Permit CITY OF TIGARD MECHANICAL PERMIT
a .' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00092
Date Issued: 03/31/2009
T I G ARID 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 25101 DD00701
Jurisdiction: Tigard
Site address: 6960 SW SANDBURG ST
Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project: Tigard - Tualatin School District
Project Description: Install (2) split- system a/c units. Project Value: $63,000
Owner: FEES
TIGARD - TUALATIN SCHOOL Description Date Amount
DISTRICT #23J, 6960 SW SANDBURG ST Permit Fee 03/31/2009 $934.00
• TIGARD, OR 97223 Plan Review 03/31/2009 $233.50
PHONE: 12% State Surcharge 03/31/2009 $112.08
Contractor:
HUNTER DAVISSON INC
1800 SW PERSHING ST
PORTLAND, OR 97202
PHONE: 503 -542 -3627
FAX:
•
Type of Use: COM
Class of Work: ALT Type of Const: Other
Occupancy Grp: El Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 2
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: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: • Total $1,279.58
Hoods: Comm Incinerators: Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: 2 split
• Duct Work: systems
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
Issued By: ACie 1 f/� /t 1� A A � 1y7) Permittee Signature:
`d1 v/
Call 503.639.4175 by 7:00 a.m. for an inspection that b • 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.
. (& a -rxoc T (off c.9 1� sArg
Mechanical Permit Application a FOR OFFICE USE ONLY
City g of Tigard i! �i Received 4 O�
pp�� q� +
OF \VII ��I Date/By: 3 PermitNo.:x�f.0� /����
, V 13125 SW Hall Blvd., Tigard, OR 1, :m , Plan
Phone: 503.639.4171 Fax: 503. "' :: jjj� Dat Review (I 9 , Other Permit:
TIGARD Inspection Line: 503.639 MAR 0 6 2 009 Y
Ready /By: Ju.. ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: , ��.09 /4 Supplemental Information
rtiN (Y i5ek®
'( TYPE O
F R� (it��`. D ���rJ�(I: � t COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
1r.Jtt
❑ New construction P't 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: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ e�
/
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling 21 Commercial/industrial ❑ Accessory building
El ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
l^ . f ) S AN B()1 T (requires site plan showing placement) 14.00
City / State/ZIP: G ,t►1 D > O R (i U'1 ✓ Furnace 100,000 BTU (ducts/vents) 14.00
66 Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg./apt. no.: I Project name ACS., ��� iZ7 -� Gas heat pump 14.00
Cross street/directions to job site: �� Duct work 10.00
Hydronic hot water system 14.00
■!nt .I d FP-4,1 �. 14!II4tJ ..: .# 1 .1•474 Residential boiler (radiator or
Aw
hydronic) 14.00
)✓. % i ��PII���ir� X121 J� �Ti� A Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances •
DESCRIPTION OF WORK Water heater 10.00
oM K5 P 6R Gas fireplace 10.00
t,��'T�LL (2.> Pal" '� Y� 1 c Flue vent ent for water heater or gas
Mp ilo rrQ,l., pLA L pi GV .c -7-60S Log l 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
IF PROPERTY OWNER I ❑TENANT Ot ylliner /Ilue/vent 10.00
,J Other: 10.00
Name Q _ / u , ¢Lf1 -Tl AJ $ 4i ,L �r 5j .. Environmental exhaust and ventilation
Address: ` , r� 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
A APPLICANT - ,® CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: ty )k a_ DA UCIDJ
Fuel
o piping
Contact name: -��� t A M $5.40 for first four; $1.00 for each additional
V Furnace, etc.
Address: 1.2rn 5 pe %ti l 51
Gas heat pump
City /StateJZIIP: c' f
Phone: (66S) _(L og ? Ix: nora Wall/suspended/unit heater
2 - 2� : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
�
A Clothes dryer (gas)
Business name: ' 4AJ - � 4 ,4 JP" Other:
Address: � v MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal 6 /34, CD
Minimum permit fee ($72.50)
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee) 2.33, j
CCB lie.: i(Q( 9,-.-- '141 State surcharge (12% of permit fee) 1 12. ,
TOTAL PERMIT FEE e 2, 7
This permit application expires if a permit is not obtained within 180
within ISO
Authorized signature: Q
days after it has been accepted as complete.
AO
Print name: i rad - ` y 1 Date:' , .6 ocl • Fee methodology set by Tri- County Building Industry Service Board
I:1 1luildingll 'urmits \MEC-PcrmitApp.doc 01/19/07 440-4617T(11 /02/COM/WI:I1)