Loading...
Permit • -; C ITY OF TIGARDMECHANICAL PERMIT al1k DEVELOPMENT SERVICES PERMIT #: MEC2004 -00193 � �i . DATE ISSUED: 5/21/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101AD -01000 SITE ADDRESS: 12703 SW 67TH AVE SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 033 JURISDICTION: TIG CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1 OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: 1 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: 148,000 BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 2 AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: New building mechanical systems.Valuation $10,580 Owner: FEES BEACON HOMES NORTHWEST Description Date Amount 25115 SW PARKWAY AVE STE C [MECH] Permit Fee 5/21/200 $157.74 WILSONVILLE, OR 97070 [MECPLN] Plan Rev 5/21/200 $39.44 [TAX] 8% State Surcharl 5/21/200 $12.62 Phone: 503 - 570 - 8828 Total $209.80 Contractor: ARROW MECHANICAL 10330 SW TUALATIN RD TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone: 692 Gas Line Insp Mechanical Insp Reg #: LIC 5193 Duct Inspection Final Inspection • 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 -0o : • ' ; OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) . -6699. Issu ° d By: ' � i .,;_ ._ �, Permittee Signature: �' � �, ,_ • • �� r- • all (503) 639 -4175 by 7:00 P.M. for inspections ne - ded the next business day 1z $i) 6-7 rH /ql/L Mecha i i ation FOR OFFICE USE ONLY }y Received ? Mechanical n $,P (� Imo/ p ! DateDate/By: �l fo� AV % Permit No./�ECAep Y OCR /` ..,, � 1� City of Tigard 2 Planning Approval Date/Hz:. Building Permit N4 � uP4 D � �� BOa �� 13125 SW Hall Blvd. �` Plan Review • Other Tigard, Oregon 97223 C . `. C: : IC;:h.� Date/By: j ,7 Permit No.: v\ Post Land Use ,y Internet: www.ci.tigard.or.us Phone: 503 -639 -4171 3?,[Qfs��fl'C�6ti I t+� Date/By: - Case No.: — , I Contact Juris.: ® See Page 2 for - a P Request: ,_ . �� - � ` 24 - hour Inspection Re uest: 503 - 639 - 4175 Name/Method: 74c Supplemental Information. - �, TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ri 7 New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work 0 Addition/alteration/replacement III Other: performed. Indicate the value (rounded to the nearest dollar) of all s'° CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit. i ° D i. 2- Family dwelling IN V alue: $ Commercial /Industrial d / 5/36: See Page 2 for Fee Schedule ❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE C" . Description 1 Qty 1 Fee(ea.) 1 Tota42 ❑ Master Builder ❑ Other: Heating/Cooling JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00 Job site address: 1 Z 7o .5w (, 7 Th Avg, Gas heat pump 14.00 Suite #: 1 Bldg. /Apt. #: Duct work 14.00 lE Project Name: 5 1 CC1 .0 M DE VE Lo pM.FJYT Residential boiler hot water system 14.00 Residenti - Cross street/Directions to job site: (for radiator or hydronic system) 14.00 Unit heaters (fuel, not electric) (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) 10.00 Subdivision: Lot #: Repair units _ 12.15 Other Fuel Appliances Tax map /parcel #: Water heater 10.00 DESCRIPTION OF WORK Gas fireplace 10.00 1 t 57/1 [,t, (z) amETDP G-n.c PA 1c5 a) CO c, to 4 - Flue vent (water heater /gas fireplace) 10.00 Xl4A V51 1=F1A() D t1rTW odiIG &ai u_SS d Wood/Pellet d /Pell (gas) 10.00 / - Wood/Pellet stove 10.00 C6411 Wood fireplace /insert 10.00 Chimney/liner /flue /vent 10.00 ❑ PROPERTY OWNER 1 ® TENANT Other: 10.00 Name: `J' PPc TaLu M QCUL- L DPM N 7" Environmental e qui Exhaust & Ventilation � Range hood/other kitchen equipment 10.00 Address: (.2 7 0g S N( (p 7 TI{ / tie Clothes dryer exhaust 10.00 City /State /Zip: T b-qa, Di d 2 Single duct exhaust Phone: Fax: (bathrooms, toilet compartments, ❑ APPLICANT ® CONTACT PERSON utility rooms) 6.80 Name: /4~r Sr/4 o c imGL Attic /crawl space fans 10.00 Other: 10.00 Address: 103 3 0 S 1,4 Tko L19 TB,/ go-A (1, Fuel Piping City/State/Zip: *($5.40 for first 4, $1.00 each additional) y p `�U Ar.�T - j o2 97 Di Z Furnace, etc. ** Phone: 563 G9 Z —r /565' Fax:503 69'1- / F79, Gas heat pump ** E -mail: Wall/suspended/unit heater ** CONTRACTOR Water heater ** Business Name: 1 40 j 2 o , A i t AN/C,J L Fireplace ** Address: /0 3 3 6 5 Val U R L T /A/ 20 fl !� Range ** T BBQ ** City /State /Zip: Tu 4t .4 T/i J pa 9 706! Z Clothes dryer (gas) ** Phone: _ 6,1l- IS4/3" [ Fax: 503 611-1F 79 Other: ** Total: CCB Lic. #: 51 93 Mechanical Permit Fees* Authorized 4 -1 & -o4 Subtotal: $ / s?-. 7 Signature: Date: Minimum Permit Fee $72.50 $ # S a ✓���D>n Plan Review Fee (25% of Permit Fee) $ 37. ei t{ 11 (Please print name) State Surcharge (8% of Permit Fee) $ i Z . ‘ Z TOTAL PERMIT FEE $ 2.-© .,R� Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information . Commercial Fee Schedule: • • , Total-valuation: , Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for each additional $100.00 or fraction thereof, to and including $25,000.00. $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to and including $50,000.00. .�s $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. :Assumed %Valuations:Per Appliance: Value Total Description: Qty (Ea) Amount Furnace to 100,000 BTU, including 955 ducts & vents Furnace> 100,000 BTU including ducts 1,170 & vents Floor furnace including vent 955 Suspended heater, wall heater or floor 955 mounted heater Vent not included in appliance permit 445 Repair units 805 < 3. hp; absorb. unit, 955 to 100k BTU 3 -15 hp; absorb. unit, 1,700 101k to 500k BTU 15 -30 hp; absorb. unit, 501k to 1 mil. 2,310 BTU 30 -50 hp; absorb. unit, 3,400 1 -1.75 mil. BTU >50 hp; absorb. unit, 5,725 >1.75 mil. BTU Air handling unit to 10,000 cfm 656 Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 Vent fan connected to a single duct 446 Vent system not included in appliance 656 permit Hood served by mechanical exhaust 656 Domestic incinerator 1,170 Commercial or industrial incinerator 4,590 Other unit, including wood stoves, 656 inserts, etc. Gas piping 1-4 outlets - 360 Each additional outlet 63 TOTAL COMMERCIAL $ VALUATION: i:\Dsts\Permit Forms\MecPermitAppPg2.doc 01/03