Permit .'
CITY OF TIGARD MECHANICAL PERMIT
II I a COMMUNITY DEVELOPMENT Permit #: MEC2009 -00218
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/11/2009
TIGARD Parcel: 2S 101 AC00700
Jurisdiction:
Site address: 0 SW 72ND_A
Subdivision: BEVELAND NO. 2 Lot: 13
Project: PAULY & ROGERS
Project Description: Install gas pack and ductwork.
Owner: FEES
ROGERS, ROY R Description Date Amount
13690 SW TWELVE OAKS CT
TIGARD, OR 97224 Permit Fee 06/11/2009 $226.10
Plan Review 06/11/2009 $56.53
PHONE: 12% State Surcharge - Mechanical 06/11/2009 $27.13
Contractor:
THOMAS SHEETMETAL & HVAC LLC
22960 NE TRANQUIL LN
NEWBERG, OR 97132
PHONE: 503 - 554 -9230
FAX: 503 - 554 -9231
Type of Use: COM
Class of Work: ADD Type of Const: VB
Occupancy Grp: B Occupancy Load:
Stories: 2
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Fumaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Fumaces >= 100K BTU: 3 -15 HP:
Floor Fumaces: 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 $309.76
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 Other Desc:
Duct Work: 1
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
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.
'(3.001 4' - t�z�ao 'C3 7Z
Mejh, . nical Permit Application RECEIVE 1 l OIL 01-1.1C1.: usl: O\l.YY
R eceived
, � 13125 of Tigard Permit No.: • 1312s Date
, SW Hall Blvd., Tigard, OR 97223 MAY 2 0 2009 B y: � S. a0 � a � �zC� ' C�O,�
C Plan Review PP . , r ) a - i r, Other Permit Phone: 503.639.4171 Fax: 503.598.1960 • Date/By: /` . I a :;; ty P i _., y • al.
- I I G A R D Inspection Line: 503.639.4175 CITY OF TIG ' 1 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISI II Not; 4 ethod: 6 /0/0 1
Supplemental Information
`�r7/ /,
=
TYPE OF WORK I / COMM RCIAL FEE* SC • ' r r' — USE CHECKLIST
El New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and rofit.
CATEGORY OF CONSTRUCTION Value: $ 99‘ -75,0 Q
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling 'Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: a / / _ 7x19 5--&, 5--&, 7
-� J/ Air conditioning or heat pump
T (requires site plan showing placement) 1 14.00
City/State/ZIP: r�� 7 e— 97 Z , 3 Furnace 100,000 BTU (ducts/vents) 14.00
i" n Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: �/ t� j 7 `4
/� Gas heat pump 14.00
Cross street/directions to job site: Duct work I 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: I Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/,/ Gas fireplace 10.00
i ,/ . y1(' i ii /& -1(.6 / Flue vent for water heater or gas
/47 kx, fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 1 10.00 _
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 1 0.1()0
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10;00
Business name:
Fuel piping
Contact name: 85.40 for first four; $1.00 for each additional
Address: Furnace, etc. 1
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Fax ::
Phone: ( ) ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name:*k/s7 5'4.. x,,4/ ,L //� e.. LL 6._ Clothes dryer (gas)
Other: 1
Address : 94.6 TKQA/ u .,.... L ,, MECHANICAL PERMIT FEES*
City/State/ZIP: a „6 ./v am_ f7/3 Z Subtotal
6 F ( _ Minimum permit fee ($72.50) Km* 1
Phone: (5 ) SS5/ Z 3 ) SSY ' 3( Plan review (25% of permit fee) 5 4. 53
CCB lic.: /6‘6 Q ejl j- lQ ? State surcharge (12% of permit fee) ,
TOTAL PERMIT FEE WI; • ',7
Authorized signature: This permit application expires if a permit is not obtained within 180
t'>nature: days after it has been accepted as complete.
1 p,;,, nom ..' °� _ rt,t” Dr 1 • Fee methodology set by Tri- Countv Building Industry Service Board