Permit (24) CITY OF TIGARD MECHANICAL PERMIT
114 ati
s. COMMUNITY DEVELOPMENT Permit#: MEC2016-00247
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
T f �h l� g Parcel: 2S 102BD02800
Jurisdiction: Tigard
Site address: 12995 SW PACIFIC HWY
Project: Guardian Systems NW Subdivision: NORTH TIGARDVILLE ADDITION Lot: 36
Project Description: Replacing air handler heat pump and strip heat.
Contractor: ARROW MECHANICAL Owner: AFTER FIVE, LLC
10330 SW TUALATIN RD 10330 SW TUALATIN RD
TUALATIN, OR 97062 TUALATIN, OR 97062
PHONE: 503-692-1565 PHONE:
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/02/2016 $266.22
Class of Work: ALT Type of Const: VB Plan Review 06/02/2016 $66.56
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 06/02/2016 $31.95
Stories: Info Process/Archiving-Sm$0.50(up to 06/02/2016 $5.00
11x17)
Project Valuation: $7,088.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm: 1
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 $369.73
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Compressor
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 ••- ion , OU • calling 503.232.1987 or 1.800.332.2344.
i • / d
Issued /j •i • Permittee Signature: •
Call 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 FOR OFFICE USE ONLY •
•
Cit of Tigard E.'„ eceived y Permit No./►�_ �j
IN • 13125 SW Hall Blvd.,Tigard,OR 97223 RE.c ,v DateBy, l ` Ai E C'"�t(p-('3(�l i
Plan Revi Other Permit:
Phone: 50Line: 3Fax: 503.598.1960 �1 2.0\(j DateBy: (•
TIGARD ht pec tion Line: 503.639.4175 pR 1 ate Re y: J H See Page 2for
Internet: www.tigard-or.gov 1\ "age
4,f17/ if", Supplemental Information
c\h F 11V if ��
x.a r OF 4k5 iO ' / CLIA# C Ir; " EDt.II:. 4,§g: ECiL
I 1 • Mechanical permit feesare based on the value of the work
❑New construction Additionialteration/replacement / r performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: 1-1 I mechanical materials,equipment,labor,overhead,
.,mss.:, ...... .. ..... ,... ..:~�*;,_,. ...3...•:.. . ..�.: .,.... ... , .. ..: .....: .. y `.' atnd profit.
Et
.
Value:
' °.
- f £3b .' VA {RU .� s ': 5I� VfT1 �i�Gl�1�i $5�
I: 1-and 2-family dwelling 'Commercial/industrial ❑Accessory building
,... .r,.r
For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
s ' , lleatin /coolie
, : , ,t) ' aif ii ... -;�H ?mss- > d
conditioning g• \46.75
Job site addres • "w -^!-•:+ S1/J PAC.., F f C.. l. 1 G L w41f'( Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: I l(7 Nf,D 01CI ,p 3 Furnace 100,000+BTU(ducts/vents) 54.91
Beat pump 61.06
Suite/bldg./apt.no.: Project name: Vfi4r�t4 / S7z'�SNGVDuct work 23.32rj
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
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
i�F,StyR[t"I'lUN��, iX/QRK { Gas fireplace/insert
33.39
�+ Flue vent for water heater or gas
'PV S' (t� V/� ) LL Rz PL1Cc, A l 2 1 A,4 PL fireplace 23.32
hIl PV'"'',f /�,'- eek S.-11 f P },�,�` Log lighter(gas) 23.32
l i f 4 Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ FROI'PRTY OWNER Other: 23.32
1.V, Environmental exhaust and ventilation:
Name: G v�. D 1 ksity X.S , V ,-7414^1C- e Range hood/other kitchen
Address: `(� S C, ►r ( ►, '^(4p r ,p 'T equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: AIp _ p C3 i `" a,,3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone: 2 ) 4?g) • 2 7,A2 Fax:(0,3) 6 .R P Attic/crawlspace fans 23.32
t y k Other: 23.32
Fuel piping:
Business name: ,QA,,/ MEC t'i I4 i CA/ V
$14.15 for first four,$4.03 for each additional
Contact name: 2-e.r'F /vizi...4Q ! Furnace,etc.
Address: /63 3 p S' -TvA_�.7-r, )20. Gas heat pump
t T Wall/suspended/unit heater
City/State/ZIP: TV pl(�/s-'i'1 62 9 ) 04: Water heater
Phone:(03) 65,A . Ls%s° Fax::( :1) 49/. / 97, Fireplace
Range
le�
E-mail: M 1'
�I `��.° �-''1 i� �t vt.,, , co.., Barbecue
--a a 2'.5... ^x a- f i- r r . s s. .r,"'t n..r -.f-.z.x
x� s sem, r .,,,,t `jCt -i Clothes dryer(gas)
Business name: V? * u/ lit 4„�t�nl„I} Other:
_ 401:#+II 'k' 1T EKS"
Address: h
0 3 3 0 �� �Ut.-/y'CI a P,..9 Subtotal
City/State/ZIP: Tu kuen 4 Ori *I`s 0(a, Minimum permit fee($90.00)
Phone:(.e 3 ) , 4 Fax:( .31 ) 6C)/, /444 Plan review(25%of permit fee)
' r+ State surcharge(12%of permit fee)
CCB lie.: .5/9 3 7 TOTAL PERMIT FEE
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: 0-EFF. fi c-L tA,4 Date: yes'''. /6
I:\Building\Permits\MEC_PerrnitApp_040113.doc 440-4617r(I I/02/COM/WEB)