Permit - n CITY OF TIGARD MECHANICAL PERMIT
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2 COMMUNITY DEVELOPMENT Permit #: MEC2013 00146
T I G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/19/2013
Parcel: 2S110DCO2300
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Jurisdiction: Tigard
Site address: 11555 SW DURHAM RD A -4
Project: Oregon Music Subdivision: 1998 -128 PARTITION PLAT Lot: 1
Project Description: Replace 3 -ton RTU, like for like with curb adapter
Contractor: REITMEIER MECHANICAL Owner: HIP WILLOWBROOK LLC
19570 SW 90TH CT BY HARSCH INVESTMENT CORP
TUALATIN, OR 97062 PO BOX 2708
PORTLAND, OR 97208
PHONE: 503 - 603 -0205 PHONE:
FAX: 503 - 603 -0150
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/19/2013 $288.70
Class of Work: ALT Type of Const: VB Plan Review 03/19/2013 $72.18
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/19/2013 $34.64
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 03/19/2013 $7.00
11x17)
Project Valuation: $7,900.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $402.52
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 OUNC calling 503.232.1987 or 1.800.332.2344.
Issued By: �N��� N (mil /J � Permittee Signature: .,
ed
CCC
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 ApnlicaRECEIVED FOR OFFICE USE ONLY
City of Tigard MAR 18 2013 Received Datc /B 4 r /3 r I Permit No �/J� 60/4/0
° 13125 SW Hall Blvd.. Tigard, OR 97223 Y a/�
Plan Review 1
s °° 77 2 Phone: 503.718.2439 Fax: 503.598 'r/ /' �� ]� Date /By: i �, 1 le( (J Other Permit:
T).Y; ai ft Inspection Line: 503.639.4175 `" 1 ► Vr TI Date Ready /By: *g://3(D,/). J its ® S ee Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Not ified/Method: Supplemental Information
TYPE OF WORK C OMMERCIAL 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: $ 7
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ I - and 2- family dwelling C ommercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
C i 555- JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 15' S (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: ,c0 p.,—Y)> 1 00— 91x1 r.1 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: 6 A Project name: A 1 1"1 (J' � ! [ �r 1IL /) \ (V \ r l "-l Heat pump
ft ( requires site Ian showin.. placement) 61.06
Cross street/directions to job site: gel 1. .. .) m .„-.... Duct work 23.32
Hydronic hot water system 23.32
I Residential boiler (radiator or
AI EA-f Unit h ic)
J ! 1 Unit heaters (fuel -type. not electric), 23.32
(� 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
Z „ 3 -ro 1` ^ r0/c Gas li f wa 33.39
ICY " '�� �1 �'t% L.— Flue vent fr water hcatcr or gas
p.,er fireplace 23.32
L-1 �` Ctit �r t �_�� Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: M c.A.k \a�.>rFSzw‘c..- 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 /crawlspacc fans 23.32
Business name: `•. l „ 4' � � kGM�
Fuel 23.32
` piping:
Contact name: Qktj c ^i , e , _ $14.15 for first four; $4.03 for each additional
Address: ! 9S s t.J 10 Curt Furnace, etc.
I Gas heat pump
City /State /ZIPrU I r " . ` f CA_ C 11 Col- Wall /suspended/unit heater
Phone: (50 )(Q®9 co 7idc Fax:: (5 (,oi) OSO Water heater
Fireplace
E-mail: ' c C -0' C' L., r1 - •-3... e--‹ tr--- ._f -L_a .".. -- • C - Range
CONTRACTOR Barbecue
Business name: SkAA1 Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: I5 '•7 7 J State surcharge (12% of permit fee)
TOTAL PERMIT FEE
T ��_ This permit application expires if a permit is not obtained within 180
Authorized Signature: days after it has been accepted as complete.
Print name: 2, Dater iii / * Fee methodology set by Tri- County Building Industry Service Board
1: \Building \Permits \M- PermitApp.doc 03/07/12 440 -4617T (11 /02 /COM /wEB)
CITY OF TIGARD FEE AND PAYMENT HISTORY
n
C _ 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
1[IGARD
MEC2013 -00146 - 11555 SW DURHAM RD A-4, TIGARD, OR 97224 .
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due
Permit Fee 230 - 0000 -43102 $288.70 $288.70 $288.70
Plan Review 230 - 0000 -43111 $72.18 $72.18 $72.18
12% State Surcharge - Mechanical 100- 0000 - 24001, $34.64 $34.64 $34.64
Info Process /Archiving - Sm $0.50 (up to 230 - 0000 -43135 $7.00 $7.00 $7.00
11x17)
Totals for Fees $402.52 $402.52 $0.00 $402.52
Receipt # Payment Method Check # Pavor: Receipt Date Receipt Amount
Total Payments: $0.00
Balance Due: $402.52