Permit II ' q CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00359
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2009
Parcel: 2S113AB00800
Jurisdiction: Tigard
Site address: 15995 SW 74TH AVE 150
Subdivision: FANNO CREEK ACRE TRACTS Lot: 0
Project: Excel Orthodontics
Project Description: Replace 5 ton RTU.
Owner: FEES
DUNCAN, JOHN A & JANICE LEE Description Date Amount
9929 NW UPTON CT
PORTLAND, OR 97229 Permit Fee 07/20/2009 $175.70
Plan Review 07/20/2009 $43.93
PHONE: 12% State Surcharge - Mechanical 07/20/2009 $21.08
Contractor:
KENTEC HEATING
PO BOX 233
WOODBURN, OR 97071
PHONE: 503 - 982 -5927
FAX: 503 - 982 -0933
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Occupancy Load:
Stories:
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 $240.71
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 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 ob ain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. 1
Issued By: cc..4 a n Q \ o :\,[\ Permittee Signature: 4 9 .._d
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 .
FOR OFFICE ; USE ONLY
i 1 eived
11:9
City of Tigard .. Permit No.: p
131 Hall Blvd., Tigard, OR 97223 � ECEW! 'e/By: „II h I, ,O(Z
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review 1t
2 0 2001 Date /By: W � MI Other Permit:
Inspection Line: 503.639.4175 � Date Ready /By:.: Juris: ® See Page 2 for
Internet: www.tigard-or.gov ®F CI GAR'/ otified/Method: 7 J �- \ C Supplemental Information
CITY TYPE, OF WORK BUI �livu DIVISION r COMMERCIA FEE* SCHEDULE t USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction A ddition /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: $ (�` 10 �, E*�
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
� Air conditioning or heat pump
Job site address:
is—ti. l :.:) ifj 7 v / -v e •, (requires site plan showing placement) 14.00
City /State /ZIP: I 4 L 5 7 `I , Furnace 100,000 BTU (ducts/vents) 14.00
���
. Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt.no.: O Project name: e O,f(j7jDlJ,c, Gas heat pump 14.00
Cross street/directions to job site: �" f 1 � <, 4 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
Flue /vent for any of above 6.80
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
�r // Gas fireplace 10.00
Ref (t , PNCIa "t ri) ll t V i4 C.-- ". ,i t "t' 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
e Chimney /liner /flue /vent 10.00
❑ ,PROPERTY OWNER TENANT
Other: 10.00
Name: EXCc f e A �,}. y ' 5 Environmental exhaust and ventilation
Address: u Range hood /other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (97!) ai _ 0 ac f Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Fuel r rn
P g
Contact name: $5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump .
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
• CONTRACTOR Barbecue
4e - J Clothes dryer (gas)
Business name:
ty 1' �t�.t! °T -t k.p Other:
Address: rr 8 ,...,, r f.i 3-7, i J r MECHANICAL PERMIT FEES* ,
City /State /ZIP: d Subtotal r 75 -•14)
� � Ct i` -ti ,/ �'i �� , _ 1 �' ) / Minimum permit fee ($72.50) .5/S. 9 3 P.
Phone: (5 13 ) j — s-23 i ` Fax ( f . ) `1 Ec' 4) 9- (25% permit fee) ' 4 i ,0,3 �. � 6 — .a Plan review 25 /o of ermit fee
CCB lic.: 6) 3 47 ,g_ 1 1 • -1 - ( O State surcharge (12% of permit fee) -
t TOTAL PERM (-/ IT FEE . 7/
( - - This permit application expires if a permit is not obtained within I80
Authorized signature: e ?%'a�� days after it has been accepted as complete.
Print name: �", A y — , t• ko i :,,e_ Date: 7 A4V 1 * Fee methodology set by Tri- County Building Industry Service Board
I: IluildingTermits\MEC- PermitApp.doc 01/19/07 X03 i o -- a1 440 -4617T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$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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