Permit n CITY OF TIGARD MECHANICAL PERMIT
II I a COMMUNITY DEVELOPMENT Permit #: MEC2009 -00460
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/09/2009
Parcel: 2S102AA03100
Jurisdiction: Tigard
Site address: 8635 SW SCOFFINS ST
a
Subdivision: Lot: 0
Project: American Legion
Project Description: Replace rooftop unit that services lower level.
Owner: . FEES
AMERICAN LEGION, THE Description Date Amount
TIGARD POST #158, PO BOX 23482
TIGARD, OR 97281 Permit Fee 09/09/2009 $164.90
Plan Review 09/09/2009 $41.23
PHONE: 12% State Surcharge - Mechanical 09/09/2009 $19.79
Contractor:
R &S HEATING INC
1123 MEADOWVIEW COURT
WEST LINN, OR 97068 •
PHONE: 503 - 657 -4137
FAX: 503 -657 -4137
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -3 Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas 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 $225.92
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 • - - ons • 'UNC .y calling 503.246.6699 or 1.800.332.2344.
Iss ed By: I ) C �C• Permittee Signature: a /1 � AJ
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.
T 1 dC'.f,, bpi .
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ' 1 � Dare Bea of Permit No.: Wee eV F erti C/620
UP Date/By:
• 1 3125 SW Hall Blvd., Tigard, OR 9722 l y plan Revi q Jl A A Phone: 503.639.4171 Fax: 503.598.1960 Date/By: ` ( l75 Other Permit:
T I G n R D Inspection Line: 503.639 S E P 0 2 2 00 9 Date Read /� ardor. ov y y' J. 0 See Page 2 for
Internet: www.ti
g g Notified/Method: 9/ o 9 �� Supplemental Information
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TYPE OF . rol; DING DIVISION ` C. I I Vi i•\. E ',1 1 ULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction gi Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 300 , (90
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling .Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
�j Air conditioning or heat pump
Job site address:
15 6 3 � s . $ O Fr, #IS pos 7- /. 8 (requires site plan showing placement) 14.00
City /State/ZIP: -- Ti 6 4 leo / a ae 9' a 3 Furnace 100,000 BTU (ducts/vents) 14.00
Fumace 100,000-F BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: I Project name: Gas heat pump 14.00
Cross street/directions to job site: 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
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
(QC J /1 c B / d -5 TOE 6 /� S Pnc k Flue vent for water heater or gas
1 fireplace 10.00
W / - / — Li Ale e-c, e 4. /e0e / to 1 2 S TON N-.t Log lighter (gas) 10.00
/ w 1 11-■ p f - A N o rn ;P Wood/pellet stove 10.00
Wood fireplace /insert 10.00
(i' PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00 _
Name: t rrn {Y ? f C Ito a A e9 / O N Environmental exhaust and ventilation
Address: -� Range hood/other kitchen
S (o<3.S S cc,pp�.vs equipment 10.00
City /State /ZIP: 77 'p. p44 , owe 9 ? as 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: spa ) (,39 » t/( I / Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: /Me Wall/suspended/unit heater
Phone: ( ) I Fax:: ( )
Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: R 4- f M" - " i � Clothes dryer (gas)
/ �
Other
Address: // 2 3 !li e bG to v. e c v C'T MECHANICAL PERMIT FEES*
City /State /ZIP: tUeJ`r 4. iMN , owe' 9'204' E j Subtotal
Phone: 5 ) � .. H / 3 / t Fax: Minimum permit fee ($72.50) /61 90
to ( ) Plan review (25 %of permit fee) f. 23
CCB lie.: /20,21. 0 State surcharge (12% of permit fee) /? . 79
TOTAL PERMIT FEE 225 9i{
Authorized signatur This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name: /` j'SS Dk,1p -PeL I Date: 9 (2../49q • Fee methodology set by Tri- County Building Industry Service Board
I:\BuildingTermits\MEC- PermitApp.doc 01 /19/07 440- 46I7T(I1 /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 . 1 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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1: Building \Permits\MEC- PermitApp.doc 01/19/07 2