Permit CITY OF TIGARD MECHANICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00229
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/01/2011
Parcel: 2S109ACO2100
Jurisdiction: Tigard
Site address: 14850 SW 132ND TER
Project: Alberta Rider Elementary School Subdivision: ALBERTA RIDER ELEM. SCHOOL Lot:
Project Description: Replace existing ductless heat pump, like- for -like.
Contractor: HYBRID HEATING & AIR CONDITIONING CO. Owner: TIGARD - TUALATIN SCHOOL DIST 23J
PO BOX 329 ATTN: BUSINESS MANAGER
CORNELIUS, OR 97113 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503 - 357 -5663 PHONE:
FAX: 503 - 357 -0668
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/01/2011 $207.21
Class of Work: ALT Type of Const: IIB Plan Review 06/01/2011 $51.80
Occupancy Grp: E Occupancy Load: 12% State Surcharge - Mechanical 06/01/2011 $24.87
Stories: 2 Info Process /Archiving - Sm Sheet (up to 06/01/2011 $1.00
11x17)
Project Valuation: $4,975.00
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $284.88
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No ' cation - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may obtain a copy of the rules
or dire questions to O ■ ' sy c _ II' , 503.232.1987 or 1.800.332.2344.
Issued y: I i _ Permittee Si. nature: ' ( ��
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
05/24/2011 11:05 5033570668 HYBRID HEATING PAGE 02/05
Mechanical Permit Application t . roiroFFit:E: usr, ow'
t�
, � c\
Received el .5 ZS / /.
IN City of Tigard \ Permit No./ �t,zoii•- or .2.;,2 9
a 13125 SW Hall Blvd., Tigard, Ol4 23\,,u - Plan Rc� s i
R' Phone, 503.718.2439 Fax 503.59 1J6U Plan
Date/By: � Other Permit.
Inspection Line: 503,639.4175 r' A
I'1vAR[7 p `t� ^ � .c l 4 ° ��
Date Ready :Y:
Supplemental e t I nn
d or.gov
�` �! V V AS Notified/Method. In[orwation
Internet: www.tigar rin
„.. _ _
Mechanical permit fees* are based n the value of the work
❑ New construction Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials eq ipment, labor overhead, ariprofit.
rE Rat Oaf CON$ 1W (zt
cue $ ��
I�5�L1W I' L� , &4�iJ�!PM�.)5��3'E ,,,� -';.
❑ 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi - family 1:1 Master builder ❑ Other: Descripti Qty. Ea. Total
,, • Hcatin cooling:
& r, t r , y u e +3 rr ,. 4T'I 'n* ,
�-;�`< _�,,, � ,, . ar; . . _ Air conditioning
Job site address: / r� N 5 / 3.t) 'FP ird c.P ._ (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) , 46.75
City /5tate/z1P: a Q,- 0E " .2 Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt. no.: Project name: 91 67 Rt der C /Wen . Heat pump
(requires site plan showing placement) 61.06
Cross steel/directions to job site: Duct work , 23
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:
. , * r r , : i t satirtI ', ' oRK Water heater 23.32
Gas fireplace 33.39
rQ '9 lt J aii.te ' __ . it: Flue vent for water heater or gas
r Fireplace 23.32
Log lighter (vas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
$;,33:',.;,:„,,,', ' ..„ y ` , a � < ` ' , , . . ; ; : , ; , ' , r . , , , , . ,a fl NAi t . chimney/liner/flue/vent 2332
Other. _
Name: , QYci r f or .. AA. r, . r G"` Environmental exhaust and ventilation: •
Range hood/other kitchen
Address: 6 , • A. .e • I� • r - _ equipment 33.39
City/State/ZIP; - / clothes dryer exhaust 33.39 ,
'• " � Single -duct exhaust (bathrooms,
Phone; ( ) Li / ( r Ott? Fax ( ) toilet compartments, utility rooms) 23.32
eS ' , lY t ro- see fans 2332
� till101 r , 1 QO AC2 Emmi . p
AttiC/crswls h
Other; 23.32
Business name: Fuel
piping:
Contact name: $14.15 for first tbur: $4.03 for each additional
Address: Furnace, etc.
- - Gas heat pump ,
City /State/ZIP: Wall/suspended/unit heater :
Phone: ( ) I Fax; : ( ) _ Water heater r
Fireplace .
E -mail: Range t:
,r "*' ; :77.',,,,T,..;' i i ,R . �, �* - 1.•. . a `' d
Bar �.�
o Cotes dryer (gas)
Business name; r I 4 I - _ F' A i r Other; _
■ Address: c7 . G • w ' . , `:..: ' ii . u: t -X? a ...
City /State/ZIP; it y, ,I2 it 0 � t 0 Subtotal 07.21
rn /� q � / / Minimum permit fee ($90.00)
Phone: ( 3 ) 3 /-r (p Fax: / (J t¢ 10� Plan review (25% of permit fec) S I.40
l CCB tic.: a 03 State surcharge (12% of permit fee)
TOTAL PERMIT FEE . , ", ., f,
. This permit application expires if a permit is not obtain wit in 1!l
Authorized signature: 9 days after it has been accepted as complete.
Print name: „ r
`„� -i(\ N..- . � ` Date: AVIRIIIII ' Fee methodology set by Tri- County Building Industry Service Board
1:\mild:ns\Pc mits\ EC- rern,liAp).da 09/09/10 440 (11/0Z/COM/WSR)