Permit a CITY OF TIGARD MECHANICAL PERMIT
IN * COMMUNITY DEVELOPMENT Permit #: MEC2011 -00046
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/01/2011
Parcel: 2S110DC01000
Jurisdiction: Tigard
Site address: 11160 SW SUMMERFIELD DR 8
Project: Summerfield Apartments Subdivision: SUMMERFIELD APARTMENTS Lot: 0
Project Description: Intalling vent for new clothes dryer.
Contractor: SKYWARD CONSTRUCTION INC Owner: SUMMERFIELD ASSOCIATES, LLC
15908 NE 10TH AVE BY HSC REAL ESTATE
RIDGEFIELD, WA 98642 1500 SW FIRST AVE STE 1020
PORTLAND, OR 97201
PHONE: 360 - 546 -1625 PHONE:
FAX: 360- 546 -1630
FEES
Specifics: Description Date Amount
Type of Use: MF Mechanical Permit - COM 02/01/2011 $90.00
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/01/2011 $10.80
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $0.00
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 - HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $100.80
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: 1 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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ■
/ I
Issued By: ermittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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
City Permit No.:
• 131 of Tigard SW Hall Blvd., Tigard, OR 97223 Date/By: 1 =WM
Plan Review -all J —
II I I Phone: 503.639.4171 Fax: 503.598.19 Date/By: Other Permit:
I I c i n it I) Inspection Line: 503.639.4175 �'� Date Ready/By: El See Page 2 for
Internet: www.tigard- or.gov 7 ri ' Notified/Method: Supplemental Information
TYPE OF WORK �� `�� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ❑ Addition /alteratioitir 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- i2- family dwelling ❑ Commercial /industrial ❑ Accessory building
• For special information use checklist.
I:1 Iulti- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/J Air conditioning
Job site address: ///6 5' e 77I
� s a pr M .P n ! ``' t" (requires site plan showing placement) 46.75
City/State /ZIP: t � I p C ' , 3 L( Furnace 100,000 BTU (ducts /vents) 46.75
At „Jr..., Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bld • � T • J o.: Project name: : 41 M 1r1 lr r% e 41 r�(f S . Heat pump 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
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
I ) 1 Gas fireplace 33.39
1/ ev / f 0 r. 4,r , e r Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
y Wood fireplace /insert 23.32
CJ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
r / / Other: 23.32
Name: S U M e1 -e r Tie 1J Q SS , AL( Environmental exhaust and ventilation
S� Range hood/other kitchen
Address:
5-O 0 SL) . % lj a/ e s f t / 0 n equipment 33.39
City/State /ZIP: s'C, a / Clothes dryer exhaust 1 33.39 33 .3
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
0 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping
Contact name: ^ A / S a $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: X03 ) 3 /0 7 / e7 ('e // Fax:: ( )
Water heater
Fireplace
E -mail` Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: 5 6l/ t ea r e f C U N 5 f r o r I ;04) Other:
Address: / 5--ga do ^ / c /0 ( d u t: MECHANICAL PERMIT FEES*
City /State /ZIP: ,e cti C j't, R ji C /2, 966 y/ Subtotal - 3� • 341
/ _ Minimum permit fee ($90.00) qij ..up
Phone: (360 5 /`,q Fax: (3 6 5"< /C / 6 3o
Plan review (25% of permit fee)
CCB lic.: j_5 I f , State surcharge (12% of permit fee) l 0 �)1) S TOTAL PERMIT FEE it)) _
Authorized signature: 9cx 4 04.-- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: K&1'-5 Q a Date: / IP^ a * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doe 10/01/09 440 -4617T (t 1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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