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Permit " CITY OF TIGARD MECHANICAL PERMIT '' It COMMUNITY DEVELOPMENT Permit#: MEC2015-00702 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2015 Parcel: 1 S136DD03800 Jurisdiction: Tigard Site address: 11675 SW 66TH AVE Project: City County Insurance Services Subdivision: WEST PORTLAND HEIGHTS Lot: 4-8&27 Project Description: Ducting modifications. Contractor: OREGON HEATING &AIR CONDITIONING Owner: CITY COUNTY INSURANCE SERVICES 19300 SW 118TH AVE 1212 COURT ST NE TUALATIN, OR 97062 SALEM,OR 97301 PHONE: 503-691-9699 PHONE: 503-763-3890 FAX: 503-691-8556 FEES Specifics: Description Date Amount Typo of Use: COM Permit Fee 10/19/2015 $218.45 Class of Work: ALT Type of Const: Plan Review 10/19/2015 $54.61 Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/19/2015 $26.21 Stories: Project Valuation: $5,370.00 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 $299.27 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.€1.01 032.2344. Issued By: •ermittee Signature: Aar a 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 Application lig City of Tigard fl\�� Received Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 972 t�tk) }} DateBy: (J s f►ioZO!5= X01 Plan Review Phone: 503.718.2439 Fax: 503.598.1,. • Other Permit �" c Inspection Line: 503.639.4175 1 V'\C3 Date/By: ��/P �(5-�)1 .Z K f T I G A R D CO Date Ready/By: luris ® See Page for Internet: www.tigard-or.gov C\ Notified/Method: Supplemental Information TYPE OF WORICvs. i ��l�l� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST tt�� Mechanical permit fees*are based on the value of the work ❑New construction fZE Addition/alteratioq�Aent performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other: ��°° mechanical materials.equipment,labor,overhead.and profit. Value:$5'-3 7(] CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ I-and 2-family dwelling [Commercial/industrial ❑Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: JJ Air conditioning 46.75 Job site address: 11 6 7 5 S tV 6 C� h� / Fumace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 'f ; td 0 12 `l 7)4'1 Fumace 100,000+BTU(ducts/vents) 54.91 7 Heat pump 61.06 Suite/bldg./apt.no.: Project name: (. >L7 (o A4-‘/ S,,,An q 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 Flue vent for water heater or gas ( 4"`0 v©Gk .P. (..+:00 5 /(/1(( u,d.`n 7 fireplace 23.32 Z-4341 �� Log lighter(gas) 23.32 y- 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 p-CONTACT PERSON Other: 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: 75-0C L.. .St-e/ Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater _ Phone:(5 c j) S 6.5 - S ! /) Fax: :( S.O) ti G/ )— gs s C Fireplace E-mail: j Range `F-0 S,ge 0 0,^r yo•,) icc,t�,ny • (0 in Barbecue CONTRACTOR Clothes dryer(gas) _ Business name: O F-P21 �.�r,,�,�VC 1 4 c Other: MECHANICAL PERMIT FEES* Address: I C1-5b o S Lei IN../...t_. A-✓f- Subtotal .-.18.c,)S City/State/ZIP: „‘el l ck `n 0 k 9 70 G-- Minimum permit fee($90.00) L Plan review(25%of permit fee) 5S41• 6 Phone:(SG)) 6 ct(- ci G`t Fax:(S(r}) 6 y I- 9S5 6 State surcharge(12%of permit fee) �fi . ). ) CCB lie.: j ( 7, j). TOTAL PERMIT FEE a.`19,)7 /�. This permit application expires if a permit is not obtained within 180 * days after it has been accepted as complete. Authorized SlgnaturC:y � Fee methodology set by Tri-County Building Industry Service Board Print name:— C) I. j-L9 4-4)( Date: /0////1 3-- 1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617r(1 1/02/COM/WEB) Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11675 SW 66TH AVE, TIGARD, OR, 97223 Commercial - Mechanical 699 Mechanical ﬁnal PASS - No C of O MEC2015-00702 Jeff Grove Violation Summary: Inspector Contractor