Permit CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC2009 -00422
T I GAR Lj 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/14/2009
Parcel: 1S136DD03800
Jurisdiction: Tigard
Site address: 11675 SW 66TH AVE
Subdivision: WEST PORTLAND HEIGHTS Lot: 7
Project: City County Insurance
Project Description: Install roofmount fan.
Owner: FEES
HAINES BUILDING, LLC Description Date Amount
PO BOX 428
LAKE OSWEGO, OR 97034 Permit Fee 08/14/2009 $72.50
Plan Review 08/14/2009 $18.13
PHONE: 12% State Surcharge - Mechanical 08/14/2009 $8.70
Contractor:
OREGON HEATING & AC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 691 -9699
FAX: 503 - 691 -8556
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 $99.33
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 any all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started wit/ n 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ado .ted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obt . +n a c py of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: `
ostA _ Permittee Signature:
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.
Mechanical Permit Application
RECEIVE :1 FOR OFFICE USE ONLY
; _ _6k a •
City Of Tigard I Date Received �y `( r Pe rmi t No.: •�
Y
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review 1,
Q . • Phone: 503.639.4171 Fax: 503.598.1960 I - G � 1 4 ?. n09 DaDate/By: �/ � ;� v * W m Other Permit:
TIGARD Inspection Line: 503.639 Date Rea. • :y: Jur' • n ® See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: ( l.0 Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ 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 head, and profit.
- CA GORY OF CONSTRUCTION Value: $ I! // 7 ( �t —��
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: 11f�_/ / ' 7 3 51-ti ( 6 "- Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: . 1 4 ) rA ) )2 Furnace 100,000 BTU (ducts /vents) 14.00
1 [ i �, / Furnace 100,000+ BTU (ducts /vents) 17.90
(1 Suite/bldg. /apt. no.: Project name: 'i ��( /vut..�1 6.4 Gas heat pump 14.00
Cross street/directions to job site: ✓ + l Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK ` Water heater 10.00
r Gas fireplace 10.00
� i
��,r��, P � Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ❑TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( Fax: ( ) toilet compartments, utility rooms) 6.80
izi APPLICANT CONTACT. PERSON Attie /crawlspace fans 10.00
10.00
Business name: ^ J Other:
O2 W & Fuel piping
Contact name: C /e L-, y. / i A 4 ,� $5.40 for first four; $1.00 for each additional
Address: C� L/ Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax:: ( � 1 �)�,, , Water heater
" /?/� LJ/ � 201 �� Ra ge
Fireplace
E-mail:
CONTRA OR Barbecue
Business name: Clothes dryer (gas)
�� Other:
Address: if MECHANICAL PERMIT FEES*
City /State /ZIP: 0144 )/I -.. �f a 7/l Subtotal
�N / Minimum permit fee ($72.50) TA-
Phone: ( ) lb2 Fax: ( )
Plan review (25% of permit fee) / 5. 1 3
�
CCB lic.: ( / y /i State surcharge (12% of permit fee) V. _
`� "7 TOTAL PERMIT FEE �� ��
This permit application expires if a permit is not obtaine wi 180
Authorized signature: days after i t has been accepted as complete.
Print name: ejti ) Jt/ L ) Vm Z Date: ell / * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp -doc 01/19/07 440 -4617T (11 OM/WEB)
•
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
•
Total Valuation , Permit Fee 4 b `;; :�J'# e ,
$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
$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
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.
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