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Permit I a CITY OF TIGARD MECHANICAL PERMIT � l : COMMUNITY DEVELOPMENT Permit#: MEC2015-00782 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2016 Parcel: 2S102AD03000 Jurisdiction: Tigard Site address: 12850 SW ASH AVE Project: Burnham&Ash Apartments Subdivision: BURNHAM TRACT Lot: 5 Project Description: Building 1 -gas piping only. Contractor: WOLCOTT PLUMBING Owner: TIGARD, CITY OF 1075 W HISTORIC COLUMBIA RIVER HWY 13125 SW HALL TROUTDALE, OR 97060 TIGARD, OR 97223 PHONE: 503-667-1781 PHONE: FAX: 503-667-9891 FEES Specifics: Description Date Amount Type of Use: MF Permit Fee 03/02/2016 $500.11 Class of Work: NEW Type of Const: VA Plan Review 03/02/2016 $125.03 Occupancy Grp: R-2 Occupancy Load: 12%State Surcharge-Mechanical 03/02/2016 $60.01 Stories: 4 Info Process/Archiving-Lg$2.00(over 03/02/2016 $8.00 Project Valuation: $15,987.00 11x17) Fuel Air Handlers Fuel Types: Natural Gas 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 $693.15 Hoods: Comm Incinerators: Required Items and Reports(Conditions) Woodstoves: Gas Fireplaces: 1 Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: fire pit,fire Duct Work: table Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: / Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date.11114 This permit card shall be kept in a conspicuous place on the job site until completion o he project. Approved plans are required on the job site at the time of each inspection. I Nhanical Permit App �� fec ) .,ii Ai FOR OFFI( I t SI 0yl.1 Received City of Tigard Date/By: �I /(� �'I Permit No.: /` —A. IIIII 13125 SW Hall Blvd.,Tigard,OR nQM3 8 Plan Review p Phone: 503.718.2439 Fax: 503. 16 , .Other Permit: ap..,C - DateBy: �C r I I t,A R I) Inspection Line: 503.639.4175 Y Date Ready/: : n See Page 2 for Internet: www.tigard-or.gov i,11 OF t 'ii,-., Notified/Meth,,: �//� / 8-2 !, Supplemental Information TYPE OF"WORK C MNIERr I►la l -.USE CHECKLIST Mechanical permit fees*are based on the value of the work tYl New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ \S C1 $-A CA G©RY OF CONStRUCTIUN ESt1p1ENTIar~L)EQIIIP C l YS ISMS FE1 S" ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. g Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total EINO�TI .. ND LOCATIONHeating/cooling: Air conditioning 46.75 Job site address:\D„.(2) -0 S.(.Z• Ps1 , (A'v�. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: .....\--\c,s4.c c! OR C\��23 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: ` Project name: �,,,,c\o„,"‘ �� (AtR2or Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 P1 C�S Unit heaters(fuel-type,not electric), r t.�U \{�1 15 in-wall,in-duct,suspended,etc. 46.75 r D ��U AI�� V • i � . Flue/vent for any of above 23.32 Other: 23.32 Subdivision: w\t��� Lot no.: 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 C��� �'c P. %`' fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ moot E ❑ 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 V CONTACT PERSON Other: 23.32 ��(�� Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: -yam ro .c.c.c. Furnace,etc. Address:\c 1S La, \-. S-lcpc- c___Ce,..1 . Gas heat pump Wall/suspended/unit heater City/State/ZIP: C"c .. -' ) 41.\,42.... id4‘ ��t,�0 Water heater Phone:(f )( '(Q?_\Z8l X- Z Fax::( )(o(o-1 Clgc, .. Fireplace Range E maill �� Barbecue C©)IOTfR; Clothes dryer(gas) 1�7o\C `..\--\ Other: Business name: Address: Cy��� �- C�\ c_ `-r Subtotal �bp, \ City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: \VD:220 TOTAL PERMIT FEE (o$S* 15' This permit application expires if a permit is not obtained within 180 v`r� d% ays after it has been accepted as complete. Authorized signature: `�x * Fee methodology set by Tri-County Building Industry Service Board Print name: ct., .. ,• ,- . Date: `\k'7 .-1 C� I]\Building\Permits\MEC_Permi�40113.doc 440-4617T(1 I/02/COM/WEB) Y_ _ . City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12850 SW ASH AVE, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Mechanical MEC2015-00782 Inspection Type: Inspector: 699 Mechanical final Chip Barnett Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor