 6 1 v
Plan Review
� . S Phone: 503.639.417] Fax: 503.598.1960��.. PI2,� DateiB y: , f 7 �.� tr
(d: Otherpenit:
T I G R D. Inspection Line: 503.639.4175 ING S 0 Date Ready•By huts: El See Page 2 for
. - • Internet: Www- or- or.gov G ` ,�I oV ,A Notified ..Method: 7 16 1 3 ) -r ' Supplemental Information
TYPE OF W4 COMMER L FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
New construction
❑ A ddition /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: $ ."��e j t (7U
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
❑ Multi- family ❑Master builder For special information use checklist.
❑ Other: Description 1 Qty. 1 Ea. 1 Total 1
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: ((cr✓Y4,L) 5 � ) Ave Air conditioning
1 requires site plan shnN•inc placement) 46.75
City/State/ZIP: ""'
7Z c OR Furnace I00,000•BTU (ducts/vents) 46.75
33 '' Furnace 100.000+ BTU ( ducts/vents) 54.91
C
Suite/bldg. /apt. no.: Project name: L' il,41 U i )C 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- riot electric),
in -wall, in -duct. suspended. etc. 46.75 1
Subdivision: 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
D Gas fireplace 33.39
1 ern e- eXI N ` o l f)5 i c &( tee Bp i 1 L Flue vent for water heater or gas
_J fireplace 23.32 •
WY elil ( e �0I h n J 4 . 1 c. Free cpit� A/L
( Log lighter (gas) 23.32
Sy Sie ill I Lb cl. M'- Op 1 L . t (% 4- v 7 l \ Wood/pellet stove 33.39
1 11 5 1 , (, _ +--� c Wood ftreplace/insert 23.32
al Chimney/liner /flue /vent 23.32
PROPERTY OWNER I ❑TENANT
Other: 23.32
• Name: C (Prt i t L�'t. - 1 3 et Li 1 e 5 Environmental exhaust and ventilation
((�� Range hood/other kitchen
Address:
l`�� -5 5 ; r -: Rive Rd • equipment _ 33.39
City /State/ZIP: 1 1 11 1 t
'tY Olp Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICANT I ' De CONTACT PERSON Atticicrawlspace fans 23.32
Business name: tfV t A Oi(1 � LL ther pi pine 23.32
\ pi
Contact name: Gre, u m A `e $14.15 for first four; $4.03 for each additional
`, � i �^ Furnace, etc.
Address:
1� \ ' Gas heat pump
• City/State/ZIP: Nutt 1)CN 1., q 7Q& ) . Wall /suspended/unit heater
Phone: (C) ) 2L1Cj --6,3 ` S Fax:: ()-') 6.3;)-`3( 7 Water heater
� , + Fireplace
'�
E -mail: 1fi(I e •L- F On 11 ne t C rV\ Range
CONTRACTOR Barbecue
•
Business name: G �, 1 r - �1 Cl 1 �L L Clothes dryer (gas)
* Co C Other:
Address: i 33 7 S c C,„ it el , 1 MECHANICAL PERMIT FEES*
City /State /Z1P: \ al l (\43 G�. i 7 L.0 Subtotal
(: Minimum permit fee ($90.00)
Phone: ( & . -S5 -1 -3) 4>3 ( Fax: (r 3 63, ' 2ro 7. Plan review (25% of permit fee) -
CCB lie.: f 5 7R /A t State surcharge (12% of permit fee)
TOTAL PERMIT FEE __
Authorized signatuvc: '/ " , This permit application expires if n permit is 001 obtained %71171n 180
cf v ' 11.i'Vl1Z days after it has been accepted as complete.
I Print namc:( w eC, C-•, ; G A nALAI Date -e� 7 --1 I Fee methedologv set by Tri- County Building Industry Service Board
1Bui
1: ldinePerniti1MEC- PermmIApp.dac 10:01/09 440- 4617T(1I1 / O2ICOWWEB)