Permit (97) CITY OF TIGARD MECHANICAL PERMIT
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.' '> COMMUNITY DEVELOPMENT Permit#: MEC2017-00337
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2017
T f 9 Parcel: 1 S135CA02600
Jurisdiction: Tigard
Site address: 11130 SW GREENBURG RD
Project: Good Neighbor Center Subdivision: None Lot: None
Project Description: (2)supplies for 375 SF addition to existing shelter.
Contractor: COLUMBIA HEATING&COOLING INC Owner: EAST WASHINGTON COUNTY SHELTER
PO BOX 230397 PARTNERSHIP COUNCIL
TIGARD, OR 97281 DBA GOOD NEIGHBOR CENTER
11130 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503-624-2704 PHONE:
FAX: 503-598-0270
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/17/2017 $78.27
Class of Work: ALT Type of Const: Plan Review 05/17/2017 $19.57
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 05/17/2017 $9.39
Stories: Info Process/Archiving-Sm$0.50(up to 05/17/2017 $0.50
Project Valuation: $750.00 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 $107.73
Hoods: 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 obtain a copy of the rules
or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344.
Issued By: / !✓ 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 Application FOR OFFR: I g1: 0\1.1
City of Tigard ReCDate/By:
.
111111 13125 SW Hall Blvd.,Tigard,OR 97223 '
(i Plan Review
Phone: 503.718.2439 Fax: 503.5984ticE,Avt.i.
Date/6y:
Other Permit 4 . ,4 ; _.)f i
1'I c;n R t t Inspection Line: 503.639.4175 b� Date ReadyiBy: � '• See Pape 2 for
Internet: www.tigard-or.gov / Notified/Method: r�ir.� Supplemental Information
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❑New construction Addition/alter ti /Pep e I�j` p rf rmed.l permit tees are based on to value of the work
i performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: ou'L® mechanical materials,equipment,labor,overhead,and profit.
c itsYValue
$
. ar az r� aArKin1S i Aq M SrLMS. E S"
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family Master builder ❑Other: Description Qty. Ea. Total
w7 :, 1,,,;,.. Heatin coolin
C k' i` j} } r r°:i'„-...;•,' 7. Air conditioning
Job site address: 1 11,0 t.7 /�6.`r fJ si (requires site plan showing placement) 46.75
City/Stale/ZIP:""�'1 /%�^ / i (, C� Furnace 100,000 BTU(ducts/vents) 46.75
rjv' O� � Furnace 100,000+BTU(dnci,Jventc) 54.91
Suite/bldg./apt.no.: Project name: J 1/3 bor- Heat pum
1 I (requires ate plan showing placement) 61.06
Cross street/directions to job site: Duct work 4 23.32 'A
Ilydronic 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
Tax map/parcel no.: Other fuel appliances:
i' " 4'-T i.,'7-ailra;y � f.i-I:;,t°4 f ns, Water heater 23.32
ADS nap �i1�/LIES a ' w*.[_ Gas fireplace 33.39
t Al d� Flue vent for water heater or gas
410 1 0 fv 41 i1 Vi. �/ 1/a !T�.- fireplace 23.32 _
Ety Qp� / Log tighter(gas) 23.32
(f F4 4 J 7" Wood/pellet stove 33.39
Wood fireplace/insert 23.32
. ?
23.32
, ppC ii, q E 415,, } COhthimne /iinerlflue/vent
23.32
Name: VI bOr
' , Environmental exhaust and ventilation:
Address: ‘t l''3 ' S 1fi -c' Range hood/other kitchen
� ,� __, equipment 33.39
City/State/ZIP: - '\ 8are.e ' to / - a3 Clothes dryer exhaust 33.39
Single-duct.exhaust(bathrooms,
Phone:( ) Fax ( )
toilet compartments,utility rooms) 23.32
0_API0M "1t ex: � � � � , : Ww ;irN,
Attic/crawlspacefats 23.32
Business name:Columbia Heating and Cooling,inc. Other: 23.32
--- ----- ---_-..-_ Fuel piping:
Contact name:Marlena Meedom $14.15 for first four;54.03 for each additional
Address:PO Box 230397 Furnace,etc.
Gas heat pump
City/State/7-1P:97281 Wall/suspended/unit heater
Phone:(503)624-2704 Fax::(503)598-0270 Water heater
Fireplace
E-mail:columbhc@teleport.com Range
2 M--�,-r;.A�.�f.w� � 1.rK�z �zy='��S'�Igrt rrl.. , };s,: Barbecue
Business name:Columbia Heating and Cooling,Inc. Clothes dryer(gm)
Other.
Address:PO Box 230397 1. fyvit PPlt;.8)
City/State/ZIP:Tigard,OR 97281 Subtotal
Phone:(503)624-2704 Fax:(503)598-0270 Minimum permit fee($90.00)
Plan review(25%of permit fee)
CCB tic.:76359 State surcharge(12%of permit fee) w
TOTAL PERMIT FEES/0-7r '73 1
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name:Marlena R Meedom Date: Gil I I I ' Fee methodology so by Tri-County Building Industry Service Board
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