Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2015-00514
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/30/2015
Parcel: 2S 112AA00400
Jurisdiction: Tigard
Site address: 14280 SW 72ND AVE
Project: Leifs Autobody Subdivision: MILLMONT PARK Lot: 49
Project Description: Replace existing RTU.
Contractor: TOTAL SYSTEM SERVICES Owner: ICON OWNER POOL 1 WEST LLC
1220 SW THIRD AVE B78 BY RYAN
PORTLAND, OR 97204 PO BOX 460169
HOUSTON,TX 77056
PHONE: 503-227-5955 PHONE:
FAX: 503-232-4026
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/30/2015 $576.31
Class of Work: ALT Type of Const: VB Plan Review 07/30/2015 $144.08
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 07/30/2015 $69.16
Stories: Info Process/Archiving-Sm$0.50(up to 07/30/2015 $12.50
11x17)
Project Valuation: $19,000.00
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $802.05
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 .rted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foil, the rul=. adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-01$0. ou ma •btain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: MI6 Permittee Signature: 4,00'„
Cal 51 .•39.4175 by 7:00 a.m.for the next available inspe ti•n d e.
This permit card shall be kept in a conspicuous place on the job site until c,,mpleti'n of the project.
Approved plans are required on the job site at the time of each inspec ion.
Mechanical Permit Application FOR OFFICE USE ONLI
City of Tigard �O Received
DateBy: 7A Permit No.• a 9 u
• 13125 SW Hall Blvd.,Tigard,OR 97223 IJ �� r
■ Plan Review -4-.
Phone: 503.718.2439 Fax: 503.598.1960 G� Date/By. , ti. MN Other Permit:
T I G A R D Inspection Line: 503.639.4175 t J R`
Q O\J Date i Ready/:o. Supplemental Pie2for
Internet: www.tigard-or.gov ` - \ p �' Notified/Metlwd: � ,s Supplemental Information
P rp. 11
r_ YP RK • Mechanical permit fees*are based on the value of the work
❑ New construction Addition/alteratiot eft performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
/
CATEGORY OF CONSTRUCTION 114.111W - Value- loop.vt!
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling $Connercial%'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
C./ Hesting/cooling:
Air conditioning 46.75
Job site address: /y 40 S Li 7x M �I Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: i ` A. or. et 7 ,L'1 Furnace 100,000+BTU(ducts/vents) 54.91
�J ! Heat pump 61.06
Suite/bldg./apt.no.: tr Project name:z. e x 0
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
$OddA - Residential boiler(radiator or
t d,1 i KS A Orr` q L_.. Gaol/ti✓ O 7,1..t� Q.".a. hydronic) 23.32
S t�I�� Unit heaters(fuel-type,not electric),
1.1 in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
! /� r _ Flue vent for water heater or gas
/cc _ L x LS yyt t , 1(J L/(i(,/,�„/ 1iC f fireplace 23.32
J Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
El PROPERTY OWNER 0-TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Ler J, A a„■ / ( _f/' Range hood/other kitchen
e.-�il �} �i✓� ui menu
�1 P 33.39
Address:
yd. to S`sj 7J"" a �w Clothes dryer exhaust 33.39
City/State/ZIP: ,"r3 Z or., 9 .11 y Single duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
in APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: ?-0 a,,4 ( sys ,,,� [�/Vi ViJ
r V S14.15 for first four;54.03 for each additional
Contact name: s 4 d ow.•‘. oJt✓6a'IJ Furnace,etc.
Address: 7�s S L ,�d �� Gas heat pump
/'7�-- J Wall/suspended/unit heater
City/State/ZIP: por.4.14w 4 f or. 97Z r(7 Water heater
Phone:(S0,)01,f4_ 73 a Fax::(SbJ) 3._ tyc)014 Fireplace
age E-mai : S OW I /s -T e S / V/ L,
L a+..-` Barbecue
CONTRACTOR Clothes dryer(gas)
Other I
Business name: St,,, Q' 01..5.4.40.......—
MECHANICAL PERMIT FEES*
Address:
Subtotal S7b,.
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee) NV,/
Phone:( ) Fax:( ) State surcharge(12%of permit fee) (p/4/b
CCB lic.: /5-3// i /1131(0 TOTAL PERMIT FEE 7fl,SS
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: _s44„,„,_ OWN S Date: 7}-7.,ilr
1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)