Permit CITY OF TIGARD MECHANICAL PERMIT
11111 I COMMUNITY DEVELOPMENT Permit#: MEC2014-00160
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/14/2014
f t G A R.f) 9 Parcel: 2S110DC01000
Jurisdiction: Tigard
Site address: 11015 SW MEADOWBROOK DR 6
Project: Summerfield Apartments Subdivision: WILLOW-BROOK-FARM Lot: 17
Project Description: Clothes dryer exhaust for units 6&8.
Contractor: ERIN ISLE CONSTRUCTION INC Owner: SUMMERFIELD ASSOCIATES, LLC
11120 SW INDUSTRIAL WY BLDG 9 BAY 2 BY HSC REAL ESTATE
TUALATIN, OR 97062 1500 SW FIRST AVE STE 1020
PORTLAND,OR 97201
PHONE: 503-691-9096 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 04/14/2014 $84.41
Class of Work: ALT Type of Const: Plan Review 04/14/2014 $21.10
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 04/14/2014 $10.13
Stories:
Project Valuation: $1,000.00
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 $115.64
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: 2 Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.33 2344. •'
Issued By: j - ••.:e Signature: ` :2?.,' —
Call 50��75 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Received FOR OFFICE USE ONLY
City of Tigard �� �� Date/By: ! �y !y Permit No.: ��J;y—no )bb
Irri
v 13125 SW Hall Blvd.,Tigard,OR 9 V Plan Review// U !p
Phone: 503.718.2439 Fax: 503.598
Date/By: Other Permit:C d J /-OOC 7
TIGARD Inspection Line: 503.639.4175 4�01� DateReadyBy: Jeri% /l See Page 2 for
Internet: www.tigard-or.gov �� N. �A Notified/Method: Supplemental Information
1� v
TYPE OF WO , COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ja Addition/alteratio tc t performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition ❑Other: AN W mechanical materials,equipment,labor,overhead,and profit.
Value:$ /, ,'t()C
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ❑Commerciallindustrial ❑Accessory building For special information use checklist.
0-Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
/ Air conditioning 46.75
Job site address: //o/5 .-2 J.776c.,c t..ub Vc;%C/`� Pf. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: /; , (t f Lt 0IQ --2,•,Q.. '? Li Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: - Project name: �,() / Heat pump 61.06
L ....5 u rrtwr etc i�' /2 �C� Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32 _
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
f( d n �/ J Flue vent for water heater or gas
k_59-(C !I 1 Pi/tieV 0,U/5 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation: _
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust _ 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) . 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: - I I Fuel piping:
�i�l J s/Pj �f�N�`�L�+[(.9.;c9/4 -Z Lf L o $14.15 for first four;$4.03 for each additional
Contact name: VCS �°
<-
Contact •�(� Furnace,etc.
C
Gas heat pump
_Address: //477c__) (,� u C' 5Y' C / ula f j/d J
J � L a 7 5, �r , aWall/suspended/unit heater
City/State/ZIP: ct t,,/G„kit l �( , g)p
Water heater
/�J
Phone:(S'jj) Gil I-6?096 Fax: :( ) Fireplace
( r r Range
E-mail: JQVa,C,F-r'1&(//VC/1 1-/A 2 /C=1 ik/S, C U� Barbecue
�% CONTRACTOR Clothes dryer(gas)
Other:
Business name: SC rat Ca 5 lJQ MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) o
State surcharge(12%of permit fee) .,/
CCB lic.: /97 q.24, Vie e )i TOTAL PERMIT FEE Y ((5 ( `7
/ This permit application expires if a permit is not obtained within 180
7 days after it has been accepted as complete.
Authorized signature: .."--7 ' j • Fee methodology set by Tri-County Building Industry Service Board
Print name: t/oJt& ° _5114;70-1-, Date: (1i-/(.1,_/Cf
1:\Building\Permits\MEC PamitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:1Building\Permi ts\MEC_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11015 SW MEADOWBROOK DR 6, TIGARD, OR,
97224
Commercial - Mechanical
699 Mechanical final
2014-04-15 00:00:00
MEC2014-00160
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11015 SW MEADOWBROOK DR 6, TIGARD, OR,
97224
Commercial - Mechanical
699 Mechanical final
2014-04-15 00:00:00
MEC2014-00160
PASS - No C of O
Violation Summary:
Inspector Contractor