Permit (44) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00501
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/18/2016
Parcel: 2S 101 AD03000
Jurisdiction: Tigard
Site address: 6969 SW HAMPTON ST
Project: Peterson Kolberg&Associates Subdivision: WEST PORTLAND HEIGHTS Lot: 19-26&
Project Description: Add new HVAC unit
Contractor: ADVANTAGE HEATING&AIR CONDITIONING LLC Owner: KF LLC
2355 HYACINTH ST SE 7407 SW HUNT CLUB DR
SALEM, OR 97301 PORTLAND, OR 97223
PHONE: 503-393-5315 PHONE:
FAX: 503-393-2253
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/18/2016 $596.63
Class of Work: ALT Type of Const: VB Plan Review 07/18/2016 $149.16
12%State Surcharge-Mechanical 07/18/2016 $71.60
Occupancy Grp: B Occupancy Load:
Stories: Info Process/Archiving-Lg$2.00(over 07/18/2016 $2.00
11x17)
Project Valuation: $19,750.00
Info Process/Archiving-Sm$0.50(up to 07/18/2016 $2.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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 $821,89
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: split system
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific.'. Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. /.., i.- obtain a copy of the rules
or dire •uestions t. •UNC by calling 503.232.1987 or 1.800.332.2344.
Issu d By: 00 � ��/ Permittee Signature: dyl ..-
'
Call 503.639.4175 by 7:00 a.m.for the next available inspectidn date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE()NIA'
Received
City of Tigard Date;By: 7 /!v Permit No.: C II di, t
III 4 13125 SW Hall Blvd.,Tigard, _..,1 I V E
■ Phone: 503.718.2439 Fax: 5 3. 1960 Plan Rev .
Date/By: aiel1Aire Other Permit�Git ellit�6l��
l i(;ARD Inspection Line: 503.639.4175 3 2016 Date Read Jens:
Internet: www.ti and-or. ov1 Ready-I Supplemental See Pe2Inr
g B NotiSed/Method: /�� /� �o/ Information
L'i I l Lit l'""' `t`- 6/4,4. 4,/ „� COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
f� iVIS1O
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor overhea and profit.
Value:$ !y� 7� -°r!
CATEGOR OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 1-and 2-family dwelling at ommercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. ` Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
/ l �y Air conditioning 46.75
Job site address:
t(j rC �7 W7 �` I `��' Furnace 100,000 BTU(ducts/vents) (4410 46.75
City/State/ZIP: 6.-'6Z- f;''6 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name:Pictirw,L DA1 ` 11450C'iHeat pump l 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
6112 C`4- j_[727769"'‘-- 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
`�1 s"' - Other: 23.32
Subdivision: I � F '/ Other fuel appliances:
Tax map/parcel no.: / , ,. "� Water heater 23.32
DESCRIPTION OF WORK '� Gas fireplace/insert 33.39
t• f, syr Flue vent for water heater or gas
�( t_) 14U.A _ ' fireplace 23.32
Log lighter(gas) 23.32
f Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER I 0 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 C;HCPPLICANT ❑-C ?NTACT PERSON Other: 23.32
6,, C 4.rJ-.e c 6).t-L'�'�(' �'f(�, Fuel piping:
Business name: 6 (
$14.15 for first four;$4.03 for each additional
Contact name: - .-- t-feA1 - Ly Furnace,etc. 1 19'lS
Address: ( (-1.- --‘t,S., 5 c____.) 0, c ct //�I ., Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Becs_te,d6,,<_,,,99.._ i(f 0.--iJy( Water heater
Phone:( rI-4/ -(44()v Fax: :( ) Fireplace
E-mail: Q 6-6,,,4-64-4,56-,),..' D ," Barbecue
CONTRACTOR L Clothes dryer(gas)
Business name: 4 d . ,
0 .4. L42 cr t- cL,,,\-t1"u Other:
`_ 1 MECHANICAL PERMIT FEES*
Address: (A3 s-5- / ( ,,Tis, 1-, N E Subtotal
City/State/ZIP: &,��,, c r Minimum permit fee($90.00)
i) i � C( Fax:( ) Plan review(25%of permit fee)
Phone:(,
State surcharge(12%of permit fee)
CCB lie.: / 4.-b"0,,,,...7 TOTAL PERMIT FEE $,591.S'g
This permit application expires if a permit is not obtained within 180
-----Z:"....--- days after it has been accepted as complete.
Authorized si r �-
g�� * Fee methodology set by Tri-County Building Industry Service Board
Printname:� /��, Li / Date: .7^1,3 /6
I:\Building\Pem \
ritsMEC_PennitApp_040113.doc 0 440-4617T(11/02/COM/WEB)