Permit (147) CITY OF TIGARD MECHANICAL PERMIT
114 i ' COMMUNITY DEVELOPMENT Permit#: MEC2017-00126
T I I.;q I?1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2017
Parcel: 1 S 135CB00600
Jurisdiction: Tigard
Site address: 11570 SW TIEDEMAN AVE
Project: LN Curtis Subdivision: None
Project Description: Mechanical for TI:(1)RTU,duct work,exhaust fans for restrooms,and 6 ft.of gas piping. Lot: None
Contractor: OREGON HEATING&AIR CONDITIONING LLC Owner: MCCALL PROPERTIES LLC
19300 SW 118TH AVE BY NED MCCALL
TUALATIN, OR 97062 5480 NW FRONT AVE
PORTLAND, OR 97210
PHONE: 503-691-9699 PHONE:
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/02/2017 $843.01
Class of Work: ALT Type of Const: VB Plan Review 03/02/2017 $210.75
12%State Surcharge-Mechanical 03/02/2017 $101.16
Occupancy Grp: M Occupancy Load:
Stories: 1 Info Process/Archiving-Lg$2.00(over 03/02/2017 $2.00
Project Valuation: $29,500.00 11x17)
Info Process/Archiving-Sm$0.50(up to 03/02/2017 $20.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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: 2 Vent Systems:
Hoods: Total $1,176.92
Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may op . : copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: f J
Call 503.639.4175 by 7:00 a.m.for the next available inspe•ndate.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
Folz oFFlcE 1 sl•:0\IA
.City of Tigard Received ,_
13125 SW Hall Blvd.,Tigard,OR 97223 „ ,As ,, DateRe Permit No.
„�� a J/S�7 , — 711.;:7c--4.,20 i 7`0)1 sit:
II _ Phone: 503.718.2439 Fax: 503.598.1 i....
f.-.•_ �
Plan Re
Inspection Line: 503.639.4175 "' Date/By: ( Other Permit: 7_f y� '��
T I(1 A R D p rpt' /
Internet: Line:gard-or.gov Date Ready J ts:
pp 1 h t Notified/Method: 2j Cj
��U Lxy2(/ Supplementallnformahon
},� //// See Page 2 for
t �� y� �
❑New construction Addition/alt Mechanical permit fees*are based on the value of the work
�, e�ilent Y performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other:
mechanical materials, andprofit
* 'YF�fF 1�'i('IIE
equipment,labor,overhead, r
Value:$ ^� ��0
❑ 1-and 2-family dwelling �CommerciaUindustrial� ,.Wi t' ;'!
0 Accessory building For special information use checklist.
❑Multi family 0 Master builder1
0 Other: Description I Qty. I Ea. I Total
:' F rust, (4Heating/cooling:
Job site address: 115 3 <G)lie( '� Air conditioning 46.75
� J Y AV t Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: V ,J 4l�l_/ ap\ ?I Z 2-3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: ProjectfLJname N `� Heat pump 61.06
�r�-�5 tl Ductwork 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: i Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater
=1sp' ll 23.32
^' Gas fireplace/insert
� ,�r � r s 33.39
/� /� 1. Flue vent for water heater or gas
Jo
VE is pele_1cG�C co ri t L iekte&i,le.1fireplace 23.32
Ex �'''�5 71.0..r. Log lighter(gas) 23.32
f ' f ' [ I( l`t ��5 f �•S riff Wood/pellet stove 33.39
L..Q �"•3 £]cf1.4Tcc.. IA2j Wood fireplace/insert 23.32
F iC er'tit C,., i 0 C FAA (c f z) Chimney/liner/flue/vent 23.32
Other: 23.32
Environmental exhaust and ventilation:
Name:
Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
Phone:( ) toilet compartments,utility rooms) 23.32
Fax ( Attic/crawlspace fans 23.32
' , '..... 0;: Other: 23.32
Business name: Cw'm 1�1 4 Fuel piping:
Contact name: C c` (C,i $14.15 for first four;$4.03 for each additional
•1 1_4 I Furnace,etc.
Address: i q 310 St.) i 1 r -A Gas heat pump
City/State/ZIP: 1—"A 14 it •v, O✓t. 1 70 Wall/suspended/unitereater heater
Tl `` / +(p� Water heater
Phone:(603) W f_i,/(02 I Fax::( ) Fireplace
E-mail: J S c.1411(,2-44; . � Range
-�!� C6�"�.. Barbecue
t3 *'R Clothes dryer(gas)
Business name: �
O �� " 1-1-c4 4...,c„,4...,c„, Other:
Address: S /m3o 51.4) 1 f 5t�� G N7 Czld(,
4..;,,4..;,,,t eye, Subtotal
City/State/ZIP: l 144I , 9 7o6� Minimum permit fee($90.00)
Phone:(.50 3) cry/.... �1 4,i.._ IFax.( ) Plan review(25%of permit fee)
CCB lic.: I /_ 5 3 State surcharge(12%of permit fee)
(Q TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: iv, days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
I Print name: •s-e 5 L hd,u,_Z I Date: 1—3 I_I
I:\Building\Permits\MEC PermitApp_040113.doc
440-4617T(11/02/COM/WEB)