Permit ` ~q� CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00312
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/30/2007
PARCEL: 25111 AD -18100
SITE ADDRESS: 14852 SW JONAGOLD TERR ZONING: R -4.5
SUBDIVISION: LADY APPLE LOT: 005 JURISDICTION: TIG
PROJECT: LADY APPLE
Project Description: AC install.
• CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BEACON HOMES N.W. Description Date Amount
12703 SW 67TH AVE.
TIGARD, OR 97223 [MECH] Permit Fee 5/30/2007 $72.50
[TAX] 8% State Surcha 5/30/2007 $5.80
Total $78.30
Phone: 503 -407 -0580
Contractor:
THERMAL FLO
7236 SW DURHAM RD. STE 100
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 670 -8343
FAX 503- 670 -9064
Reg #: LIC 151847
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 Signatu .: Ar
Call 503.639.4175 by 7:00 a.m. for inspections at busi'ess 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.
Mec .apical Permit Applica On '' a Y� ni�,li, . i
tt� a �< z '; FOR OFFICE USE ONLY l "' ' `* (r t
114 City of Tigard Received � �7 8 Permit NoM ��T .... 3
4 ° 13125 SW Hall Blvd,, Tigard, OR 97233 AY 3 2007 Date/By:
Plan Review
Phone: 503 639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503 639 CITY C:' i lt3ARD
Date Ready/By: tuns
} r � 9 � g �e ® 7 Supplemental See Pen l Information
Internet: wtvw.tigard -or gov BUILDING DIVISION Notified/Method: Supplemental nformation
. TYPE OF WORK _'7' - COMMERCIAL FEE* SCHEDULE _ USE CIWCIC IST
❑ New construction ddition/alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
dwelling ❑ D g .. RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
- and 2-family g ❑ Commercial /industrial Accessory building special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 y tj ., 2 Sw -To N Atoka le t i " Air conditioning or heat pump
�� (requires site plan showing placement) 14.00
City /State /ZIP: -- n „,..0 e '>� Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: 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
�� t / A �� 1 S Flue /vent for any of above 10.00
Subdivision: VV // � Lo t no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
�
,g� A Gas fireplace 10.00
V� �T C. U l Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
• equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
. ErAPPLICA1NT [a1CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Contact name:
Business name: � QN e �1/t W Fuel piping p p g
DY G--i. l` m a D t. $5.40 for first four; $1.00 for each additional
Address: (-1:3_03 S u— 69. A-0 Furnace, etc.
Gas heat pump
City /State /ZIP: T R 0 er Wall /suspended/unit heater
Phone: (S 3) t+ o9.- 05130 Fax: : (S *S) 540 15 at Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: '1'1/�,QP1M,q(_ TAB Clothes dryer (gas)
-{ Other:
Address: a.2. 7) 5 W 0, ( h /i. 0,D 5 u! `G tat MECHANICAL PERMIT FEES* •
City /State /ZIP: Pe,erk 6R, al 9-22 Lf Subtotal
C,, ^'� [�, Minimum permit fee ($72.50) 7g,
Phone: (T'3) T O 4' 3 -! Fax: (SO 7j) 6-40 q l0 6 (f
Plan (8% ��
review (25% of permit fee)
CCB lic.: State surcharge of permit fee)
TOTAL PERMIT FEE 7v ., 3v
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: toy , (t 1 tUt d1 bKwv Date: 5 30 03_ ' Fee methodology set by Tri- County Building Industry Service Board
C\Building \Permits \MEC- PermitApp.doe 04/06/06 (J 440 -4617T (11 /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: ° • Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
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