Permit (41) CITY OF TIGARD MECHANICAL PERMIT
74 ' .' COMMUNITY DEVELOPMENT Permit#: MEC2016 00595
T/GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/16/2016
Parcel: 2S 112AD00301
Jurisdiction: Tigard
Site address: 14610 SW SEQUOIA PKWY
Project: John Barleycorns Subdivision: BONITA GARDENS Lot: 4
Project Description: Replacing existing grease fan.
Contractor: HVAC INC Owner: SMETS, JOHN E&MARIETTA D TRS
5188 SE INTERNATIONAL WAY PO BOX 560
MILWAUKIE, OR 97222 AURORA, OR 97002
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/16/2016 $179.58
Class of Work: ALT Type of Const: Plan Review 08/16/2016 $44.90
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/16/2016 $21.55
Stories: Info Process/Archiving-Sm$0.50(up to 08/16/2016 $2.00
Project Valuation: $4,100.00 11x17)
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 $248.03
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Grease Fan
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma(o,tain a copy of the rules
or direct questions to OUNC by callin. � 40.332.2344. �[
Issued By: f Permittee Signature: l ( I i
V
all 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completio %f the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE FSE O\1.1
City of Tigard Received
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 RECEIVE DateBy: tLryi��/ Ala►— (p^— )
Phone: 503.718.2439 Fax: 503.598.1960 ,�I'Plan Review
Date/By: Other Permit:
TI G x D Inspection Line: 503.639.4175
Internet: www.tegard-or.gov Date Ready/By: H See Page 2 for
AUG 1 2016 Notified/Method:�( pp>j, t
- ' is Supplemental Information
TYPE OF woFtk;I f Y OF I IGARD COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
tl i/jL Ta�lla DIVISION Mechanical permit fees*are based on the value of the work
❑New construction Addition/altera o GP a nt performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ L. l 1) f'
RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ 1-and 2-family dwelling V 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
Job site address:
11 C1\"0 S Co?_, 1 ok p K VA *j (requires site plan showing placement) 46.75
City/State/ZIP: �,/t j A 1 ,, `'� 6 v 1 Furnace 100,000 BTU(ducts/vents) 46.75
t 4 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Heat pump
i (requires site plan showing placement) 61.06
Cross street/directions to job site: 6 rev t{Ai
U vq, Duct work
23.32
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.:
Tax map/parcel no.:
Other: 23.32
Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
/� � {'� � Gas fireplace/insert
' Q ,/Qc i w� } ou `e,," Flue vent for water heater or gas 33.39
�
\ d) t W�l 0c - ( "5 O ( "L fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER 0 TENANT
Name: Other: 23.32
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( )
toilet compartments,utility rooms) 23.32
0 APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32
Business name:HVAC,Inc. Other: 23.32
Fuel piping:
Contact name:Jody DePew
$14.15 for first four;$4.03 for each additional
Address:5188 SE Internaitonal Way Furnace,etc.
City/State/ZIP:Milwaukee,OR 97222 Gas heat pump
Wall/suspended/unit heater
Phone:(503)462-4822 Fax::(503)462-6555 Water heater
E-mail:jodyd @hvacincorp.com Fireplace
Range
CONTRACTOR Barbecue
Business name:HVAC,Inc. Clothes dryer(gas)
Address: Other:
} MECHANICAL PERMIT FEES*
City/State/ZIP: /` Subtotal
Minimum permit fee($90.00)
Phone:( ) Fax:( )
Plan review(25%of permit fee)
CCB lic.:50897 "
State surcharge(12%of permit fee)
TOTAL PERMITFtEEgq3Authorized Slgttature: \c?„,,A1
This permit application expires if a permit is not obtai d within 180
days after it has been accepted as complete.
Print name:Jody DePew ` Date: q I 1 l)l? 0 * Fee methodology set by Tri-County Building Industry Service Board
1:Building\Pem�its�MEC-PermitApp.doc 03/07/12 440-4617T(1]/l02/COM/WEB) / r
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
14610 SW SEQUOIA PKWY, TIGARD, OR, 97224
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00595
Chip Barnett
Violation Summary:
Inspector Contractor