Permit Ph CITY OF TIGARD MECHANICAL PERMIT
= COMMUNITY DEVELOPMENT Permit #: MEC2011 -00067
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2011
Parcel: 2S110BC00900
Jurisdiction: TIG
Site address: 12475 SW BULL MOUNTAIN RD
Project: Tigard 10 MG Reservoir Transfer Pump Station Subdivision: Lot:
Project Description: Mechanical for pump station.
Contractor: GREY WOLF HVAC INC. Owner: TIGARD WATER DEPT.
7306 NE 37TH AVE 8777 SW BURNHAM ST
VANCOUVER, WA 98665 TIGARD, OR 97223
PHONE: 360 - 588 -3207 PHONE: 639 -4171 395
FAX: 360- 326 -8506
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/09/2011 $1,488.21
Class of Work: NEW Type of Const: Other Plan Review 03/09/2011 $372.05
Occupancy Grp: U Occupancy Load: 12% State Surcharge - Mechanical 03/09/2011 $178.59
Stories: Info Process /Archiving - Sm Sheet (up to 03/09/2011 $4.50
11x17)
Project Valuation: $55,000.00
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: 5 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 5 Vent Systems: Total $2,043.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: motorized
Duct Work: 1 and counter
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
issuan -, •r i ' • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili Notification Cen :. T • - rules are set forth in OAR 952 - 001 -0010 through 1 ' • • '090. You may obtain a copy of the rules
or • rect questions to OUN . call g 503.232.1987 or 1.800.332.2344.
1
Issu d By:
■ ' 4 . � . Permi • e Signature: /, ' /(g.
Call 503.639.4175 by 7:00 a.m. for the next available • pection 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 of Tigard " ai Date /By: � j�� Permit No: — . / . _
- ■ 13125 SW Hall Blvd., Tigard, OR 9722 1 �' `
Phone: 503.639.4171 Fax: 503. 0; x' " �i s Plan Review�� Egli Other Permit: g _ _ i it, Date/By: U
IGARD Inspection Line: 503.639.4175 r 411 Date Ready /By: n ' luris ®See Page 2 for
Internet: www.tigard - or.gov V Not led/, ethod:a /��ll ii. Supplemental Information
TYEE Ult Wd .. 4.. it 1 x 1t °r ... ` , CO I RC FEE *.. SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ZI Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
s CATEGORY Qk CONS'TIL�OI5 ,. Value $ oat, . . L R EsstrA LEQU,tII!I4trsrISYS *,
❑ 1- and 2- family dwelling (N Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. I Ea. I Total
`.14B SITE INFORMATION .AND LOCATION Heating/cooling
Job site address: 114-1 �`+ A Air conditioning or heat pump
1 tr 1 (requires site _plan showing placement) 14.00
City/State /ZIP: 1 i ctra o . oat-L-3 Furnace 100,000 BTU (ducts /vents) 14.00 1
(� Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name: �6.) G Q 1 &i( V ®0 t" !. 4. as heat pump 14.00
Cross street/directions to job site: .
A M ^ •C-1-41) C),�/ Duct work 14.00
, 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. 10.00
Subdivision: I Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
', s � � g % <t ' • .. ° �i 1 > 4,�� . Water heater 10.00
� Gas fireplace 10.00
\h l t' A 012) A- A l r qS i t5) A �C hla tisi , t�Vtts I (6 u . Flue vent for water heater or gas
�'1.lLl�',t,YS(p) inkverS (3 caotDri darner (3 mu-kr_ fireplace 10.00
r . Log lighter (gas) 10.00
i
�0(iJ 11CCQ �{ yS li ne.L. Wood/pellet stove 10.00
f Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
- z ! , ,, , .a .. � 0 : ,.� , .; ... 'i .. ..., Other: 10.00
Name: C419 cc, /t/'t 0 L Environmental exhaust and ventilation
Address: J'�JF Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) _ 6.80
� F. , .,
r ; n� rg e i i s Attic /crawlspace fans 10.00
� e ..; a : :. Other: 10.00
Business name: c Art a � \' w t , Fuel piping
Contact name: 1)(1,ifelk Os rn.R., $5.40 for first four; $1.00 for each additional
N 5 eli t n Furnace, etc.
Address: t,tJC Gas heat pump
City/State /ZIP: v aAvotA g ty l l Wall/suspended/unit heater
Phone: (3� '
a) 6 Qf�, • 3 20 Fax:: (NiQ) 3 Z� p $� co Water heater
" ` Fireplace
E-mail: fo r TU. oreoydolf KVlt /t e (j A Range
1 .
CONT(1iACTOR`° - R „a . Barbecue
�� dif e t `n Other: dryer (gas)
Business name , ” ^^ `` ,,..��� tt
Address:latp ,V� �• -KP )11 $4 HAZNICAI.P IITIFEI S*
City/State /ZIP: V V or 10 J 02tecc _ Subtotal
Phone: `'`� Minimum permit fee ($72.50)
(? Q) � ax: (gyp 3 tp Q'3o e P lan review (25% of permit fee)
CCB lie.: LI l� ,-, State surcharge (8% of permit fee)
119 TOTAL PERMIT FEE
f ,� I \ _.- This permit application expires if a permit is not obtained within 180
Authorized signature: `1),- or
i days after it has been accepted as complete.
Li Print name: reAk , kb IV Date' C)2, I f 2 (1 * Fee methodology set by Tri -County Building Industry Service Board
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