Permit '` � � CITY OF TIGARD MECHANICAL PERMIT
14 _ ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00600
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2011
ZlGA'R? g Parcel: 2S112DB00200
Jurisdiction: Tigard
Site address: 15255 SW 72ND AVE
Project: Pittman & Brooks Subdivision: FANNO CREEK ACRE TRACTS Lot: 45
Project Description: Duct modifications
Contractor: AIRFLOW ENGINEERING Owner: BROOKS & PITTMAN RENTALS
PO BOX 999 15255 SW 72ND AVE
WELCHES, OR 97067 PORTLAND, OR 97224
PHONE: 503 - 789 -0841 PHONE:
FAX: 503 - 789 -0841
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/22/2011 $127.39
Class of Work: ALT Type of Const: Plan Review 12/22/2011 $31.85
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/22/2011 $15.29
Stories:
Project Valuation: $2,400.00
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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $174.53
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Wor
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 ification C- -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir ct questions to OU . by c. • Ig 503.232.1987 or 1.800.332.2344. /
Issu d By: 4-- I te/f4c4d/ Permittee Signature: / i
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. dr
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 Applicat[RECEIVED - • FOR=OFFICE USE ONLY -__ : - _- _
GA
City Tigard Permit No.: Lc f+ O (//
ODIY�
13125 SO! W Hall Blvd., Received
Iii .., . Tigard, OR 97223 2 Date/By: / p / ,0 g
Phone: 503.718.2439 Fax: 503.598.1960 DEC 2 2 2011 Plan Review
Date/By: Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready/By: tuns: H See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARRD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on 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, equipment, labor oyerhead, profit.
Value: $ ��/
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /'SYSTEMS FEES*
❑ 1 - and 2- family dwelling im Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: /5 Srw 7 Z �"�If _ ,Q_ t rr + (requires site plan showing placement) 46.75
City /State /ZIP: 7, z ! l• 7-2- e qt Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: ¢�- - � i Heat pump
r (requires site plan showing placement) 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 Water heater 23.32
� („ _ / �_ r a /_ y/ Gas fireplace
vent for 33.39
T .�._ �'- ��'(' Z�T�dL.f�.— or water heater or gas
At-- 1 ± ' a'''S fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
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
Business name: A I .k2,„LJ Other: 23.32
-7 - Fuel piping:
Contact name: j /t e ' Li 1 $14.15 for first four; $4.03 for each additional
Address: f}0 6. ice? 1 Furnace, etc.
/ " fir / Gas heat pump
City /State /ZIP: twig �7L Wall /suspended/unit heater
Phone: (.5P 7 79 U 8 + I Fax: : ( )
6:-)A./.. Water heater
E -mail: A' 0A1.4 c A ,t,--4.1r--- Rangeace
cy��
CONTRACTOR Barbecue
Business name:
5344/411- Clothes dryer (gas)
Other:
Address: MECHANICAL PERMITFEES*
City /State /ZIP: Subtotal /A 7. 3?
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee) 5/. tj
CCB tic.: 4'$ (4- O C-i j i State surcharge (12% of permit fee) (5. ,V9
TOTAL PERMIT FEE j 711 S
Authorized Signature: '[his p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 4veDeed ZI v / ,r¢. 7 i" Date: - 2-- Z..Z - / * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -4617T (I I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $1 0,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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