Permit CITY OF TIGARD MECHANICAL PERMIT
1111 $ COMMUNITY DEVELOPMENT Permit#: MEC2015 00331
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/03/2015
Parcel: 2S102BA00500
Jurisdiction: Tigard
Site address: 9760 SW TIGARD ST
Project: Francis Corp Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 60
Project Description: Install(1)5-ton ground mounted a/c unit. Placement of unit must comply with manufacturer's clearance
requirements.
Contractor: ADVANCED HEATING&AIR CONDITIONING INC Owner: JACKSON, PAUL R&SIMONE D
5825 SE FOSTER RD 10250 TIGARD ST
PORTLAND, OR 97206 TIGARD, OR 97223
PHONE: 503-774-0161 PHONE:
FAX: 503-774-4391
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/03/2015 $121.25
Class of Work: ALT Type of Const: Plan Review 06/03/2015 $30.31
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 06/03/2015 $14.55
Stories:
Project Valuation: $2,200.00
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $166.11
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, o • • k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules .••• -• by the Oregon
Utility 'otification Cen - Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. o m. obtain a cop of the rules
or rect questions to OUNC . c. •• 503.232.1987 or 1,800.332.2344.
issued By: f Permittee Signature: r /
Call 503.639.4175 by 7:00 a.m.for the next available iq pection d. e.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr•' t.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLI'
E V Received
City of Tigard "�• �J• Date/By: t��� Permit No.: ' G',/r�' ni533
;I . 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C� C/C•
Phone: 503.718.2439 Fax: 503.598.1960 JUN 2 Date/By: Other Permit:
T I G A R[) Inspection Line: 503.639.4175 JUN 4 2 �5 Date ReaayBy: g
7uri�: RI See Page 2 for
Internet: www.tigard-or.gov CITE f Notified/Method: Supplemental Information
1,l V I/
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Mechanical permit fees'are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor overhead,andgfit.
Value:$ ULJ
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. 1 Ea. I Total
Heating/cooling:
Air conditioning 46.75
Job site address:
Ut'7 at,-.1 A \ tTr( Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -r-; r. 0 Y c7\1.2.-a3
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: reA ije /5 �e/ Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: r Y,CA,�‘. Hydronic hot water system 23.32
�1 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
=r-,.o-i--ce■\ S-} y--1 frL vvv, 1 fi 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 1 II f L�. TENANT im Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dyer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) . 23.32
Phone:( ) Fax:( ) Attic/crawlspac"fans 23.32
CONT4cT P ER__SON Other: 23.32
Business name: Fuel piping:
�r c�v\(.....-% 'Lo v-t? $14.15 for first four;$4.03 for each additional
Contact name: FrcNv, t,15 R,n,a'V Furnace,etc.
Gas heat pump
Address: —7:.2. l:-- N ,D ■t St Wall/suspended/unit heater
City/State/ZIP: DO C )v.r V\ 0 Y '\101 ) Water heater
Phone:(c3p'3) a1 1 5 - cis-76 I Fax::( ) Fireplace
Range
E-mail:.osr,`\.. _op 1 e covet Lc.s-t t Barbecue
Clothes dryer(gas) ,
Other:
Business name:
pa v'GV,C G d &..g. ,Tinul
Address: 6-12,4 jSruz. RD Subtotal
City/State/ZIP: prL - OIZ t p 7 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(5-0 )774--o t(.o I Fax:( ) State surcharge(12%of permit fee)
CCB lic.: l $5`7.6 TOTAL PERMIT FEE 6 ,I/
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: -- - • Fee methodology set by Tri-County Building Industry Service Board
Print name: Date:
172- / 5
I:1 Building\PermiuVMEC_PermitApp_040113.doe . , .171'(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
$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.
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