Permit , /0 /4
q CITY OF TIGARD MECHANICAL PERMIT
11111 . COMMUNITY DEVELOPMENT Permit#: MEC2013-00011
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/07/2013
7 tCi,4(t 9 Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST 100
Project: Pacific Paint&Supply Subdivision: BURNHAM TRACT Lot: 1
Project Description: Duct work modification. 2/10/14,reprinted to add suite address and correct project name.
Contractor: HVAC INC Owner: DOLAN&CO LLC
5188 SE INTERNATIONAL WAY BY FLORENCE T DOLAN
MILWAUKIE, OR 97222 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/07/2013 $99.76
Class of Work: ALT Type of Const: Plan Review 01/07/2013 $24.94
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/07/2013 $11.97
Stories:
Project Valuation: $1,500.00
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: 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 $136.67
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 obtain a copy of the rules
or direct questions to ODUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � /J Permittee Signature:Q el-tr
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.
•
CITY OF TIGARD MECHANICAL PERMIT
, COMMUNITY DEVELOPMENT Permit #: MEC2013 -00011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/07/2013
Parcel: 2S 102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST
Project: A -Boy Subdivision: BURNHAM TRACT Lot: 1
Project Description: Duct work modification
Contractor: HVAC INC Owner: DOLAN & CO LLC
5188 SE INTERNATIONAL WAY BY FLORENCE T DOLAN
MILWAUKIE, OR 97222 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503 - 462 -4822 PHONE:
FAX: 503 -462 -6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/07/2013 $99.76
Class of Work: ALT Type of Const: Plan Review 01/07/2013 $24.94
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 01/07/2013 $11.97
•
Stories:
Project Valuation: $1,500.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $136.67
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /1
•
Issued By: ,/ '4.i— Permittee Signature: Di 4 PPL( C_- 47 - 10k1
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.
•
t •... Approved plans are required on the job site at the time of each inspection.
•
01/07/2013 11:34 5034626555 HVAC INC PAGE 02/03
Mechanical Permit A p p u icationRECEIVE 0 1 1 ) 1 3 Nil 1 I f I. I .1.0\1.1
City of Tigard ; . Pe
r m;t xc, : �, ( /3 _cx Q
13125 SW Hall Blvd., Tigard, OR 97223 JAN 0 7 2013 P t Review
° . Phone: 503.718.2439 Fax: 503.598.1960 p t,jg ottler Permi �aD ( Q p✓ A ,
I' 1 h.; A I f Inspeeticm Line: 503.639.4175 CITY OF TIGARD Thte Rea<I}'/fly: SS See Page 2 for
Internet www.tigard- or.gov Nolifled/Mothed: �J Supplemental Intbrmation
BUILDING DNISI01,
:cm; mix,`:
Mcchanicat permit fees* arc hawed on the value of the work
❑ New construction Er Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, Tabor, overhead, and profit
Value' $
•
c
El 1- and 2- family dwelling I Commercial/industrial ❑ Accessory building Fa. et� u ched�
❑ Multi - family ❑ Master builder ❑ Other. Description F Qty. [ Ea. I Total
: • : . 3 • tt €iitl 'A17 •.LtICAttor - • Heathy/A:outing: - -
LL
Air conditioning
Job site address: l'21-"S l'21-"S SW irk D�1 \1 .1 frmubes site phln showing eltcement) 46.75
City/State/ZIP: ` `� Q ^Y Furnace 100,000 . Wets/vent) , 46.75
i ci t v to d p 3 Furnace 100,0004 BTU (ducts/vents) 54,91 .
Suite/bldg. /apt. no.: I Project name: t1 ,. (1 Heat pump
(requires site plan showinp 61.06
Cross street/directions to job site: Duct watt 23.32
Hydrtmic 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: i Lot no.: Flue/vent for any of above 23.32
Other 23.32
Tax map/parcel . no.: Other fed appliances:
llt)EV9C IAN' 11 I Water heater 2332
` 1 V Gas fireplace/Moen 33.39
F.9 ___.-1A-4.-10. In( ��„ „� Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 3339
Wood fireplace/insert 23.32
" ..0: . ' ': { • O• . himncyAincr /ilue/vent 23.32
1.. . . C Other: 23.32
Name: Rnvironmental exhaust and ventilation:
Address: Range hood/other kitchen
cqu ipmerrt 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
toilet cnmpsrmncnts. utility moms) 23.32
;j Mitxcitrot ' . . . ; • 1;7:.0524dxCf .rintsoisi.. Attic/crawlspace Ihns 23.32
Business name: . V L 1/ Other 2332 _
A Fuel piping:
.r ontact name:. * % f . _r /, Al � \ . a 514.15 fbr unit four; $4.03 far each additional
•
Address: Y' K ` "t( h -e' Furnace, eta
'- ity /State/ZTP: 6- Gas heat pump
Wall/suspended/unit heater
pltrnrc: �)4ko .�) Fax:: 45 kit Xo� I �- Water heater
E-mail: r y l VW a L \ tArr C itNin Range r Fireplace
CtrlVlRi� r Barbecue
Business name: 1I , U• IAA C10 dryer (Ras)
Address:°
�/�� _ ihl; E'+ CI9GSitl�Act, :'��Vlll'i'1?�i�
City/state/ZIP: v \ Subtotal
Phone: ( ) Fax: ( ) Minimum permit fcc ($90.00)
0 r Plan review (25% of permit fee)
CCB lie.: State surcharge 2% o f
urg ( permit fee)
TOTAL PERMIT FEE 1 l 2,( ' i
Authorized signature: - 1 This permit npp>ioa ca h*st Ifs permit Is not obtaated i m 1
! .I 111 - days after it has been accepted se complete.
Print name: ..., d� lb, r ! Date: \, l � • flee methndotogy Net by Tri.connry Sodding Industry Service Board
• T: \Building\PanneilMEC•Parmi • • doc 03/07/12 44n 4ri1Tr (11107 /COM/WCB)
01/07/2013 11:34 5034626555 HVAC INC PAGE 01/03
TWENTIETH :%
"
I
Iiiii;r: * AN '
NNNEARY
OR CCB# 50897 WA L&I# HVACI"125J6 CA 663290
HVAC FAx # (S03) 462 -6555
DATE: 1/7/2013 FROM: JODY DEPEW
TO: DEBBIE ADAMSKI
COMPANY: CITY OF TIGARD
SUBJECT: A -BOY MECH PERMIT APPLICATION /CC AUTHORIZATION
FAx #: (503) 598 -1960 No. OF PAGES: 3
(INCLUDING THIS SHEET)
HERE IS THE APPLICATION AND CREDIT CARD AUTHORIZATION FORM FOR OUR
MECH PERMIT. PLEASE FAX BACK OUR PERMIT AND RECEIPT FOR CREDIT
•
CARD. .
THANK YOU,
JODY DEPEW
HVAC, INC, j
i
•
I
i . .. ,. . •
IF ALL PAGES ARE NOT RECEIVED, PLEASE CALL US AT (503) 462.4822
5188 SE INTERNATIONAL WAY, MILWAUKIE, OR 97222.4602