Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00524
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/18/2011
Parcel: 2S 112 DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 130
Project: Yecuris Subdivision: Lot: 0
Project Description: Installation of new exhaust fan, ductwork for upgrade of existing exhaust system.
Contractor: HYDRO -TEMP MECHANICAL INC Owner: PACIFIC REALTY ASSOCIATES
28465 SW BOBERG RD 15350 SW SEQUOIA PKWY #300
WILSONVILLE, OR 97070 PORTLAND, OR 97224
PHONE: 503 - 582 -8525 PHONE: 503 - 624 -6300
FAX: 503 - 582 -1914
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/18/2011 $629.65
Class of Work: ALT Type of Const: Plan Review 11/18/2011 $157.41
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 11/18/2011 $75.56
Stories: Info Process /Archiving - Sm Sheet (up to 11/18/2011 $11.50
11x17)
Project Valuation: $21,011.00 Info Process /Archiving - Lg Sheet (over 11/18/2011 $2.00
11x17)
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:
Heat Pump:
Appliances
Vent Fans: 1 Vent Systems: Total $876.12
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: 2011 Oregon
Duct Work: 1 Code
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC • calling 503.232.1987 or 1.800.332.2344.
Issued By: 4r Permittee Signature:
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, „ , . .: • FOR OFFICE USE ONLY
tl_ >'- )d l';
City of Tigard Rece ived 1 Permit No.: �ct �0�� Q0
° 13125 SW Hall Blvd., Tigard, OR 97223 NOV 18 2011 Date/By: �� �� // . —
Plan Revie f'A
Phone: 503.718.2439 Fax: 503.598.1960 Date /By/ f t � Other P `� oO- , U f/
TI GARD inspection Line: 503.639.4175 aril OF TIGAF D Date Ready :y: Jens: El See Page 2 for
Internet: www.tigard or.gov Notified /Method: 77 Supplemental Information
BUILDING DIVISION
TYPE OF WORK , COMMERCIAL. FEE* SCHEDULE — USE CHECKLIST j
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement perfonned. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $21,011.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS,FEES*
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special infor,nasion use checklist.
❑ Multi - family El Master builder ❑ Other: Description Qty. Ea. Total
/505 JOB SITE INFORMATION AND LOCATION i Heating/cooling:
Air conditioning
Job site address: 1 SW Sequoia Pkwy. (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City/State /ZIP: Portland, OR 97224 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. n... 130 Project name: Yecuris Heat pump
...._ (requires site plan showing placement) 61.06
Cross street/directions to job site: 72nd 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, Water heater 23.32
Gas fireplace 33.39
Installation of new exhaust fan, ductwork for upgrade of existing exhaust system Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood lireplace/insert 23.32
® PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: PacTrust Environmental exhaust and ventilation:
Address: 15350 SW Sequoia Pkwy. #300 Range hood /other kitchen
equipment 33.39
City/State /ZIP: Portland, OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)624 -6300 Fax: (503)624 -7755 toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON i Attic /crawispace fans 23.32
Business name: Hydro Temp Mechanical, Inc.
Other: .t 23.32
Fuel piping:
Contact name: Craig Smit $14.15 for first four; $4.03 for each additional
Address: 28465 SW Boberg Rd. Furnace, etc.
Gas heat pump
City /State /ZIP: Wilsonville, OR 97070 Wall /suspended/unit heater
Phone: (503) 582 -8525 Fax: : (503) 582 -1914 Water heater
Fireplace
E -mail: craigs@hydrotempmech.com
Range
CONTRACTOR Barbecue
Clothes, dryer (gas)
Business name: Hydro Temp Mechanical, Inc. -
Other:
Address: 28465 SW Boberg Rd. MECIIANICAL.PERMIT FEES*
City /State /ZIP: Wilsonville, OR 97070 Subtotal
Phone: (503) 582 -8525 Fax: (503) 582 -1914 Minimum perntit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: 63907 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180 j) days after it has been accepted as complete.
Print name: Craig Smit Date: 11/18/11 * Fee methodology set by Tri- County Building Industry Service Board
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