Permit ' CITY OF TIGARD MECHANICAL PERMIT
;� £ . COMMUNITY DEVELOPMENT Permit #: MEC2009 -00319
Date Issued: 08/07/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102DA00401
Jurisdiction: Tigard
Site address: 13125 SW HALL BLVD PD
Subdivision: Lot: 0
Project: Tigard Police
Project Description: Install 3 ton ductless split system for server room.
Owner: FEES
TIGARD, CITY OF Description Date Amount
13125 SW HALL BLVD
TIGARD, OR 97223 Permit Fee 08/07/2009 $195.50
Plan Review 08/07/2009 $48.88
PHONE. 12% State Surcharge - Mechanical 08/07/2009 $23.46
Contractor:
RINU
19570 SW 90TH CT
TUALATIN, OR 97062
PHONE: 503 - 603 -0205
FAX: 503 - 603 -0150
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $267.84
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: CO¢ f ol n in Q . 1 , Q . ij ajuN Permittee Signature: / / / / ;• 0 i , - /
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
1 , . T ( 3 k2 ' -93 t/kL--
Mechanical Permit ApplicatiREcEi FOR OFFICE USE ONLY
City of Tigard Received
k 4 Permit No.
q 13125 SW Hall Blvd. Tigard, OR 97223 • I, ._ i to , 0 0
Blvd., ,
11111 " Date/By:
Plan Revievi
1 Phone: 503.639.4171 Fax: 503.598.1960
JU N 2 6 2009 Date/By: el kJ i ' 41-0 Other Permit: p
Inspection Line: 503.639.4175
TIGARD Date Ready/By: , . 1 Nal El See Page 2 for
Internet: www.tigard-or.gov a gov CITY OF TIGARD NotifiecVMethod:IPI • • 0 _ A
I Supplemental Information
Mechanical permit fees* are based on the value of the work
El New construction N Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
t:'"1. - nt.:::'eAtfieeiiiiioi , RNaKtiefidi■l-M:::;' , ':,, , ..
Value. 74, q... .
,,triagiibittA- 1,-;:ti:itiiikk
0 1- and 2-family dwelling DI Commercial/industrial 0 Accessory building
For special information use checklist.
El Multi-family 0 Master builder 0 Other:
Description Qty. Ea. Total
nAgg,;KIWIPACiP,Wg4e*004#03:14)10.T Heating/cooling
Air conditioning or heat pump
Job site address: 13 ) 2_5 50 14,11 Dia (requires site plan showing placement) 14.00
City/State/ZIP: 77 e ,t,rA oi. ? 7 2 2 , Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: 1 i . 9.13 ,, c , A / ' e
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
i.0**:::0;tiON$
...iv ...v.6 ' il , tz, i ,ii ,4o,,,,.i,.„,i- - f 0.,, .o.migt&i. - .....„'-'4.- ..,, '..1:=.: Water heater 10.00
* , ,-, ,,,,:.,z.famosse6:::, , 4:
Gas fireplace 10.00
kifia.,li 3-1-,,, laines.f rt cs. i'el.- ,
1 Ce,r Flue vent for water heater or gas
, i ' fireplace 10.00
< - -r Ve-r- re wt . R4 / // Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
i:UP'W15?"
PROPERTY OWNER ""'' .
--,:;,_,.,,. _... ,,,,, Chimney/liner/flue/vent 10.00
-:77-,... :-- .,". -„-- ,..fila", 440rOMENNE '' k4'; V.iI' %;.e..,%;;A"tka'$ Other: 10.00
Name: i 4 ,-f - 7 - , i, a.m ..01 Environmental exhaust and ventilation
Range hood/other kitchen
Address: ) 3 1 5 5 A bh,d, equipment 10.00
City/State/ZIP: T r ) C)R /712-3 Clothes dryer exhaust 10.00
,./
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
g4iileAfFft#ERMA0,2 :- A',` Attic/crawlspace fans 10.00
:;',.. :; ,,,„: ., , A ',
Other: 10.00
Business name: R •
• e41 i eA_Vi ILA I Fuel piping
Contact name: ,AL-h- P
i\vp_r 5 $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: (5-03 )o3 _ 0 2,0 5 Fax: : (50..› ,
) ‘ 03 - Water heater
0 I So
Fireplace
E-mail:// r ef 0 reiffri e.../e.tr 0.1 ex.,41 , co 141
' ech "tAl Range
:.:11111111.EalMr.
III , 7t'AII:!= It Barbecue
Clothes dryer (gas)
Business name: e ih neje . r A er l aitiza I
Other:
Address: Icts 7 $ o y (...,,,,..f 'it-,: '
City/State/ZIP: - 7 - - A , L i a: /,,: 5 o K ¶ 706'2_ Subtotal
Minimum permit fee ($72.50)
Phone: (5o3 )4; _ 0 2 _,„ 5 Fax: (5 ) ‘ _
Plan review (25% of permit fee)
CCB lie.: 15 3 7 70 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: 7 ,4�e'e-z_ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: /.4 /2...„,c, e_r-s Date: ‘/2C/o ei * Fee methodology set by Tr-County Building Industry Service Board
01/19/07
... 91-(
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