Permit a p CITY OF TIGARD MECHANICAL PERMIT
`1 2 ' COMMUNITY DEVELOPMENT Permit #: MEC2011 00501
T!GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2011
Parcel: 25101 DA01500
Jurisdiction: Tigard
Site address: 7150 SW FIR LP 100
Project: Halstead International Subdivision: 72ND BUSINESS CENTER Lot: 5
Project Description: Replace (1) 3 ton a/c ground mounted unit and associated supply /return air duct.
Contractor: AMERICAN HEATING INC Owner: DHS LLC
1339 SE GIDEON ST 15 OAKWOOD AVE
PORTLAND, OR 97202 NORWALK, CT 06850
PHONE: 503 - 239 -4600 PHONE:
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/08/2011 $194.93
Class of Work: ALT Type of Const: Plan Review 11/08/2011 $48.73
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/08/2011 $23.39
Stories:
Project Valuation: $4,540.00
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 $267.05
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
applicable law. Au work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, if work is s ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility otification Center. Th se are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir ct ques ions to OUNC by c ng 50 . .1987 or 1.800.332.2344.
Iss ed By: `- / / Permittee Signature: LI Ne4Gle..5* /e/'
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.
Mechanical Permit Application Iolz O1 l l( I i til Oil \
Received �� `� w / D O
City of Tigard
Date/By: : PermitNo.:
111
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
= Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction 2 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labo , overhead, and profit
CATEGORY OF CONSTRUCTION Value: $ 5—(40
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. 1 Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: r l 1 J 0 C ( Air conditioning
`l g V _ (requires site plan showing placement) 46.75
City/State /ZIP: `' l G . 97 I -1 Furnace 100,000 BTU (ducts/vents) _ 46.75
Suite/bldg. /apt no.: Project name: , t lik.1/24-(1thjjilk, Furnace 100,000+ BTU ( ducts/vents) 54.91
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
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK _ heater , 23.32
Rae ° O n � i\ 461\ n r i W - ; / and Gas f replace 33.39
�y l ,l X ) ( �' po (
f �! l�l Flue vent for water heater or gas
Q , • I l�t_a d (4Q 1.(q / ft frl d,a , fireplace 23.32
1 J �('l Log lighter (gas) 23.32
Wood/pellet stove 33.39
0--cA .-
��, Wood fireplace/insert 23.32
AO Chimney/liner /flue/vent 23.32
PROPERTY R , ❑ TENANT Other: 32
23
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name: k.Aciin 0 if l ` T at r Fuel piping
Contact name: fQ t 1 0 ,, ` / 1 '� " y ' ti $14.15 for first four; $4.03 for each additional
v "J i4--6g =k-/ L Furnace, etc.
Address: �� S 6 S ` Gas heat pump
City/State/ZIP: ev oN 4ta rte j O a ch a. a Wall/suspended/unit heater
Phone: (j (p)) x73(1 L 0 O ( Fax::'( a3 Ct _103 g Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue _
Business name: n ^ �\ C 1c
Clothes dryer (gas)
„ UC l Other:
Address: 13 Se ( l ��� ' MECHANICAL PERMIT FEES*
City/State/ZIP: 1 � 0 (Z. 47 ? Subtotal /W. F3
Phone: ( `� _ 1.u V U Fax: ( ,) '- 03 $ Minimum permit fee rmit fee) �
Plan review (25 °!0 of permit fe) t . 7 ?
CCB lie.: 3 v ( 3 5— State surcharge (12% of permit fee) 3 O TOTAL PERMIT FEE A .
Authorized signature: �� 7l 1 AN( This permit application expires if a permit is not obtained within 180
�,� signature: �/ days after it has been accepted as complete.
Print name: r � r 1" rt l'w � Date: 11—g -4 I • Fee methodology set by Tri -County Building Industry Service Board
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