Permit (47) CITY OF TIGARD MECHANICAL PERMIT
r IIat: . COMMUNITY DEVELOPMENT Permit#: MEC2017-00321
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/15/2017
T i�'�'� ° g Parcel: 1S135DCO2000
Jurisdiction: Tigard
Site address: 11905 SW 91ST AVE, OFC#
Project: Greenburg Oaks Subdivision: None Lot: None
Project Description: Replace existing gas furnace with like kind in manager's office.
Contractor: DELUXE HVACR LLC Owner: VILLA LA PAZ LIMITED PARTNERSHIP
1013 NE 62ND AVE BY COMMUNITY PARTNERS FOR
PORTLAND, OR 97213 AFFORDABLE HOUSING INC
PO BOX 23206
TIGARD, OR 97281
PHONE: 503-287-6688 PHONE:
FAX: 503-287-0614
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/15/2017 $127.39
Class of Work: ALT Type of Const: Plan Review 05/15/2017 $31.85
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 05/15/2017 $15.29
Stories: Info Process/Archiving-Sm$0.50(up to 05/15/2017 $4.50
11x17)
Project Valuation: $2,389.00
Fuel Air Handlers
Fuel Types: Natural Gas Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 1 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 $179.03
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
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
Utilit enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or.irect questions to •.NC • ailing 503.232.1987 or 1.800.332.2344.
=sued By:
di
,�`�/ _ 4 / Permittee Signature:
Call 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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicatioECEIVED
FOR OFFICE USE ONLY
City of Tigard Received
ill . PPermit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 5 , / - O 3�,r
Phone: 503.718.2439 Fax: 503.598.1960 Y 2017 Dan Review
DateBy: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Read/B Jnris
Internet: www.tigard-or.gov a Ready/By: See Page 2 for
l!OF TIGARD Supplemental Supplemental Information
Is-t-;-6,',2J < .. . T 'PE ga, ?.+ g9 0 1 S *0»R1rLEAia C r.X1S`r ,
Mechanical permit fees*are based on the value of the work
9 New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
9 Demolition 9 Other: mechanical materials,equipment,labor,overhead,and profit.
T O X;:
i Value $$2,389 00
9 1-and 2-familydwelling �f � � E .1 M E 8,t , .<
® Commercial/industrial 9 Accessory building For special information use checklist.
9 Multi-family 9 Master builder
9 Other: Description Qty. Ea. Total
f~ . A,.. . Oar$n.:D****--oici ill•LL ATIO1s1: Heating/cooling:
Air conditioning 46.75
Job site address:11905 SW 9151 Ave
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:OFC Project name:IPM-Greenburg Oaks Heat pump 61.06
Duct work 23.32
Cross street/directions to job site:SW Lincoln&SW 91St Ave 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
'_ , . 9, DF' .. Oh WO)., Gas fireplace/insert 33.39
" Flue vent for water heater or gas
Installing like for like gas furnace in office. 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
n Ptp1� � �1 . '.5.` ....'. � 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 23.32
7
"PL)em,iI ` , ►a\CON`TAPERS(114Other: 23.32
Business name:Deluxe HVACR (dba:Deluxe Heating&Cooling) Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Peter S. Furnace,etc.
Address: 1013 NE 62"d Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland,OR 97213 Water heater
Phone:(503)287-6688 Fax::(503)287-0614 Fireplace
Range
E-mail:pschulmerich@gmail.com Barbecue
.;U1 :5::. t Clothes dryer(gas)
,... (g )
Business name:Deluxe HVACR (dba:Deluxe Heating&Cooling) Other:
:: 40„ 1I F
( 7LANICAL PEI2l4Il�f FEES*
Address:1013 NE 62nd Ave Subtotal
City/State/ZIP:Portland,OR 97213 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)287-6688 Fax:(503)287-0614 State surcharge(12%of permit fee)
CCB lic.:200103 TOTAL PERMIT FEE f/79•65
'- This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Peter Schulmerich Date:4/12/17
1.\Budding\Permits\MEC_PennitApp_040113.doe 440-4617T(11!02/COM/WE13)