Permit (53) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00583
T f Aft D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2017
Parcel: 2S110DC01000
Jurisdiction: Tigard
Site address: 11065 SW MEADOWBROOK DR 6
Project: Summerfield Appartments Subdivision: WILLOW-BROOK-FARM Lot: 17
Project Description: Clothes dryer exhaust.
Contractor: SAGE GENERAL CONTRACTING LLC Owner: SUMMERFIELD ASSOCIATES, LLC
8190 SW DURHAM RD BY HSC REAL ESTATE
TIGARD, OR 97224 1500 SW FIRST AVE STE 1020
PORTLAND, OR 97201
PHONE: 503-430-8572 PHONE: 503-819-5181
FAX:
FEES
Specifics: Description Date Amount
Type of Use: MF Mechanical Permit-COM 08/15/2017 $90.00
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/15/2017 $10.80
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $0.00
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 $100.80
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: 1 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
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: 4- Permittee Signature:
/0/1/7L
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 OFF►cl, t SE ON LI
Cl Of Tigard ``R ceived / r
'5 g 1 Date/By: t��7 I2 /i Permit No. 2re�,al �t�c- i
13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 �}((} Other Permit:
4442N
l� Date/By: N 7~00.311.
T 1 G A R D Inspection Line: 503.639.4175 ,!\1,4GDate Ready/By: Juris: WI See Page 2 for
Internet: www.tigard-or.gov .Tg( ltid/Method: Supplemental Information
K LP'Grtezc oto( //iLA
TYPE OF WORK �il 1 G 9f ?SIU' COMMERCJAt FEE* SCHHLDULII `ttJ E C~IECEtIST
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacem t performed.Indicate the value(rounded to the nearest dollar)of all
o Demolition ]Other: butyl fv A'rYe! Ve ilk,t--
mechanical materials,equipment,labor,overhead,and profit.
Value $
CATEGORY OF. COI4STRU J, N
.; i . "'RES DENTIAL QUiPMENT YsYSTE1N1tu" FEES* .' .
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
o Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND"L CATION - Heating/cooling:
Air conditioning 46.75
Job site address: 0!(0 & 5 A201.8 c ciJ lb r tC,L 0 r Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 'I-zit i L. (.), i-7- 2 ?frait Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:' Project name: _Su,v eI ie._1G1. Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
f ��,e,h ( ' Residential boiler(radiator or
(i f_i @ Ki hydronic) 23.32
Ii I .7 (Y16104)12r6 L Unit heaters(fuel-type,not electric),
i 6 in-wall,in-duct,suspended,etc. 46.75
1744 Qg-- q7 2 Z Lf 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
t #64- k , xt.:��* : Gas fireplace/insert 33.39
LO, `°' Flue vent for water heater or gas
O(kai Coo/tX151 ,\ fireplace 23.32
C__(a'P 1 1 A ri Roo i(,'rl Log lighter(gas) 23.32
Wood/pellet stove 33.39
P\QC,MGttit J 1 -J e b `t q cf— f I6Cc4 Wood fireplace/insert 23.32
J Chimney/liner/flue/vent 23.32
' i" ;14-4) ,_ s Other: 23.32
,i",-,,`":-...,11,... .-, ° "s°- ..n,d.* f . ;• ,'A'
" . Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust f 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
max: y"' 3 ..-c" 't°t ti 1.� /-13-1".,- ',--.':';‘"'.„<„--e : ' ,- t 'Ai:A Other: 23.32
ry �.. �� ���� � - qft
Fuel piping:
Business name: U ' (Lt` p p g
4 �` $14.15 for first four;$4.03 for each additional
Contact name: `L^ Of tplaP Furnace,etc.
Address: SO% 5 - 17Orf c,,w, 0 C( Gas heat pump
" Wall/suspended/unit heater
City/State/ZIP: ¶ 8, 04- 91 az Z Water heater
Phone:(,--5) s i 4 s(o'�^ Fax::( ) Fireplace
E-mail: „01..<-*\(((( S 0. Range
L Cif5 RA Barbecue
COt-' � Clothes dryer(gas)
Business name: �p
So* as /��
S ”-L_- €Other ME,CHANICAL PERMIT FE .
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee)
CCB lic.: t b 8 Gb L TOTAL PERMIT FEE (X. &
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
°r<I Print name: "
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t eche__ 5- -/7
'`, Date:
%.,..\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)-