Permit p CITY OF TIGARD MECHANICAL PERMIT
1111 a . COMMUNITY DEVELOPMEN Permit #: MEC2009-00487
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/16/2009
Parcel: 2S110AA00500
Jurisdiction: Tigard
Site address: 10580 SW MCDONALD ST 101
Subdivision: Lot: 0
Project: Ogden Building
Project Description: Replace existing 3 ton RTU, like for like.
Owner: FEES
OGDEN, JOAN Description Date Amount
24030 AIRPORT RD NE Permit Fee 09/16/2009 $141.50
AURORA, OR 97002 Plan Review 09/16/2009 $35.38
PHONE: 503 - 678 -5330 12% State Surcharge - Mechanical 09/16/2009 $16.98
Contractor:
ROTH HEATING & COOLING
PO BOX 1265
CANBY, OR 97013
PHONE: 503 - 266 -1249
FAX: 503 - 266 -3478
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 $193.86
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 nrk is . uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility . ication Center. . . ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or . ct questions to OUN . 3.246.6699 or 1.800.332.2344. _
Issued By: Permittee Signature: / ', S' ,' 7� /� 0.9-12--,- rr
Call 503.639.4175 by 7:00 a.m. for an inspection that • • ' 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.
SEP-14-200G MON 03:21 PM ROTH HEATING FAX NO. 5032663478 P. 02
EIV C.' 1
. :.,..., t .
Mechanical Permit Application'', AI A roll ou'FluE usE oNLy
1 NOS
City of Tigard SEP ' Received ,
Date a / /By: 7 , OS rEffES!nrall
r
• 13125 SW Hall Blvd., Tigard, OR 97223
IV:7N" Phut Review
' • Phone: 503.639.4171 Fax: 503.398.1960 - cry Or . , , • b auilB . Other Permit:
.,
AR I) Inspection Line: 503.639.4175 -V.r.\\,..E. Y'
el See Page 2 for
Internet: www.tigard-or.gov P L- P'7"1 \ ' ' D1,1nott?RgeedagrhYo;d; Eiri Suppiementai lararmation
77 ''''' : ;•'; ! ?••`. ;4i 'l'!::'•:.!'k : : :: !: 5 ' c. ';',Ir r T r77 . : ! ',.,V,,•,':!''''' 1- '•• . ,7'''•,;! : •.l''''''''•,' 5 7 r'.: 0 ' 4,* 9114 '''',,l',.
Mechanical permit fees* are based on the value of the work
Ej New ConStruction Addition/alteration/replacement performed, Indicate the value (rounded to the nearest dollar) of all
1:1 Demolition ID Other: mechanical materials, equipment, labor overhead and profit.
Value: $ 0.0c-•
•• ..,4, •,•'%1', • '.!! •i,."''ifYIPA• .'••••, •-• ,•,.•:.,•:,:" ::•,.',' .•' ., . ,.. , . • • • , •- , , • •-•-• - , • 7., •,, -- ..' • I'L. +,,, . ," ;," .j.' ., • '
., 7 ,gN.S4 i gw ,, i.
o 1- and 2-family dwelling efommercial/industrial 0 Accessory building
For special Information use checklist.
D Multi 0 Master builder El Other: Description I Qty. Ert7 Total
•,.., :•'•"i,::4••ilk:ii oo,,p)otpol■r...., Heating/cooling
Air conditioning or heat pump
Job site address: I 05 0 . s L i Ma Nvi4i...-1) gs.o , (requires site plan showing placement) 14.00
City/State/ZIP: T Le-, ci Furnace 100,000 BTU
14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt, no.: I"--/ '' i I Project name: 6( , (ducts/vents) • 14.0P
A • Gas heat pump
Cross street/directions to job site: Duct work 10.00
4i:PLD So 15 Hydronic hot water system 14,00
,< ;t0r cokfil S-1.. k -b 4ve.
_ i Residentia/ 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
Y.,, :1‘. ; ,.' .0:14,04101,0.t.toF ii-vow. .,:., '',:,,.‘*-.‘,., -.,..,;. -:;,. --. Water heater 1 0,00 J
Gas fireplace _ .10.00
(EP/4Q EN ISTPU (-t 3 %WV g Tti Of[l i T Flue vent for water heater or gas
/cj C ----- ; FOV-- 1,- l Ic-e (-A,T7g offi fireplace
. Log lighter (gas) 10,00
,.• 10.00 _
Wood/pellet stove 10.00 4
Wood fireplace/insert 10.00
Chimney/liner/flue/vent l 0.00
litt,itnilft ' Tliiiii0ti,HH! !'„; I , '• , 'L': si ,0,r, '-,''
',, , ., , ,,;;■,'■:'' !•;.:.::.,,:' , '''*.i;i ■77.!;%.• :f, .: i',;. • !:w , !'•;-,i.;:•.:' ':•;..:il','!::",.: Other: I 11,t0 ---------
Name: ---", A-A 2,rAj Environmental exhaust and ventilation
.
11 : • P ,,,,.,..2 A . .
Range hood/other kitchen
AddreSS: z- L 7 c•- "rit:rfof d', / 1 - 1 / ::: equipment , 10.00
.
City/State/ZIP: ( ji0/4- ( C ) 7 CO 2— _ Clothes dzer exhaust 10.00
) ,..-, Single-duet exhaust (bathrooms,
Phone: ( SD3 )1, 7 g. _ n i_... Fax ( ) toilet compartments, utility rooms) 6.80
'':;'',''t:'',..'''''::;! miciormwomiac fans 10.00
, . .
Other:
Business name: g 8-6u/4_4 £ Crzt4 A)c) Fuel piping 10.00
Contact name: 3 AA-Ada-1, $5.40 for first four; S1.00 for each additional
Address: e 1 "/ /1 c'
3) -eer) -v_tf-- — Furnace etc
• 1 . ' - - -
Cos heat pump
City/State/ZIP: 6 a 4 b7 , , q ? Wall/suspended/unit heater .. , . . _ ..
i b /
Phone:) , 4 ..._ /2 „1.1.1 , Fax; : ( s6-3 ) -2d . d i, . 73 , 47 1 ._ Water heater
Fireplace
E-mail: ) .6 S 5-e_ 41 TO '-' e . D ' Range
....:,,„,.:•:ii,',,,4K , Xi ,,‘,:,.: .,., ,,,,.. :,,,,,„,:,,,,;:,,,,,,,,,,..,,,.., .,,,.:.,,,,,,,.:,,,,,..,.:. Barbecue
Business name: # ‘e-- f r .„/A( Clothes dryer (gas) ,
7
Other:
Address: (‘-) Cf ri 0 5, 4 1 7 c i 3 O-75 - 0,1 ..P... • :-...,•, X:: : ;. '';'MECirj
City/State/ZIP: (.., 4
( r) at ?Di Subtotal
Minimum permit fee ($72.50)
Phone: ($C13 ) 2.-Cp1 ' (( ' Fax: (St\ 3 )2c., C -3247y —
Flan review (25% of permit fee)
c A6,
CCB lie.: ) Lf 00 it' State surcharge (12% of permit TOTAL
' TOTAL PERMIT FEE Cif 1. 8(.#
Authorized • signature:
5 - ( - -- --__ ilia permit application expires if a permit is not obtained within ia0
days after it has been accepted an complete.
Print name: cr( _ ( ,..., iii:av 1 ( e___ Date: ci I le-11 D 7 . Fee methodology set by Trt-County Building Industry Service &lard
IN:Wilding Termite 1 MEC•PsrmitApp.d Da 01/19/0 40-401 Tr (I iiniCOWWEri)