11977 SW ELEMAR COURT i
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11977 .SW ELEMAR CT
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Plan CrcIc1F 1 I
CITY OF 1'lGARD Merhani::al Permit Application Recd j
13125 SW HALL BLVD. Commercial and Residential Date Recd f
TIGARD, OR 57223 Date to P.E _—
(503) 639-4171, x304 Date to DST - -
Print or Type Permit#M4.C'./vi`i`i
Incomplete or illegible applications will not he accepted Called
Name Development,/Project Description
l _ Table 1A Mechanical Code _ 2t Price Amt
Job Address SuA) Permit Fee
Heq
1 f 1) Furnace to 100,000 BTU 1600
Address JA140includingducts&vents see footnote 1,2 9.65
Bldgl► late Zlp 2) Furnace 100,000 BTU+
te;] Including ducts&vents see footnote 1,2 12.00
Name(or name of business) 3) Floor Furnace
Owner Including vent _ _see footnote 1,2 9.65
Halling Address 4) Suspended heater,wall heater
- ���� or floor mounted heater � see footnote 1,2 9,65
` J ` _ 5 Vent not included in appliance permit 4.75 _
Cny/ tete Zip Phone (' Check all that apply 'Boiler Heat Air
C�� r � 1-1 footnotes
���(!? For Items 5.10,see or Pump Cond Qty Price Amt
footnotes 1,2 Com
Name(or name o1 business) --
6)<3HP;absorb unit to
100K BTU9.65
Occupant Mailing Address 7)3-15 HP;absorb unit
100k to 500k BTU _ I 17.65 /7'
Cny/Srate Zip I Phone 8)15-30 HP,absorb
unit 5-1 mill BTU 24.15 _
Na ie 9)30-50 HP;absorb
Contractor r' ^ ►� .` unit 1-1.75 mil BTU 36.00
G v ICS ' ` w, )IyL 10)>50HP;absorb unit
Prior to permit Meiling Address Jnr— >1.75 mil BTU 60.15
Issuance,a copy lJ S & 11 Air handling unit to 10,000 CFM
of all licenses C"//S to Zlp Phone.„�y 7.00
are required if V4 0� 91 �c�"/JJ 0 12)Air handling unit 10,000 CFM+
expired in COT Oregon orif Cont,Board Llc N Exp.Dat& 11.85
database _ 0it 13)Non-portable evaporate cooler
Architect Name 7.00
14)Vent fan connected to a single duct
- 4.75
or Halling Address 15)Ventilation system not Included In
appliance permit _ 700
Engineer Cnr/stale Zip Phone 16)Hood served by mechanical exhaust
700 _
Describe work to be done: 17)Domestic Incinerators
12.00
New Repair O Replace with like kind. Yes O No O 18)Commercial or Industrial type Incinerator
Rest ential� Commercial O - 48.25
19)Repair units
Additional Information or description of work 8.40
20)Wood stovelges FP/other units/clothe dryer/etc.
7.00
NOTE: For Commercial projects only;Units over 400 lbs require 21)Gas piping one to four outlets
structural gas calcs. See footnote 1 j 3.75
type of Diel oil O natural gas O LPG O electric�9 22)More than 4 per outlet(each)_ 's
Mint .permit Fee$50.00 SUBTOTAL -
I hereby acknowledge that I have read this application,that the information 7% PCH GE
given Is correct,that I am the owner or authorized agent of PIAN REVIEW 25%OF SUBTOTAL
the owner,that plans submitted are In compliance with Oregon.State laws Required for ALL commercial permits only _
Sigrtalt f Owner nt` - Date - -�TOTAL — ,
Other Inspections and Fees:
1. Inspeztions outside of normal business hours(minlnum charge-two
Contact Person Name /// Phone hours) $50.00 per hour
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. Inspections for which no fee is specifically Indicated (minimum
FFFf"'✓✓✓�JJJ� I charge-half hour) $50.00 per hour
F 1 3. Addhional plan review required by changes,additions or revisions to
oonotes for commercial projects only:
1 Provide full schematic of existing and proposed gas fine and pressure plans(minlrnum charge-one-half hour)E50.00 per hour
2. Provide drawings to scale showing existing and proposed me--hanical
units. `State Contractor Boiler Certification required
"Residential A/C re, -res site plan showing placement of unit
1.ltnechperm doc rev 7/19/99
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