Permit Er • ' .CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00739
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2007
PARCEL: 2 S 102AD -01900
SITE ADDRESS: 08935 SW BURNHAM ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TVF &R
Project Description: HVAC Replace roof top unit. Value: $3850.00
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm:.
GAS OUTLETS: 1
Owner: FEES
TUALATIN VALLEY FIRE + RESCUE Description Date Amount
20665 BLANTON ST
ALOHA, OR 97007 [MECH] Permit Fee 12/19/20( $116.20
[MECPLN] Plan Rev 12/19/20( $29.05
[TAX] 8% State Surcha 12/19/20( $9.30
Phone:
Total $154.55
Contractor:
ANCTIL HEATING & COOLING
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:,xG
Call 503.639.4175 by
7:00 a.m. for inspections that bun a .
Y P Y
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.
Me cha> cal Permit A 1'rw in
/ EIVE 0 FOR OFFICE USE ONLY City of Tigard Received Q
DDate/By: ,� q, r / ' Permit No i
116 C40741D7 ef
7a
Hall Blvd., Tigard, OR 97
' v 13125 SW C Phone: 503.639.4171 Fax: 503.598 1, i 2007 Plan Review
Date/By: Other Pen.' .
Inspection Line: 503.639.4175
T 1 G A R D CITY V O F rr AfU Date R B:
Internet: www.tigard otgov U y y S Page 2 for
BUILDING U1 DIVISION
Notified/Method: Supplemental Wormation
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TYPE :OF WORK COMIVI> RCIAL FEE* SCHEDULE r, HE
USE;CCKLIST'
Mechanical permit fees' are based on the value of the work
❑ New construction 0 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
' CATEGORY OF °'CONSTRUCTION - N . ''a s ;. ' Value: $ 3X0
RESIDENTIAL,EQUIPIIMENT./ SYSTEMS°FEES *"
❑ 1- and 2 family dwelling Commercial/industrial ❑ Accessory building '
❑ Multi - famil For special information use checklist.
Multi ❑ Master builder 0 Description Qty. Ea. Total
,,, ,•,' •, ". JOB. SITE` INFORMATION' AND,: LOCATION'" ,; Heating/cooling
Job site address: � `�� '✓ � - j ` 1A , Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: T 7 X93 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg, /apt. no.: Project name: 7v L ai it _ sq.-Ai- c—) Gas heat pump 14.00
Cross street/directions to job site: J 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: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
�- • _- :DESCRIPTION OF WORK. " ; Water heater 10.00
. ... .. . ; ,
,fi Gas fireplace 10.00
I `', e t 6 , E 1 S7" ,4 l c /v.. to / , 2.4, (.,,,,j I T-,-, Flue vent for water heater or gas
_Auk ) L'W tT iloisT 6 OW..�p(4 t"/� ua 6f, Log
fireplace 10.00
1 '? Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
' PROPERTY OWER Chimney/liner /flue /vent 10.00
�� ., . , . N E o TENANT
Other: 10.00
Name:
s ° / Fl/Z.,
Environmental exhaust and ventilation
Address: 1 .i(- $, .1 , 04( 1 ,/1 .n Range hood /other kitchen
� Ds rW/ equipment 10,00
City/State/ZIP: S'; 1, � -fin , /1 7 / , /� Clothes dryer exhaust 10.00
Phone: ( 5) h r l � 1 � Y , • v 1 �I Fax: ( 7 ) Single -duct exhaust (bathrooms,
' j/ toilet compartments, utility rooms) 6.80
.o APPLI , W ' - ' ❑ CONTACT PERSON Attic /crawlspace fans 10,00
Business name: Other': • 10.00
"wilt, j., f>~'477iiJ C6+a, „,d( Fuel piping
Contact name: (fin, �.�� $5.40 for first four; $1.00 for each additional
Address: It / /Lt//4-01.2 Furnace, etc.
Gas heat pump
City/State /ZIP: pM.4 -
0 0 , 9 6v24, `j7 / 7 Wall/suspended/unitheater _
Phone: (,543 ) j - p j - r Fax: ( ) Water heater
Vv' 5 Via- ,tea Fireplace
E -mail: vll 4> a /I v!7 /�/ A . e_ify 1. Range
CONTRACTOR Barbecue _
Business name: Clothes dryer (gas)
S .y�I�IP, as_ akk'„
Address: Other
MECHANICAL PERNIIT FEES*
City / State/ZIP:
Subtotal j 1, •71
Phone: ( ) p er: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee) q.0 4,
CCB lie.: 7 State surcharge (8% of permit fee) 3tro
`� TOTAL PERMIT FEE /4 ,,55
Authorized signature: / i Ihis permit application expires if a permit is not obtain within 180
days after it has been accepted as complete.
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Print name: j' Date: a _ i , _ Fee methodology set by Tri-County Building Industry Service Board
I: tBu PemvtApp.da; 04/06!06 440.46177 (11 /O2/COM/WEB) 36 P.
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