Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00432
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/21/2010
Parcel: 2S 114AA00500
Jurisdiction: Tigard
Site address: 16375 SW 85TH AVE
Subdivision: Lot: 0
Project: Clean Water Services
Project Description: Replacement of foul air duct, install odor control fan, a/c unit and make -up air unit with associated
duct work.
Owner: FEES
CLEAN WATER SERVICES Description Date Amount
2550 SW HILLSBORO HWY Permit Fee 09/21/2010 $7,353.71
HILLSBORO, OR 97123
Plan Review 09/21/2010 $1,838.43
PHONE: 503 -547 -8177 12% State Surcharge - Mechanical 09/21/2010 $882.45
Contractor:
STAYTON HEATING & COOLING
PO BOX 307
INDEPENDENCE, OR 97351
PHONE: 503 - 838 -3863
FAX:
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: F -1 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 $10,074.59
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units: 1 BUP Bolts in Concrete
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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification 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 direct questions to OUNC by calling 503.246.6699 or__t800.332.2344.
J
Issued By: �• _ �
. . ` • ee Signature: A � / A0 , , I J
,
CaII 503.63 0 a.m. for an inspection that ;T ness 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 rt,li.t�l I, lc,l (Si Uhl
City of Tigard e Q
0 A /0 . :: itNo.: IC A - c7.
II • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
. C r DateBy: Phone: 503.639.4171 Fax: 503.598.1960 9,d/O ,a' ,'' Other Permit: LjegeyQ er /og
l�
- r 1 c A It a Inspection Line: 503.639.4175 Date Ready/By: q orris: Hi See Page 2 for
. Internet: www.tigard or.gov Notified/Method ( , /, 0 IN Supplemental Information ■
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i 'cal permit fees' are based on the value of the work
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
• -'''''-• a.0 =e, - ,N Value: $262
K .� • .� - _ : " ; 4 ' y ti -.a � ' ,500
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Mme....,. . .. ... . -.eta _ ___
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❑ 1- and 2- family dwelling ® Commercial/industrial ❑Accessory building
, WY••t � .i,.' l ....4t :=;.••, + '1 ' a ; a nc
For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other. Description Qty. Ea. Total
_ ,-Ak Head ' eoolin
Y== ��• �z r, 13 7 � , ���'� .s �' } A A--L---,a,,,, a 11.�:.��� =�,c� - = r. - -
Air conditioning
Job site address: 16375 SW 85th Avenue
(requires site plan showing placement) 46.75
City/ State/ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducis/vents) 54.91
Suite/bldg./apt. no.: I Project name: DURHAM ADVANCED WASTEWATE Heat um 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, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of' above 23.32
Subdivision: I Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
.. s et _� Water-heater 23.32 _.. a _ �s-z z
Gas fireplace 3339
Replacement of Foul Air Duct Flue vent for water heater or gas
Install of an odor control fan, an air conditioning unit and a make -up air unit fireplace 23.32
Log lighter (gas) 23.32
and associated ductwork. Wood/pellet stove 33.39
Wood fireplace/insert 23.32
=1.__ .....V.- . _,.... :, Chimp /liner/flue/vent 23 -32
. 1 �:'�..> .�4 ".�__. -.s . . .. ,t. . _ -._.‘ ' ' . _ -' ,- . n, Other. 23.32
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
City/ State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
_ -:, �_� �"- - '"-'" .T'''...1-,---..... Anic/crawls. ace fans 2332
i,,. : -""te pi a 5' ? (_. � -^ --.'. "si," �1.. _ - .. - - a..,.. - 4�.-
i-a r :;. --,1-, - Other: 23.32
Business name: Robert Lloyd Sheetmetal Fuel piping
Contact name: John Williams $14.15 for first four; 54.03 for each additional
Address: 4485 Independence HWY. / PO Box 307 Furnace, etc.
Gas heat pump
City/State/ZIP: Independece, OR97351 Walls •ended/unit heater
Phone: (503) 838 -3863 I Fax: : (503) 838 -3964 Water heater
Fireplace
E -mail: john.williams®rlsm.net Range
,;._• ,, ei. : :
� -� • ..._ T D"" s -* Barbecue
Clothes dryer (gas)
v Business name: Robert Lloyd Sheetmetal ■. --
Other. _ •
Address: 4485 Independence HWY. / PO Box 307 -- ` -TVA) ° 5 3 a . ii "• - 14
City /State/ZIP: Independece, OR 97351 Subtotal 7353.7
Minimum permit fee (590.00)
Phone: (503) 838 -3863 I Fax: (503) 838 -3964 Plan review (25% of permit fee) 1838.4
CCB lic.: 62476 State surcharge (12% of permit fee) 882.44
TOTAL PERMIT FEE 10075.
This permit application elpires if a permit is not obtained within 180
Authorized signa e days after it has been accepted as complete.
Print name: ,3eb d 'T C. Aar( ti •f 41_5 I Date: 08 - 2010 • Fee methodology set by Tri- County Budding Industry Service Board
1.\ auilding \PennilsIMEC- PermitApp.doc 10/01/09 4404617T (11 /02/COMMEB)