Permit R. '
CITY OF TIGARD MECHANICAL PERMIT
1 , q
e.. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00301
T t G ARE) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/23/2009
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12272 SW SCHOLLS FERRY RD
Subdivision: Lot: 0
Project: Greenway Pub
Project Description: Demo existing duct run to restrooms, replace w/ new duct system.
Owner: FEES
RN OR- GREENWAY TOWN CENTER LLC Description Date Amount
PO BOX 790830
SAN ANTONIO, TX 78279 Permit Fee 06/23/2009 $72.50
Plan Review 06/23/2009 $18.13
PHONE: 12% State Surcharge - Mechanical 06/23/2009 $8.70
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222
PHONE: 503 - 462 -4822
FAX: 503- 462 -6555
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 $99.33
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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:
VAS) `` 1\� _ Permittee Signature:
// Call 503.639.4175 by 7:00 a.m. for an inspection that business y.
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 Application r-oli orrlci: USE o
City of Tigard Rec Permit No.: c At �.
• 13125 SW Hall Blvd., Tigard, OR 97223 t
' e Phone: 503.639.4171 Fax: 503.598.1960 P pffiwg M� ��/ NE Other Permit:
T I G A I2 D Inspection Line: 503.639.4175 Date R.r : y: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: OM Supplemental Information
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: mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $ 7�
1- 2-family dwelling C ommercial/industrial RESIDENTIAL EQUIPME / SYSTEMS FEES*
❑ y g ❑ Acc essory building
For special information use checklist.
❑ Multi- family 0 Master builder 0 Other: • Description I Qty. I Ea I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
q /J� Air conditioning or heat pump
Job site address:
/ZZ7Z .>� _00(1_5 , S72117 A • (requires site plan showing placement) 14.00
City/ State/ZIP: 74 ' Furnace 100,000 BTU (ducts/vents) 14.00
Smrite/bldgJapt. no.: Project name: / /v Furnace 100,000+ BTU (ducts/vents) 17.90
N� im`/ Tog
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
.50/01 ST 4/6 9� ..i / . fti aS c6 47 IO . Residential boiler (radiator or
/ hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: I 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
Gas fireplace 10.00
..4V/!I7 4t' /.577dy I;JC AfY I✓ ; ,e6girtertr, Flue vent for water heater or gas
�� fireplace 10.00
/ek :ire . j x / 'Lr -.y_/ ' . Log lighter (gas) 10.00
Zen-7- "9 -7, f�S .11P_S/ • Wood/pellet stove 10.00
/ Wood fireplace/insert 10.00
❑ PROPERTY OWNER I TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: we /AffM 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 moms) 6.80
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: xvL • Fuel m i
PPng
Contact name: Rikqq mgzeez $5.40 for first four; $1.00 for each additional
Address: .5-Mb �/v -1 71�4t✓ ,,�A Gas etc.
�J axe/ Gas heat pump
City/ State/ZIP: /e/LGlhtme/ E Ue. 9n2Z Wall/suspended/unit heater
Phone: ) 142 . l fd�2- Fax: : (?j_i) 4� j • — Water heater
Fireplace
E -mail: / & A vac/ /1 C ore , ( pM Range
CONTCTOR Barbecue
_ Clothes dryer (gas)
Business name: ` /
Address: N 45 t� � i Other.
MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee)
TOTAL PERMIT FEE 99 33
Authorized signature' This permit application expires ifs permit is not obtained within 180
days after it has been accepted as complete.
I Print name: �/9 ii/C Z I Date: 6 • �3 { • Fee methodology set by Tri -County Building Industry Service Board
I:\Building\Permits'MEC- PermitApp.doc 01/19/07 440-4617r (I 1/02/COM IWEB)