Permit CITY OF TIGARD MECHANICAL PERMIT
■ COMMUNITY DEVELOPMENT Permit #: MEC2009 -00432
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2009
Parcel: 2S102AB04300
Jurisdiction: Tigard
Site address: 12400 SW MAIN ST
Subdivision: Lot: 0
Project:
Project Description:. Install (1) bath fan.
Owner: FEES
TIGARD MAIN ST COMMERCIAL PROPER Description Date Amount
12488 SW AUTUMNVIEW ST
Permit Fee 08118/2009 $72.50
TIGARD, OR 97224 12% State Surcharge - Mechanical 08/18/2009 $8.70
PHONE:
Contractor:
RELIANT PLUMBING & MECHANICAL
11575 SW PACIFIC HWY STE 219
TIGARD, OR 97223
PHONE: 503 - 246 -1201
FAX: 503 - 246 -1205
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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $81.20
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: Permittee Signature: Q Q
AR9
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.
MechaniCiai'Permit ApplicatiollREO 1VE t FOR OFFICE USE ONLY
City Of Tigard AUG 1 8 2009 DateBy 1 Permit No. V 1 1 % .00 2.
a 05
II
u Plan Review
uT
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Ins Line: 503 C ITY OF 71G ARD D at e /B y:
T I G A R D BUIL DING DIVISIO Date Ready /By: See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental lnformation
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ❑ Addition /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: Ceiling Fac mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
Master builder For special information use checklist.
Multi -famil
❑ Multi-family ❑ ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 12400 SW Main Street (requires site plan showing placement) 14.00
City /State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 12400 SW Main Street Gas heat pump 14.00
Cross street/directions to job site: Burnham 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: exhaust Fan 1 10.00 10.00
Tax map /parcel no.: 2S102AB04300 Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
CI l Gas fireplace vent 10.00
) 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
0 PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: Chris Cach Environmental exhaust and ventilation
Range hood/other kitchen
Address: 12400 SW Main Street equipment 10.00
City /State /ZIP: Tigard, OR Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)807 -1387 Fax: ( ) toilet compartments, utility rooms) 6.80
0 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Reliant Plumbing & Mechanical Fuel piping
Contact name: Amanda Ray $5.40 for first four; $1.00 for each additional
Address: 11575 SW Pacific Hwy Suite 219 Furnace, etc.
Gas heat pump
City /State /ZIP: Tigard, OR 97223 Wall /suspended/unit heater
Phone: (503) 246 -1201 Fax: : (503) 246 -1205 Water heater
Fireplace
E -mail: amanda @reliantplumbing.com Range
CONTRACTOR Barbecue
Business name: Reliant Plumbing & Mechanical Clothes dryer (gas)
Other:
Address: 11575 SW Pacific Hwy Suite 219 MECHANICAL PERMIT FEES*
City /State /ZIP: Tigard, OR 97223 Subtotal I QUO
Minimum permit fee ($72.50) - 1,2_ CO
Phone: (503) 246 -1201 Fax: (503) 246 -1205 Plan review (25% of permit fee)
CCB lic.: 169844 State surcharge (12% of permit fee)
TOTAL PERMIT FEE 1a • c-
/� This permit application expires if a permit is not obtained within 180
Authorized signat Pi.' �� / /t_ �Ati/` days after it has been accepted as complete.
Print name: Amanda ' . y Date: 08/17/09 ' Fee methodology set by Tri-County Building Industry Service Board
I:\Building'Permits\NEC- PermitApp.doc 01/19/07 440-46I7T (11 /02/COM/WEB)