Permit CITY OF TIGARD MECHANICAL PERMIT
al COMMUNITY DEVELOPMENT Permit #: MEC2011 -00049
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2011
Parcel: 2S102AA01200
Jurisdiction: Tigard
Site address: 11895 SW GREENBURG RD
Project: Luke -Dorf Subdivision: Lot: 0
Project Description: Duct work, extending gas line, and installing heat pump.
Contractor: MPS HEATING & COOLING LLC Owner: LUKE -DORF INC
PO BOX 5597 11895 SW GREENBURG
BEAVERTON, OR 97006 PORTLAND, OR 97223
PHONE: 503 - 319 -7798 PHONE:
FAX: 503 - 746 -6117
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/04/2011 $416.29
Class of Work: ALT Type of Const: VB Plan Review 02/04/2011 $104.07
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 02/04/2011 $49.95
Stories: 3 Info Process /Archiving - Sm Sheet (up to 02/04/2011 $1.00
11x17)
Project Valuation: $12,623.00
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: 2
Heat Pump: 1
Appliances
Vent Fans: Vent Systems: Total $571.31
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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
applica• - All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
iss . ce, or if wo is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U ity Notification Cent- . • rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may o•tain a copy of the rules
• direct questions to OU ., by c• g 03.232.1987 or 1.800.332.2344.
I ued By: Permittee Si Signature: ' 41101%
Call 503.639.4175 by 7:00 a.m. for the next available inspect'. n 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.
` ,. .-- n , ( ie, ji- q.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard c Date/By: 11 Permit No.: L � L (
Inspection Line: 503.639.4175 ,�
lig
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review �,
Phone: 503.639.4171 Fax: 503.598.1960 -
1 ti� DatDate/By: I Other Permit:
I I I; A K I n specton ne: .639.4175 1 Date Rea dyBy: Ju de: El See Page 2 for
Internet: www.tigard- or.gov 0 � •'�.1oiiSed/Method: ;7/ Supplemental Information
oY \‘ ,� b • . 1 I•.
. TYPE OF WORK 6v ,„ \ c 4 CJ t . ' COMMERC.IA . FEE* SCHEDULE USE CHECKLIST
Cr Mechanical permit fees* are based on the value of the work
❑ New construction j, Addition /alteratton/replace
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
',CATEGORY ' OF CONSTRUCTION .
Value: $ 7. , (O ZZ . 5+
RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
❑ 1 - and 2- family dwelling RC ommercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
• JOB S1 INFOR AND LOCATION Heating/cooling
Air conditioning
Job site address:
it Sq5 7)v) G Y 'v. \f r.\ (requires site plan showing placement) 46.75
City/State/ZIP: — T -- ‘30, v• Furnace 100,000 BTU (ducts/vents) 46.75
97)2,3 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: Lo to e . — box 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
Flue /vent for any of above 23.32
Subdivision: I Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
•
( p Gas fireplace 33.39
� h S A \ al t4 t �a r )OW t.a IA et. , Flue vent for water heater or gas
Add �( l fire, lace 23.32
*. { 1 r g U V\ S \ ■ h'Q, CAA cl' Log lighter (gas) 23.32
\('L `COLA- a 6 v f_ S t tiro Y1' \ v* e 1L 1 S k' \ Y�g Wood/pellet stove 33.39
1� . ` r� 1 `� Wood fire lace/insert 23.32
O 0 PROPERTY ` OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
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
A APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: L ` Other: 23.32
M P5 T'\ c ilk a �{1�` \ /q tL-� Fuel piping
Contact name: (\r u Y C
O O \ T a �+ $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: `` �• ✓ p, ,�
55 'AI C n . 0 V `'k Gas heat pump
City/State/ZIP: 8 G�lt Y � d � i cc O c) 6 Wall/suspended/unit heater
Phone: (553) "'Mk_ - Q t1 I Fax :: 953) ' \ L(6 — G( l 7 heater
Fireplace
E -mail: \ l
Range
CONTRACTOR. Barbecue
Business name: Clothes dryer (gas)
S Q &� Other:
Address: . MECIIANIICAL PERMIT FEES;
City/State /ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: IA ' '4 etc( State surcharge (12% of permit fee)
TOTAL PERMIT FEE
` This permit application expires if a permit is not obtained within 180
Authorized signature: elljV days after it has been accepted as complete.
Print name: M y 0 .e 6 Date:2 / //// I * Fee methodology set by Tri -County Building Industry Service Board
I:\Building\PermitsM C ' PermitApp. doc 10/01/09 440-4 61TP(11 /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.
I: \Building \Permits\MEC- PermitApp.doc 10/01/09 2
_
0
jc
4 ' : S t J 'III
MIi .L S .. 1 8. ® e 1€ r : j , ,, ,......,, , ,.: ..4:-....,. -
tt . Q _ _ C . 2
1 f 'T OHY ' d X. EXI
3 t
O H 6- I 0 C1
� '\ ,
ar i7.71 8I O
MI
CC O.E 11
a ct C1
rte .; ;t •
-'fit - �
TV t e \ ova o-_— — = 1. - • =-
Q OF TIGA
R r CT ;l •.: :'.' • VI', .. Approved .... .. .. r ter
b o w f i Conditionally Approved [ ]
/ See Letter to: Follow [ ]
N 1 ' . E O Atta ed
C C, I P Permit N . e r
•L -- i i — 4.r0e_
I 1°"1 17 1 A..r-ss: i ' S J�'?� -�: P- '>
o B 4 `T 4 D ate: — = !
0 17;1
O —
1Z • '• .
s, �c,
.._ ______,_._ .. i
OFFICE COPY
O . CE
® 1.1_,41.1
i1
All
IZIW AI
ti
O BLDG A - GROUND FLOOR PLAN ® :'�
G
Mir 1'V
AI -•
MY
1
1 Tr
1 1 1
Fl
1 I
1/1
Cc
I I I
Ft
CQ
I 1
1 I CC
I
S--) 1
- .1.,
I 17c'w . 0
I"''' I; !
ilik
1Z17 _ ()____ r ____ 1 _ _ r , 1
- I
. I
•
la,
.• Fl -------- ------- - ' '. ; -, ..
I . 1
,- -
1 ,
NC \ t ‘ I
Ft MI
1 1Z17 ,
'1„-)
171 171
[ 1 , c4
T• - GE I
D4i■
1
TYPE 7C GWEI-11 .
I I
tO YMI W.1 I ll \ '', ' , ' '1, VA C\ UNDER STAIRS 4 . _ x.E.ff
Fl
O rli-) qe- V't,r , ■." I -4 F •.- ‘ . • ‘ r ra
:' • '. " . t - '
V \ C- L) Oki4 ; l c .\ C\ \ 1 I
Ft
I F
i i
1 I 1
" I
AM 4,
4 237 qP).
O BLDG A - BASEMENT REFLECTED • ILING PLAN •St
3/W .. 1,0.