Permit CITY OF TIGARD MECHANICAL PERMIT
111 -1
3 COMMUNITY DEVELOPMENT Permit#: MEC2011 -00006
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/04/2011
Parcel: 2S110DCO2400
Jurisdiction: Tigard
Site address: 11565 SW DURHAM RD 110
Project: Dr. Tollenarr Subdivision: Lot: 0
Project Description: Relocate ducts and grilles for TI
Contractor: RITE WAY HEATING & A/C INC Owner: MOODY 2005 TRUST
PO BOX 1815 BY PAUL W & LINDA L MOODY TRS
HILLSBORO, OR 97123 9811 NE 114TH CIR
VANCOUVER, WA 98662
PHONE: 503 - 693 -3161 PHONE:
FAX: 503 - 647 -9999
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/04/2011 $115.11
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 01/04/2011 $13.81
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $2,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $128.92
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
app• • e law.�vork will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
uance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
tility Notification Center. os= les are set forth in OAR 952 - 001 -0010 through OAR 952 -01 :;90. You may obtain a copy of the rules
or direct que lions to OU by g 503.232.1987 or 1.800.332.2344.
sued By: I �I g Permi' ee Signature: ,
Call 503.639.4175 by 7:00 a.m. for the next available inspection • : e.
This permit card shall be kept in a conspicuous place on the job site until ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
YA /
- Cl of Tigard ey Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI GAR D Inspection Line: 503.639 Date Ready/By: NI ® See Page 2 for
Internet: www.tigard- or.gov . Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE
* - USE CHECKLIST
Mechanical 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.
Value: $ A tntitzt CATEGORY OF CONSTRUCTION ire.
•• RESIDENTIAL EQUIPMENT / SYSTEMS FEES *'
❑ 1- and 2- family dwelling B( Commercial /industrial ❑ Accessory building -
For special information use checklist.
❑ Multi- family ❑ Master builder , ❑ Other:
Description Qty. I Ea. I Total
JOB. ;SITE INFORMATION AND LOCATION ;• Heating/cooling
d i7 . it Air g conditioning
Job site address: s
��� :S .,7 � v / t ` • (requires site plan showing placement) 46.75
City /State /ZIP: �{ L7i� / 7 e/A Furnace 100,000 BTU (ducts/vents) 46.75 -
`l Furnace 100,000+ BTU (ducts/vents) 54.91
Suite /bldg. /apt. no.: 110 Project name: Q. ta-E1J4Q lL Heat pump 61.06
Cross street/directions to job site: • Duct work- 23.32 •
Hydronic hot water system 23.32
. 9f i ,a nek 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: Lot no.:
Other 23.32
Tax map /parcel no.: Other fuel appliances
._ - • . DESCRIPTION OF WORK � . , , �•
Water heater 23.32
�,/ Gas fireplace 33.39
'C /G G ' ..S ' ! 4 7 ¢ /� ( v' - rs") Flue vent for water heater or gas
�� fireplace 23.32
"" ��` Log lighter (gas) 23.32
Wood /pellet stove - 33.39
. Wood fireplace /insert . 23.32
•
y iner /fue /vent
Chimne %I' 23.32
❑:PROPERTY OWNER. : ' , . 0 ".TENANT
Other: 23.32 '
Name: . Environmental exhaust and ventilation
Address: • Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax:
(, ) toilet compartments, utility rooms) 23.32
• ❑ APPLICANT.
❑ CONTACT PERSON . Attic /crawlspace fans 23.32
Business name: f � i L / N � IJ � �f Fuel Fuel 23.32 piping
U L E 4 ,,,2, Contact name: 4,,,2, !� O if d Z..N l � r / $14.15 for first four; $4.03 for each additional
Address: /p ,6".1e- g
//5— C Furnace, etc.
Gas heat pump.
City /State /ZIP: !�, / /S..6y e)17...--[...5 0 t o Wall /suspended/unit heater -
G ) Fax:: ( Water heater •
Phone: (
v 3 6 - 3/ e / a !) 6 -/ - c ,7 ` Fireplace
E -mail: S.fLd
- Pi � e li !i✓4� A . G:- ,- e d-r. _ Range •
C CONTRACTOR Barbecue.
Clothes dryer (gas)
Business name: - (Nr ���� l Other:
Address: �, r✓ d /.g. � MECHANICAL PERMIT FEES *`
City /State /ZIP: 0 4/ /4 5 -6 0 e, )/Z «yin Subtotal //5'."
/ Minimum permit fee ($90.00) --
Phone: ( 6 fj'- I` c. ( Fax: (5'03) e v 2 f '2 i Plan review (25% of permit fee)
CCB tic.: 7/ -State surcharge (12% of permit fee) / 3 . Fji
TOTAL PERMIT FEE /d $. 92,
T his permit application expires if a permit is not obtained within 180
Authorized signature:. !� i��i days after it has been accepted as complete.
Print name: J 2.- io c - "ae(7µ79J / Date: / - 4w * Fee methodology set by Tri- County Building Industry Service Board
I.\ Building \Permits\MEC - PermitApp.doc 10/01/09 44046t7T (I I /02/COM/WEB)