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Permit CITY OF TIGARD MECHANICAL PERMIT 1111 a',: COMMUNITY DEVELOPMENT Permit #: MEC2009 -00339 Date Issued: 08/19/2009 T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110DC00700 Jurisdiction: Tigard Site address: 11205 SW SUMMERFIELD DR Subdivision: Lot: 0 Project: Summerfield Clubhouse Estate Project Description: Replace (4) RTU5, (4) attic ventilators, and a cooler condenser. Owner: FEES TIGARD RETIREMENT RESIDENCE LLC Description Date Amount 600 UNIVERSITY ST STE 2215 SEATTLE, WA 98101 Permit Fee 08/19/2009 $569.00 Plan Review 08/19/2009 $142.25 PHONE: 12% State Surcharge - Mechanical 08/19/2009 $68.28 Contractor: JET HEATING LLC P.O. BOX 7352 SALEM, OR 97303 PHONE: 503 - 363 -2334 FAX: 503- 363 -8909 Type of Use: COM Class of Work: ALT Type of Const: VB Occupancy Grp: A -2 Occupancy Load: Stories: 2 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: 1 Heat Pump: Appliances Vent Fans: Vent Systems: Total $779.53 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Attic Duct Work: ventilators 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 issua • • suspend -d for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon ity Notification Dente . T• .se ule -re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OW ' by • , Ili' .., 03.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: 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. zc, IF f - 'Ie , C)S� 1 12©& tkl- c- �1 t_c_ Mechanical Permit Applicatio V FOR OFFICE USE ONLY City of Tigard ��CEI I. Received DaDate/By: O �n l'1n V t Permit No. :� e2 O ( C7q Y ° 13125 SW Hall Blvd., Tigard, OR 97223 Q t e Phone: 503.639.4171 Fax: 503.598.1960 JUL 10 2009 ' Plan Rev• • M Date Anti L , p �' Other Permit: T 1 G A R D Inspection Line: 503.639 Date Ready /By: � luris: ® See Page 2 for Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: g 1 �y Supplemental Information TYPE OF WO _WILDING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST El 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: $ 6 ( RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: ' �e ," ,p C DV' Air conditioning or heat pump �. `��`- T ' ' (requires site plan showing placement) 14.00 City /State /ZIP: LI Furnace 100,000 BTU (ducts /vents) 14.00 ` 1 � � Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project nam e 1/ �� p ''w Gas heat pump 14.00 Cross street/directions to job site: f}-{—» 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 , I i Gas fireplace 10.00 V ` L Q(,C� i Z. `- 3 - -1p Flue vent for water heater or gas f �l ' _ k n w ` I _ ` fireplace 10.00 �/ (,(.tfLC� Yj/ IT ( l ('j)ps Log lighter (gas) 10.00 `� "` /) / .j31_ L. 6a )Le Aim ei..to st_. Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ❑ PROPERTY OWNER l ❑ TENANT Chimney/liner/flue/vent 10.00 Name: Environmental exhaust and ventilation Range hood/other kitchen Address: equipment 10.00 City/State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: . 3 p 5i Q n -i-Vn p� l) Fuel piping Contact name:"b. o � C1 U .� S5.40 for first four; $1.00 for each additional Address: P t v+ 9 � )Le Furnace, etc. l� Gas heat pump City/State /ZIP: `eAm1/4... r 'Q— c v Wall /suspended/unit heater Phone: 3l0' .2 I Fax: (5,4 3 at/ Water heater ` O� Fireplace E -mail: anY1 . ( . t) Range CONTRACTOR Barbecue Clothes dryer (gas) Business name:0.---1-1.1\--.. (y Other: Address: V � �31 Ci jv( MECHANICAL PERMIT FEES* City/State /ZIP: �¢ IS1— 3� Subtotal Fax `� Q t� Minimum permit fee ($72.50) Phone: 6 " 22,16L ' ( ..le )' Z}9 ✓ Plan review (25 %of permit fee) CCB tic.: `stoIu q . 24 • 09 State surcharge (12% of permit fee) t TOTAL PERMIT FEE Authorized signature: This permit appllcatloa expires If a permit is not obtained within 180 days after it has been accepted as complete. Print name: s, e _ 1 Dater let ri . • Fee methodology set by Tri -County Building Industry Service Board I:\ BuildingTennits \IvtEC- PermitApp.doc 01�/19 440-4617T (11 /02/COM/WEB)