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Permit zooii CITY OF T ARD MECHANICAL PERMIT 0 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00404 T 1 G R. D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/12/2010 Parcel: 1 S135BA00100 Jurisdiction: Tigard Site address: 10205 SW WASHINGTON SQUARE RD Subdivision: WASHINGTON SQUARE TOO Lot: 0 Project: Thirsty Lion Project Description: Gas piping. 9/15/10, additional gas piping added: 12' of 3/4" underground and 20' of 3/4" in kitchen. Owner: FEES PPR SQUARE TOO LLC Description Date Amount BY THOMSON PROPERTY TAX SERVICES, permit Fee 08/12/2010 $127.39 2235 FARADAY AVE STE #0 Plan Review 08/12/2010 $31.85 PHONE: 12% State Surcharge - Mechanical 08/12/2010 $15.29 Additional Plan Review 09/16/2010 $90.00 Contractor: HVAC INC 5188 SE INTERNATIONAL WAY MILWAUKIE, OR 97222 PHONE: 503 - 462 -4822 FAX: 503 - 462 -6555 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: A -3 Occupancy Load: Stories: 1 Fuel Air Handlers Fuel Types: Natural Gas 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 $264.53 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: 10 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 Notific ' er. 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 estions to OUNC by calli • • 503.246.6699 or 1.800.332.2344. Iss d By: k • r;), , (,14k4 Permittee Sig ature: ' � Ca 503.639.4175 by 7:00 a.m. for an inspection that bu ' ss 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. CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2010 -00404 T I G/iRD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/12/2010 Parcel: 1 S135BA00100 Jurisdiction: Tigard Site address: 10205 SW WASHINGTON SQUARE RD Subdivision: WASHINGTON SQUARE TOO Lot: 0 Project: Thirsty Lion Project Description: Gas piping. Owner: FEES PPR SQUARE TOO LLC Description Date Amount BY THOMSON PROPERTY TAX SERVICES, permit Fee 08/12/2010 $127.39 2235 FARADAY AVE STE #0 Plan Review 08/12/2010 $31.85 PHONE: 12% State Surcharge - Mechanical 08/12/2010 $15.29 Contractor: HVAC INC 5188 SE INTERNATIONAL WAY MILWAUKIE, OR 97222 PHONE: 503 - 462 -4822 FAX: 503- 462 -6555 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: A -3 Occupancy Load: Stories: 1 Fuel Air Handlers Fuel Types: Natural Gas 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 $174.53 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: 10 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 b the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -81 _ through OAR 952 - 001 -0100. You m.y • 'lain a • py of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800. v:VS l♦ g , Issued By:# L ;/ � - Permittee Signature: Uv Call 503.639.4175 by 7:00 a.m. for an inspection that business .ay. This permit card shall be kept in a conspicuous place on the job site until comp =tio of the project. Approved plans are required on the job site at the time of each inspe on. • • Mechanical Permit Application - . -, , 1 OIZ O l l CI 1 ��Sl ) 1 1 City of Tigard Received R Dat .g j ri g , e .` Permit No.: y Il V 13125 SW Hall Blvd., Tigard, OR 97223 1 Phone: 503.639.4171 Fax: 503.598.1960 Plan Review 1 a if ( 40 Other Permit: i lon Line: 503.639.4175 Date/By. � /.�� iCJ ►�1 � t I — "7 Ti C A h'D' Inspection Date Ready : y: See Page 2 for t Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK . COMMERCIAL FEE* SCHEDULE — _ USE CHECKLIST El 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. CATEGORY OF CONSTRUCTION Value: $ O 0� RESIDENTIAL EQUIPMENT / SYSTEMS FEES* • ❑ 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description II Qty. I Ea I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: S �\ CL Air conditioning or heat pump 1 O S w J(� . ♦ (requires site plan showing placement) 14.00 City/State/ZIP: I I 6 CUVOt " \)') St t . 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldgJapt. no.: Project name: TA/V �1 U qV\ I Gas heat pump 14.00 Cross street/directions to job site: I Duct work 10.00 Ilydronic 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 Gas fireplace 10.00 G rti.- 0 .' \0 \\/\-0- 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 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 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: _ 10.00 Business name: rn V Ci Fuel piping Contact name: ro . ( 'C $5.40 for first four; $1.00 for each additional Address: S I U 1 S C, ��VVV��` c v\ � X �O Fuace, etc- ` Gas heat pump City/State/ZIP: � 1 1 w k) 0\2 0, Wall/suspended/unit heater Phone: (cV23) 4 b ) Li $' Fax:: ( 03) q l0 v � ko Water heater � Fireplace E -mail: r i O � \ (t' v L7 on �✓9, , /�\ Range CONTRACTOR Barbecue Business name: V At Tv (../ Clothes dryer (gas) Address: t 1i R 5c 4 V I �/j/` i uu Other * " 7fr �Vv MECHANICAL PERMIT FEES City /State/ZIP: , Subtotal �)' " �—' k J ax " t : ( ) ` Minimum permit fee ($72.50) f).7 3 q ( ) (I V Plan review (25% of permit fee) 3i , y-s CCB lic.: '-O % CA State surcharge (12% of permit fee) ( S TOTAL PERMIT FEE y j; i -74 ,fi Authorized signature: f This permi application expires if a permit is not obtaiaed within 180 days after it has been accepted as complete. Print name: ',ia , 1 I Date: - S /I 1 J i D * Fee methodology set by Tri-County Building Industry Service Board 1 :\ Building \ Permits \MEC -P- .. doc 01/19 /07 440-4617T (11 /02/COM/WEB)