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Permit 71 ' .... CITY OF TIGARD MECHANICAL PERMIT - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00004 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011 Parcel: 2S101AC00700 Jurisdiction: Tigard Site address: 12700 SW 72ND AVE Project: Ras Subdivision: BEVELAND NO. 2 Lot: 13 Project Description: Replace (1) rooftop unit with like kind. Contractor: OREGON HEATING & AIR CONDITIONING Owner: ROGERS, ROY R PO BOX 241 13690 SW TWELVE OAKS CT DUNDEE, OR 97115 TIGARD, OR 97224 PHONE: 503 - 691 -9699 PHONE: FAX: 503 - 691 -8556 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 01/11/2011 $204.14 Class of Work: ALT Type of Const: VB Plan Review 01/11/2011 $51.04 Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 01/11/2011 $24.50 Stories: 2 Project Valuation: $4,900.00 Fuel Air Handlers Fuel Types: 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: Appliances Vent Fans: Vent Systems: Total $279.68 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 r les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You m ob in a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: d gt' Permittee 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 Applicati c, F OR OFFICE USE ONLY r "CEI�I�� ' ---_- City o Tigard Date /By: /� Permit No.: � j.O/(a+ G 4 Iii 13125 SW Hall Blvd., Tigard, OR 97223 C. Phone: 503.639.4171 Fax: 503.598.1960) A N 0 4 2011 Date/B Plan Review G Other Permit: Inspection Line: 503.639.4175 ea .tom. 'f I G A RI) p Date Ready /: y: 10 See Page 2 for Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: i 51)1M, I&, Supplemental Information RIJILDING DIVISION l/ TYPE OF WORK COMMERCIAL 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. CATEGORY OF CONSTRUCTION Value: $ t i / %7 7 ) RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1 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 Job site address: f 2-700 ceA) � )--1441 1 f '� � Air conditioning fires ite plan ng g f (requires site Ian showtn placement) 46.75 City /State /ZIP: I I r ^9 eV Furnace 100,000 BTU (ducts /vents) 46.75 � Furnace 100,000+ BTU (ducts /vents) 54.91 �� � Suite/bldg. /apt. no.: Pr6ject 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 jydronic) 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 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 /4 C© / , VA c (i � r r Gas fireplace 33.39 , G L L ( � � Flue vent for water heater or gas fireplace 23.32 t l Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 ❑ PROPERTY OWNER ❑ TENANT 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 ,N I APPLICANT I CONTACT PERSON Attic /crawlspace fans 23.32 ss" Other: 23.32 Business name: .A Ci Fuel piping Contact name: ( L t toms t 47 LiJZ____ $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater .� l/, �/ /� Phone: ( ,� �) 0 - C. '"L Fax: : ( ) Water heater l Fireplace E -mail: C - { L ��'. c9 cvie /l`,- 1 1 /) 1 \ Z,4 Range /t CON "I " E X A CTOR 1 Barbecue Clothes dryer (gas) Business name: (3V-46, Other Address: ,7 Aj l MECHANICAL PERMIT FEES* City/State /ZIP: 6in ,wQ �� 97 tic Subtotal Phone: ( ) ( ) Minimum permit fee 0) Fax: Plan review (25% of permit rmit fee) CCB lic.: t 7 7 v - State surcharge (12% of permit fee) !! TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: / `,,,} /' days after it has been accepted as complete. Print name: - it i f ` (i (_ I 1 V� u0A1,� Date: C yii * F ee methodology set by Tri -County Building Industry Service Board 1:\Building\Permits\MEC- PermitApp.doc 10/01/09 44 -46172/COM/WEB) 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. I: \Building \Permits \MEC- PermitApp.doc 10/01/09 2