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Permit . q CITY OF TIGARD MECHANICAL PERMIT IL a ._ COMMUNITY DEVELOPMENT Permit #: MEC2010 00409 T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/17/2010 Parcel: 2S102BA00600 Jurisdiction: Tigard Site address: 9730 SW TIGARD ST Subdivision: Lot: 0 Project: DataSafe Project Description: Replace 4 ton rooftop with like kind. Owner: FEES MULL, GREGORY S AND Description Date Amount MULL, GEORGE E, 19350 SW POMONA DR BEAVERTON, OR 97007 Permit Fee 08/17/2010 $198.00 Plan Review 08/17/2010 $49.50 PHONE: 12% State Surcharge - Mechanical 08/17/2010 $23.76 Contractor: OREGON HEATING & AC PO BOX 241 DUNDEE, OR 97115 PHONE: 503 - 691 -9699 FAX: 503- 691 -8556 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Occupancy Load: Stories: Fuel Air Handlers Fuel Types: Units < 10000 cfm: Gas Pressue: 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 $271.26 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 Utility Notif - •• • -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a cop of the rules or • • -ct questions to 0 NC • . ailing 503.246.6699 or 1.800.332.2344. Issued By: � L .� �' Permittee Signature: /� _ � � . _..... L Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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 1 Q,R.,O I Icl: -J,sl c)N IN . Received IV ! G C - / Q "� , /� City of Tigard Date/By: Permit No.: G 7 q 13125 SW Hall Blvd., Tigard, OR 97223 C Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: 17 l /D A,,, Other Permit: .1.1( i n K I ) Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction ddition/alteration / replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, lab overhead , and profit. . CA EGORY OF CONSTRUCTION Value: $ / JC/�� 'RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1 and 2 family dwelling CommerciaUindustrial ❑ Accessory building For special information use checklist. ❑ Multi- family Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND 'LOCATION. Heating/cooling Job site address: 941 (' J l / ')/ ) Air conditioning ( requires site plan showing placement) 46.75 City /State /ZIP: /- j �' V // Furnace 100,000 BTU (ducts/vents) 46.75 l / Suite/bldg. /apt. no.: Project/name: 014 +A 4 r Furnace 100,000+ BTU ( ducts/vents) 64.0 Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 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 Subdivision: Lot no.: Flue /vent for 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 / �11 e� y ez,1(.1/4_41,e F lue vent for water heater or gas fireplace 23.32 L i 4- L f Log Wood/pe llet t sto 23.32 _L Wood/pellt stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen equipment 33.39 City /State /ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 tT APPLICANT . It CONTACT PERSON Attic /crawlspace fans 23.32 l3 n Other: 23.32 Business name: N Fuel piping Contact name: C � l 1 144— 1,A4- ��/ � $14.15 for first four; 54.03 for each additional Furnace, etc. Address: /� / / v-( Gas heat pump City /State /ZIP: &Ai...4z_ a✓ c/ 7// ', Wall/suspended/unit heater Phone: (1 ) crLfej r 0 / 1,-v Fax: : ( ) Water heater f , l Fireplace E -mail: a/ iv, v �/ Q'�' ,g-r 12 2 / J 7� Range C/1 , CONTRAdFOR Barbecue Business name: ,1, r., Clothes dryer (gas) (/ Other: Address: �a MECHANICAL PERMIT`FEES* City /State /ZIP: S" _ Subtotal j 9 ,�� Phone: (p3) //�� Fax: ( ) Minimum permit fee ($90.00) U Z� S Plan review (25% of permit fee) q9.51) CCB lie.: ( 7 . 0 State surcharge (12% of permit fee) . , 7 "`777 TOTAL PERMIT FEE �ln Authorized signature: g `1 / This permit application expires if a permit is not obtai d t m l { days after it has been accepted as complete. Print name: C / 1 / . > / i 7' ) !Z - l�/ Date: �/f 0.. v * Fee methodology set by Tri- County Building Industry Service Board I:\ Building \PennitsU�C- PermitApp.doc 10/01/09 �� 440- 4617T (I IMh'EB) • Mechanical Permit Application - City of Tigard Page 2 - Supplemental 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. • 1:\Building\Permits\MEC- PermitApp.doc 10/01/09 2