Permit (50) CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit#: MEC2017-00584
TiG r R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2017
Parcel: 2S110DC01000
Jurisdiction: Tigard
Site address: 11285 SW MEADOWBROOK DR 8
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 $100.80
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: 1 Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o.. in a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r„4 Issued By: AZ. Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.` /
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
FOR OFFICE USE ONLY
City Tigard Received 7b/i/J�n Q
1,1 .. 13125 SWW Hall Blvd.,Tigard,OR 97223IAN Date/By: (�i/r/'�— Permit No.: C �/'
• 6 tip Plan Review y��U/� �����
Phone: 503.718.2439 Fax: 503.5
Inspection Line: 503.639.4175 Date/By: Other Permit: / /��j n–ca
.....2c I G A R D Date Ready/By: kris ��"[ /, `��
Internet: www.tigard-or.gov See Page 2 for
01� notified Method: Supplemental Information
\3- Z Gam(free
TYPE OF WORK motr COMMERCIAL'FEE* SCHEDULE – USE CHECKLIST
❑New construction ❑Addition/alte �i e.la . siON Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
o Demolition ]Other: tit
r ye/ veq mechanical materials,equipment,labor,overhead,and profit.
,` r
CATEGORY OF CONSTRU I N Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling g Commercial/industrial 0 Accessory building
ID ❑Master builder For special information use checklist.
❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND'LOCATION Heating/cooling:
/ Air conditioning 46.75
Job site address: '
�� S ci �ec.,j ),, b rC 0" Vr- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:
tC,/,k(f.:1 (�IC' Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:sji <6 I Project name: �j v a-kt�f tie 1�l Heat pump 61.06
V! Duct work 23.32
Cross street/directions to job site:
Hydronic hot water system 23.32
m e(„f Residential boiler(radiator or
I �c hydronic) 23.32
i t 7 r 5 MoAcy3bm 4- Unit heaters(fuel-type,not electric),
I �� `C� _CJ'n` 7 Z 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:
r Water heater 23.32
.DESCRI 'IO "
N OF~W+ORK
�� a4'
• „ 4 t � '4 ' ' Gas fireplace/insert�6 � ��jr o✓� `` Flue vent for water heater or gas 33.39
fireplace 23.32
c..'(a iP 1 vxl-b L o t4 r� r,�Roo, Log lighter(gas) 23.32
f Wood/pellet stove 33.39
�QG �r J,Ab:iq � Lte ,f f t4 Wood fireplace/insert 23.32
J Chimney/liner/flue/vent 23.32
( vritol'iRW .,. 4 ii. r: , Iv $ 4'
vas''' `z `. 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 C ACr PERSON ' *i Other: 23.32
Business name: 1{0mfr_ _ `ercti 4`_�1 Fuel piping:Al —
Contact name: � ,,,, J.. $14.15 for first four;$4.03 for each additional
I `bi-K tort, ` Furnace,etc.
Address: j l a S j�vf Gas heat pump
leo
City/State/ZIP: Wall/suspended/unit heater
4, Oi 916C Z– Water heater
Phone:(,5-5) 3/ 5-721 I Fax::( ) Fireplace
E-mail: K.(a Ba b
r-le ' ,� :fir 4 4 ,w PA� '. ,� � * ,V f+ �4A Barbecue
it
4~. . Clothes dryer(gas)
Business name: Other:
5. as A .
Address: ~ MECNICa1LPEl211IITFEES*. iw c"'
;:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) I Fax:( )
(b Q £ State surcharge(12%of permit fee)
CCB lic.: ! C� L
TOTAL PERMIT FEE Ia
This permit application expires if a permit is not obtained within
Authorized signature: days after it has been accepted as complete.
"� ��[ * Fee methodology set by Tri-County Building Industry Service Board
Print name: I rte tick,fr-er-
Date: 5-6—i f
:\Building\Perms',MEC_PermitApp_040113.doc
440-4617T(11/02/COM/WEB)
MechaniPermit - City of Tigard
Page 2 - Supplementalcal Information
Commercial&Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2