Permit (176) CITY OF TIGARD MECHANICAL PERMIT
rig COMMUNITY DEVELOPMENT Permit#: MEC2018-00714
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2018
TIC ;\I<.Dg Parcel: 2S101 DA02101
Jurisdiction: Tigard
Site address: 6958 SW VARNS ST
Project: CIC Portland Subdivision: VARNS ACRES Lot: 4
Project Description: Use Existing(3)ton furnace and NC with new duct for HVAC system. Add venting for(2)110CFM bath fans
supplied by others gas line to furnace.
Contractor: ROTH HEATING&COOLING Owner: AVANOA, LLC
PO BOX 1265 4904 S POWER RD STE 102-203
CANBY, OR 97013 MESA,AZ 85212
PHONE: 503-266-1249 PHONE:
FAX: 503-266-3478
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/24/2018 $690.61
Class of Work: ALT Type of Const: Plan Review 09/24/2018 $172.65
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 09/24/2018 $82.87
Stories: Info Process/Archiving-Sm$0.50(up to 09/24/2018 $0.50
Project Valuation: 11x17)
$23,450.00
Fuel Air Handlers
Fuel Types: Natural Gas 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: 1
Appliances
Vent Fans: 2 Vent Systems: Total $946.63
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 100
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. Y9 may obt n a cop of the rules
or direct questions to OUNC • Gain. 503.2. .1987 or 1.800.332.2344. l.) y/4
(},
Issued By: / �"� - 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 of Tigard Received
V76,)
f o Permit N tt pA y Ti.iy��/u
Date/By: (/( 'G (� O (i(/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.196V- ' /� Other Permit:
t 1 Date/By: 1 •)�, g l�
TIGARD Inspection Line: 503.639.4175 Date Ready/By: / Sufis: m See Page 2 for
Internet www.tigard-or.gov Notified/Method: / !��. Supplemental Information
/�
TYPE OF WORK C'!s[MERCIAL FEE* SCHEDULE — USE CHECKLIST ':
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement - performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$23,450.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building
For special information use checklist.
❑ Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75 _
Job site address:6958 SW YARNS ST. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:TIGARD Or 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:cic Duct work f 23.32
Cross street/directions to job site: 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 _
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
DESCRIPTION OF WORK Gas fireplace/insert 33.39
USE EXISTING 3TON FURNACE AND AC WITH NEW DUCT FOR HVAC Flue vent for water heater or gas
SYSTEM fireplace 23.32
Log lighter(gas) 23.32
ADD VENTING FOR TWO 110CFM BATH FANS SUPPIED BY OTHERS Wood/pellet stove 33.39
GASLINE TO FURNACE Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT LICONTACT PERSON Other: 23.32
Fuel piping:
Business name:BOTH HEATING AND COOLING $14.15 for first four;$4.03 for each additional
Contact name:JERRY H Furnace,etc.
Gas heat pump
Address: PO BOX 1265 Wall/suspended/unit heater
' City/State/ZIP: CANBY OR 97013 Water heater
t Fireplace
Phone:(503)519-0782 Fax: :( ) _ Range
E-mail:JERRYII ROTH-HEAT.COM Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name:SAME
MECHANICAL PERMIT FEES*
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.: 14008 TOTAL PERMIT FEE
------ -- 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
Print name:JEREMIAH I IIARLON Date:008/29/18
I\Building\Permils\MEC_PenuitApp_0401 13.doc 440-4617T(11/02/COM/WEB)