Permit 41 CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00063
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/10/2011
Parcel: 2S110DC00700
Jurisdiction: Tigard
Site address: 11205 SW SUMMERFIELD DR
Project: Summerfield Clubhouse Subdivision: Lot: 0
Project Description: Exhaust system for dishwasher room.
Contractor: JET INDUSTRIES INC Owner: TIGARD RETIREMENT RESIDENCE LLC
PO BOX 7362 600 UNIVERSITY ST STE 2215
SALEM, OR 97303 SEATTLE, WA 98101
PHONE: 503 - 363 -2334 PHONE:
FAX: 503 - 363 -2622
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/10/2011 $182.65
Class of Work: ALT Type of Const: Plan Review 02/10/2011 $45.66
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 02/10/2011 $21.92
Stories:
Project Valuation: $4,200.00
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 $250.23
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
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 Notification Center. Those rules are set forth in •: r • -101 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to 0 C by calling 503.232, • - -
r` �
Issued By: I j =_ Permittee Signature: � � �iyt }2., Or P"
Ca. . • 75by 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 nnnnn- 777nnnnnnnnnn❑❑; ❑❑ ❑n❑nnnnn
City of Tigard �cj Date / B y:
B ', 6 , _ 13125 SW Hall Blvd., Tigard, OR 9722 ' • , F, Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 , �� Other Permit:
D Date/By:
T I G A RD Inspection Line: 503.639 ® 1� Date Ready /By: Juris: la See Page 2 for
Internet: www.tigard or.gov < <� . ^s Notified /Method: Supplemental Information
TYPE OF WORK � COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
❑ New construction ® Addition /alteration /replacement Mechanical permit tees* are based on the value oY'the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ $4,200.00
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. I Ea. Total
JOB SITE INFORMATION. AND LOCATION Heating /cooling
Air conditioning
Job site address: 11205 SW summerfield Dr (requires site plan showing placement) 46.75
City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Summerfield Clubhouse 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
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
Gas fireplace 33.39
add HVAC exhaust system to dishwasher room Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 2332
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
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
_ Other: 23.32
Business name: Jet industries Fuel piping
Contact name: Chris Mott $14.15 for first four; $4.03 for each additional
Address: 1935 silverton rd n
Furnace, etc.
Gas heat pump
City /State /ZIP: salem or 97301 Wall/suspended/unit heater
Phone: (503) 3632334 Fax: : (503) 3632622 Water heater
Fireplace
E - mail: chris.m @jetindustries.net Range
CONTRACTOR Barbecue
Business name: Jet Industries
Clothes dryer (gas)
Other:
Address: 1935 silverton rd n MECHANICAL PERMIT FEES*
City /State /ZIP: salem or 97301 Subtotal • i 6 d .6s
Minimum permit fee ($90.00) —
Phone: (503) 3632334 Fax: (503) 3632622 Plan review (25% of permit fee) • uS 60
CCB lie.: 3944 State surcharge (12% of permit fee) ' j, 4)-
TOTAL PERMIT FEE , . fa.
Authorized signature: /1,, fr 1 21. 44v7— This permit application expires if a permit is not obta ed within 180
days after it has been accepted as complete.
Print name: l i m 09 Z Date: a , / O •,// • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits \MEC- PermitApp.doc 10/01/09 440-4617T (11/02/COM /WEB)
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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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