Permit (44) CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit#: MEC2016-00459
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2016
Parcel: 251060001801
Jurisdiction: Tigard
Site address: 17480 SW CLEMENTINE ST
Project: Clean Water Services River Terrace Pump Station Subdivision: 2002-032 PARTITION PLAT Lot: 3
Project Description: HVAC for new sewage pump station
Contractor: RAY'S PLUMBING DBA PIPER MECHANICAL Owner: CLEAN WATER SERVICES
PO BOX 685 16060 SW 85TH AVE
BRUSH PRAIRIE,WA 98606 TIGARD, OR 97224
PHONE: 360-892-8700 PHONE:
FAX: 360-892-9644
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/21/2016 $962.39
Class of Work: ALT Type of Const: VB Plan Review 07/21/2016 $240.60
Occupancy Grp: F-1 Occupancy Load: 12%State Surcharge-Mechanical 07/21/2016 $115.49
Stories: Info Process/Archiving-Sm$0.50(up to 07/24/2016 $12.50
11x17)
Project Valuation: $34,200.00
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: 1 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump: 1
Appliances
Vent Fans: 2 Vent Systems: Total $1,330.98
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct•- ions • •UNC by calling 503.232.1987 or 1.800.332.2344.
Iss Ied By: Permittee Signature: A __
Gam_.
Call 503.639.4175 by 7:00 a.m.for the next available inspe on date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
e . i bt)P0201 G -00001
Mechanical Permit Application FOR OFFICE USE ONLY
REe
ived /_ /_
City of Tigard ' D (l87 PermitNoM 13125 SWHallBlvdTigard,OR 97223 •l � �I([T"(j(7 L
• ' Phone: 503.718.2439 Fax: 503.598.1960 „ F Date/By. . y 7 i
Other Permit: ll..r .)oi
1 11;.>>R I) Inspection Line: 503.639.4175 y 1(1$ Date Re..' y: Juris: See Page 2 for
Internet: www.tigard-or �1 24 I. Notified/Method: 7 1 /6, � I Supplemental Information
TYPE OF WORKIal vl0 ' C MMERCIAL FEE* SCHEDULE— USE CHECKLIST
(1 011\‘ �' Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteratio. htement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$34,200
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/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:
Air conditioning 46.75
Job site address• .7,1c(2, ; `, 1e. T— Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP � L., ;;,..ii)
Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace Pump Stn 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
Intall HVAC Cooling and Heating fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name:Clean Water Serices Range hood/other kitchen
equipment 33.39
Address:16060 SW 85th Ave Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:Piper Mechanical Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Scott Erickson Furnace,etc.
Address:9317 NE 72"d Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98665 Water heater
Phone:(360)892.8700 Fax::( ) Fireplace
Range
E-mail:scott@pipermechanical.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Piper Mechanical Other:
MECHANICAL PERMIT FEES*
Address:9317 NE 72"d Ave Subtotal
City/State/ZIP:Vancouver,WA 98665 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)892.8700 Fax:( ) State surcharge(12%of permit fee)
CCB lic.:33217 TOTAL PERMIT FEE I
/ i 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:Scott • on Date:4/28/16
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEE)