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)
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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.
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