Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00468
T f G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/13/2012
Parcel: 2S112DC01400
Jurisdiction: Tigard
Site address: 15865 SW 74TH AVE 115
Project: Builder Services Group, Inc Subdivision: FANNO CREEK ACRE TRACTS Lot: 4
Project Description: Install restroom exhaust through the roof
Contractor: WILLAMETTE HVAC LLC Owner: JDS LLC
3075 SW 234TH AVE. #206 CRITERION CREEKVIEW LLC
HILLSBORO, OR 97123 ATTN JAMES A MEYER
PO BOX 6525
BEAVERTON, OR 97007
PHONE: 503 - 259 -3200 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/13/2012 $69.06
Class of Work: ALT Type of Const: Plan Review 09/13/2012 $17.27
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 09/13/2012 $8.29
Stories:
Project Valuation: $400.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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 $94.62
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 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 -0090. You may • , tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: AAA/ atit Permittee Signature: / ` — ` ))V fiN Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 A 1 I tic • 1,t.
rt
FOR OFFICE USE ONLY
a
City Ti and i f. r -, V i m Received Permit No.
° 131 Hall Blvd., Tigard, OR 9722 Date/By: pa?.joioZ' f04 s
III ° C 1 3 2012 Plan Review Other Permi
I Phone: 503.718.2439 Fax: 503.598.19 Date/By: alp ,)a..-• 00/454
TI G A R D Inspection Line: 503.639 Date Ready /By: kris: ® See Page 2 for
Internet: www.tigard or.gov CITY OF TI(ARD Notified/Method: ( /t o Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $400.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ I- 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:
Air conditioning
Job site address: 15865 SW 74' ave (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
Ci , /State /ZIP: Tigard OR
Furnace 100,000+ BTU ( ducts/vents) 54.91
uite • Idg. /apt. no.: 115 Project name: Builder services group Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert
Install restroom exhaust through the roof Flue vent for water vent for ater 33.39
heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: same as below Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address:
Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR • Barbecue
Business name: Willamette HVAC, LLC
Clothes dryer (gas)
Other:
Address: 3075 SW 234'" Ave Suite 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro, OR 97123 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 259.3200 Fax: (503) 848.2597 Plan review (25% of permit fee)
CCB lic.: 56951 State surcharge (12% of permit fee)
• TOTAL PERMIT FEE g4.Ir2
1 Thi perm application expires if a permit is not obtained within ISO
Authorized signature: ! ` /L days after it has been accepted as complete.
Print name: michael malstrom Date: 5 /29/12 • Fee methodology set by Tri- County Building Industry Service Board
I: \Building \Permits \MEC- PermitApp.doc 03/07/12 440-4617T(II /02/COM/WEB)