Permit (5) CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT Permit #: MEC2012 -00603
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/21/2012
Parcel: 2S 101 AB90000
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Jurisdiction: TIGARD
Site address: 12011 SW 70TH AVE
Project: CH Physical Therapy Subdivision: 2012 -009 PARTITION PLAT Lot: 1
Project Description: (1) duct work alterations /additions and bath vent fan for TI
Contractor: TRI COUNTY TEMP CONTROL INC Owner: RED ROCK CREEK CONDOMINIUM
13150 S CLACKAMAS RIVER DR OWNERS OF ALL UNITS
OREGON CITY, OR 97045 00000
PHONE: 503 - 557 -2220 PHONE:
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/21/2012 $170.37
Class of Work: ALT Type of Const: Plan Review 11/21/2012 $42.59
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/21/2012 $20.44 •
Stories:
Project Valuation: $3,740.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: I :
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 $233.40
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
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
. 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 503.232.198877 or 1.800.332.2344. /�
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Issued By: )114/111-11 J l A T Permittee Signature: Dki A PPL/ C 477 ,)A /
�� 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.
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NOV -20 -2012 03:12P FROM: RECEIV ; O:5035981960 P.1
Mechanical Permit Application NOV 2 p ZO ! 11)u 01.1:1( , 1 I.()'N I.'
City of Tigard eceived
• Pemtit � Ia � OQ ��
1 ,11
13125 SW Hall Blvd., Tigard, OR 97223
CITY TIG . ejBY t� -
0 Phone: 503.639.4171 Fax: 503.598.1960 CITY "' 1 IG '1 Other Permit: 8i 0.„10 1 0001i 7
t t �.,-, it i 1 Inspection Line: 503.639.4175 BUILDING ()NIS �lift' RI See Page 2 for
Internet: www.tigard -or.gov t i y Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - .USE.CHECKLIST
Mechanical permit fees* are based on the value of the work
New construction
❑ ®AdditioNalteratloNreplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 37 4 , 4 0
® I- and 2- family dwelling ❑ Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES+
❑ Accessory building
Multi - For special information use checklist.
❑ y ❑ Master builder ❑ Other: Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: MO I @W 70 k U Air conditioning
���� ��� (requires site plan showing placement) - 46.75
City/Statc2IP: Furnace 100,000 BTU (ducts/vents) 46 75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
Iydronic) , 23.32
Unit heaters (fuel -type, not electric),
in-wall, induct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent fur any of above 23.32
_ Other. '" 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater . 23.32 , -
Gas fireplace 33.39
Flue vent for water heater or gas
i `�iwory �, i- frintioV i I ndt rt 011 fireplace 23.32
,IJ1 1 �, ll,(f ll C I,J 11 ItJ U 1 I f 7 Log lighter (gas) 23.32
e J £/ ., f 11 Wood/pellet stove 33.39
-^� . - Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
PROPERTY OWNER n ❑TENANT Other. 23.32 _
Name: D4 V k,ir In Environmental exhaust and ventilation
Range Address: �'` j equipment hood/other kitchen
equipm 33.39
City /State/'LIP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (M) tif:1 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32 , ,
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $14.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall /suspended/unit heater
Water heater
Phone: ( ) Fax: : ( ) _
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES*
City /State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fcc ($90.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCI3 lie.: 72623 State surcharge (12% of permit fee)
fringe TOTAL PERMIT FEE CI- t
/(! ),) Thb permit application expires if a permit is not obtained within 1811
d'
Authorized signature: [[[ days after It has been accepted as complete.
[ name: D O IV M0OV1 Date:I1943 I IL I • Fee methodology set by lb-County Building Industry Service Board
I1Buitdina \VermitdMP.C•PermiIApp,doc 10/01/09 • 440.461 /02/COM/WEB)
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