Permit CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00338
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/10/2009
Parcel: 25101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY
Subdivision: FARMERS INSURANCE Lot: 0
Project: Triangle Pointe
Project Description: Install new VAV box, ducting & diffusers.
Owner: FEES
TRIANGLE POINTE LLC Description Date Amount
901 NE GLISAN ST #100 Permit Fee 07/10/2009 $299.00
PORTLAND, OR 97232 12% State Surcharge - Mechanical 07/10/2009 $35.88
PHONE:
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: 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 Fumaces: 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 $334.88
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 not started within 180 days of
issuance, or i • . is . - .ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No "cation Center. .o - - are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to OUN . callin : 46.6699 or 1.800.332.2344.
Iss =d By: L r! !i / Permittee Signature: v /
•
CaII 503.639.4175 by 7:00 a.m. for an inspection that business da'
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.
w- Mechanical Permit Application 1 ( : ) 1 z 01.4 t s r ()NI.)
City of Tigard EC I e 7 g o9 ,4 Permit No.: eiLJ i /Ci 40 35E a 13125 SW Hall Blvd., Tigard, OR 9722 V E® P la n Review ether Permit:
.� P hone: 503.639.4171 Fax: 503.598.1960 Date/By:
TIGARD
Inspection Line: 503.639.4175 JUL 10 2009 Date Ready/By: Mill El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE OF valADING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction IN Addition/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: $ 1 c 10 D p
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling El Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ,?j -7 -j •- ;`3 S W koc 4l (`v Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP: f , 1 , 11 :0,01 1 0c 12.2-3 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldgJapt. no.: Project Hamer � (0 Gas heat pump 14.00
Cross street/directions to job site: 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
n U1 v C `` / ��� 1 , 1 ^ OJ � i d i _ I + Gas fireplace or water heater or gas
10.00
��S V V V l �J Flue vent fo
- 1 , n ' ,� fireplace 10.00
V �/t15 J 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
j$( APPLICANT CONTACT PERSON Attic/crawlspace fans 10.00
Business name: l\' / f ^ Other: 10.00
t-i V l� V �� Fuel piping
Contact name: _ `0 v v $5.40 for first four; 51.00 for each additional
Address: S i r 6 / (7 vv�� Y I GV61pv\ ( n I Furnace, etc.
Gas heat pump
City/ State/ZIP: r l w � 1 ( _ )�Y/ ' Wall/suspended/unit heater
Phone: (56j) , Fax:: ( ) 4 - 34 0 to Water heater
1� Fireplace
E -mail: 1 0 �\I �l �/ V '^ lV C1,G y 1,, 1 Gov p, (,Q • 1 Range
r CONTRACTOR Barbecue
Business name: tr t \ I A � LA Clothes dryer (gas)
v I - Other:
Address: /� /�� ((11�) MECHANICAL PERMIT FEES* •
City/ State/ZIP: C��G v' VVVV Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) p (y9. oa
Plan review (25% of permit fee)
CCB lic.: � p cb O State surcharge (12% of permit fee) fc: t1 TOTAL PERMIT FEE cV, ° 0
Authorized signs 1 " -: This permit application expires if a permit is not obtained within 180
. / days after it has been accepted as complete.
Print name: / t.'ngn Date: ,nI, • Fee methodology set by Tri- County Building Industry Service Board
1:\Building\Pennits 1 , .,App.d. 01 /19/07 440 4617T /02/COM/WEB)