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Permit
CITY OF TIGARD MECHANICAL PERMIT °" COMMUNITY DEVELOPMENT Permit #: MEC2009 -00691 T f G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/02/2010 Parcel: 2S113B000600 Jurisdiction: Tigard Site address: 16580 SW 85TH AVE Subdivision: SEWER TREATMENT PLANT Lot: 0 Project: Clean Water Services - Struvite Recovery Facility Project Description: HVAC system upgrade. Owner: FEES CLEAN WATER SERVICES Description Date Amount 2550 SW HILLSBORO HWY HILLSBORO, OR 97123 Permit Fee 02/02/2010 $1,109.71 Plan Review 02/02/2010 $277.43 PHONE: 12% State Surcharge - Mechanical 02/02/2010 $133.17 Contractor: LDE COMPANY 23342 DOANE CREEK RD. SHERIDAN, OR 97378 PHONE: 503 - 876 -2524 FAX: Type of Use: COM Class of Work: ALT Type of Const: IIB Occupancy Grp: Occupancy Load: Stories: Fuel Air Handlers Fuel Types: Natural Gas Units < 10000 cfm: 1 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 $1,520.31 Hoods: Comm Incinerators: Required Items and Reports (Conditions) Woodstoves: Gas Fireplaces: Clothes Dryers: Other Mech Units: Gas Outlets: 1 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 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 Notifi - - - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or dire questions to OUNC by j 503.246.6699 or 1.8 Is ued By: ./1 Lt f Permittee Signature: 4des.„/„A .f`. Call 503.639.4175 by 7:00 a.m. for an inspection that busi 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 Applicalq> FOR OFFICE USE ONLY 17 r City of Tigard �{.t1 C I V Date/By/U. �� Permit Nc �© Q 13125 SW Hall Blvd., Tigard, OR 9 7223 fir" �� ��� Plan Revie I Phone: 503.639.4171 Fax: 503.598.196 ®E 3 0 2009 Date/By: , + 1 / l OtherPermit:41 y 701 c ow I Inspection Line: 503.639.4175 �+ l• Date Ready/By: lads: ® r S r ee L P a e 2 for `^ W ` TIGARD Y y: g Internet: www.tigard -or.gov Notified/Method: I �7 t ( , ,_ Supplemental Information CITY OF TIGARD lT TYPE OF L l DIVISION ) 1 i 4 1, . IAL FEE* SCHEDULE - USE CHECKLIST III New construction Addition /alteration/replacement ical permit fees* are based on the value of the work , - • • • ed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ 4 000 '-' CATEGORY OF CONSTRUCTION t RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling VI Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description p I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling ,,, Air conditioning Job site address: / 6 510 S' e S _ /1 v� (requires site plan showing placement) 46.75 City /State /ZIP: f G i 4 -{L,() 6 (Z /-722.4- Furnace 100,000 BTU (ducts /vents) 46.75 Furnace 100,000+ BTU (ducts/vents) _ ' I 54.91 Suite/bldg. /apt. no.: S Q.} I Project name: 5 l Q ` Z e lc O frO-( r/( l L I .j 7 Heat pump 61.06 Cross street/directions to job site: lfV4< -- S 'l S 5 - 5 1 t. to PG R-( Duct work 23.32 Hydronic hot water system 23.32 l7 Q.i} 3 R b w 51-.) QS` / Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: I 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 /I Gas fireplace 33.39 12-i- P L4(, C 1� ( S 1 1 i- C, l I / 46 (4 A/l'f vi 1 Tl} At; oJ Flue vent for water heater or gas s /401) 2 G15 C I etc/a-L bk r�l ,1 IdC4 -j-/2 S Log fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 tgl PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: ( C ,,,j 1,4 A-Q-s/L S if.,/ I C 5 S Environmental exhaust and ventilation Range hood/other kitchen Address: .p1$3b Sul /fitaaci2.O h /equipment 33.39 City /State /ZIP: ff YLLS/3 oft. q f/ RI, Cl othes dryer exhaust 33.39 / Single -duct exhaust (bathrooms, Phone: (`;-= j) toilet compartments, utility rooms) 23.32 gl APPLICANT LA CONTACT PERSON Attic /crawlspace fans 23.32 , Other: 23.32 Business name: (L R 'J�t 54. ' ;- VtG4 S Fuel piping Contact name: A..A, 0 .. A $14.15 for first four; $4.03 for each additional Address: i 6 6 6 o S t�1 es - 4"- Furnace, etc. I Gas heat pump City/State /ZIP: TkG (-o p D 2 CJ 7 Z 2-4 Wall/suspended/unit heater J Phone: (xo 3) e -j __ 6 I I Fax:: (5 S 7 - Ei l '( Water heater 3 Fireplace E -mail: I'1AC Y'� t l eA vt w 0 5 e)-,v Ic4 C , or) Range CONTRACTOR / Barbecue Business name: L .D� Clothes dryer (gas) Other Address: 2 't p. /q of e sG/i MECHANICAL PERMIT FEES* City /State /ZIP: Nit 6 1 ) 4 1 3 © e �' 7 S79 Subtotal /lop .71 / Minimum permit fee ($90.00) I ( ) Phone: ( ) Fax: Plan review (25% of permit fee) ,,V7. «3 CCB lie.: (e'1J 740 CCB 11f . t ( State surcharge (12% of permit fee) . TOTAL PERMIT FEE +J l Authorized SI e: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:) j 7 n Date: 05 (, g p I_JV( * Fee methodology set by Tri- County Building Industry Service Board 1: Building \PermitAMEC- PermitApp.doe 10/01/09 440-4617T (I1 /0?JCOM/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. 1:\ Building \Permits \MEC- PermitApp.doc 10/01/09 2