Permit 1 w w CITY OF TIGARD MECHANICAL PERMIT
7 COMMUNITY DEVELOPMENT Permit#: MEC2011 -00215
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/18/2011
Parcel: 1 S134BC00403
Jurisdiction:
Site address: 12505 SW NORTH DAKOTA ST, OFC# OFC
Project: Meadow Creek Apartments Subdivision: GREENWAY TOWN CENTER Lot:
Project Description: Replacing existing gas logs.
Contractor: AMERICAN CHIMNEY & MASONRY INC Owner: BEL -EQR III LIMITED PARTNERSHIP
PO BOX 13311 BY EQR -REAL ESTATE DEPT
PORTLAND, OR 97213 PO BOX 87407
CHICAGO, IL 60680
PHONE: 503 - 644 -0393 PHONE:
FAX: 503 - 284 -0368
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 05/18/2011 $84.41
Class of Work: ALT Type of Const: Plan Review 05/18/2011 $21.10
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/18/2011 $10.13
Stories:
Project Valuation: $1,000.00
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:
Appliances
Vent Fans: Vent Systems: Total $115.64
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 OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1 :44.
Issued By: � — Permittee Signature: �i
• <<– if/ /ate_ 1 - ��
• ; 9.4175 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.
05/17/2011 09:10 5032840368 AMERICAN CHIMNEY PAGE 01
_ .
Mechanical Permit Application
-9 Received - 1 OFFICE I. ONLY
R 4
N 13125
City SW l tall Blvd of Tigard Tigard, Date/By: /7 AM! Permit No.:
eo." der --
. ., O ', :'.i 1 1/4./1.. )
. , . Phone: 503.718.2439 Fax: 503.59 A.••• EffillI
CA R !!,i
Inspection Line: 503,639.4175 \ 'PP\ Data Ready/B MINIIIIIIII y, AUI gl see Page 2 for
'FII)
Internet: www.iisard-or,gov 0 Notified/Method:
1. Supplemental Information
....
, : . ,,..".:' , ...,::: , .., .,i",iit).: ',:.:;,■ ,.c il! ■:, . .7 Clo_...I,'„': E,,■'.::7; .':,
. '- ' Mechanical permit fees* are based on the value of the work
0 New construction 11 Addition/alterag eplacement performed. Indicate the value (rounded to the nearest dollar) of all
0 DcmolitiOn E-4ther: mechanical materials e• ui•ment, labor overhead and tont.
.. , IIIIIIIIIIMEMMIMi . ,f.... ..I.Zi i :5
atifjoiViiiii. 't ' ::. ;•1 1 , 1 T .. .. ... :•':.. :::, , t1 ;WE ' 7, .:. ,i' -. 1r.r':.;..1„
n - and 2-family dwelling 0 Commercial/industrial 0 Accessory building ffirerfli
KM„till-family CI Master builder 0 Other: Description Qty. IMO Total
- . - Illeatin
—7--- 14"11 116641tAititig•ii****,1:::;q:::;,,,1. ''.. :, ... ‘: . _ . . ,
- • '. -... . . ,, • - , , ._.:L' ,,.• , "- ' '. -.,.' """,,, '-- ' Air conditioning .
_
Job site addrcss: >SO SLA.-) V..) - i'■ urea at .Ian ShQW/11_ .lacement III
46.75 11111
City/State/ZIP i cS,S').-- . ,"3 Furnace 100,000 BTU (ducts/vents MINIM
Project name: i k .. ,, , _, .._, i .. r a , _.,
soileibidgiont.. no , Furnace 100 000+ FU ducWvents) MINI
Cross reet/directions to job site st Heat pump
, re•uires silo • Ien ShOwin rn
.. laceent .11 61.06 IMO
, i )
'‘N‘- O__i_9-1,/k---Asc>6 • Duct work 23.32 11
14 dronic hot water $ stem MI 23.32
L.A.. A Lik.■ Residential boiler (radiator or
h dronic III 23.32 Ell
Subdivision; Lot no.:
Unit heaters (fuel not electric),
Tax map/parcel no.: in-wall, in-duct, sus•ended etc. 46.75 11111
.:.... :' **.V...E.T '.:' Flue/vent for an of above El
Other: MIEN
• • 0
. 1112.
cras fire 'lace 33.39
. . . .. tiiii70`00EW:' Y,*140..*.4t Flue vent for water heater or gas II
Illb. ....■ i
memmim .1 a CC III , . 2 MI
23.32
Nar . --- ":- - "'"' - ' 11 -"• 0 ' .- 1Ca■soill - .._ -. . - 1
...._
Address: A , 0 I,. . i-, /7/ .. IA A.
6 I--
■
COY ISOAC/ZIP: W4)0d1 t die( StrIVe 33.39 NM
Phone ( ) Fax: ( ) Wood fire .1am/insert El
rj. (*"*Cr:::41"": : ••
' Ill 1,1111111
13usincss narne: ' 46. A A 's go. ■t \._ ' - . , _ I$11114_ InIM
Contact name Cl"...-,, _ ,/iiii - Cfn5 Environmental exhaust and ventilation:
Address: i'" TC3 4 I-- \ 1 \ Le / Range hood/other kitchen
C tit ment 33,39 II
City/State/ZIP: ii,
... 33.39
Phone: ($53) , c ..._ 0 c '7 Fax: : ( .5 ) ......r i..,,,-,i,,,, oxhau5t (bathrooms, MIIII
toilet com•artments utili MOMS
li-mail'
- • . :• .. CONTiatlAk . . . '• .. . ''''''' ' ' ' • • Attic/crawls•ace fans
ERMIIMil IRS
Business name: SeetA-14---"e-
Address: Fuel •I•in_i
— $54.15 for first tour; $4.93 for gad, additional
City (Statef7.1P:
M=
Furnace etc.
Phone: ( ) Fax
. ( )
V ' IMENIMIll
CCI3 lic.; • A MINIM
Wall/sus •ended/unit heater
Authorized signature m
i ,.. i t
Al
....••••
1,11111
Print !worm: 1, . A lo g allinatEMIAIE Date: 5 agrami
1:,9„,,„,1g,,,,,,nit„m„,,.1'.„An.doc05(55„, .40-4617 (11/02/CUM/WEA)
05/17/2011 09:10 5032840368 AMERICAN CHIMNEY PAGE 02
lather: M
Subtotal MEIPI
Minimum permit fee $90.00) �b( 1.(�
Plan review 253' of permit fen) �� I • t P4
Slate surcharge (12% of permit fee) �.:�� r
TOTAL PERMIT FEE 171
Thle permit application expires it a permit Is not obt - ed within 180 J
days after it has bees) accepted at complete.
• Fee mothodvlogy set by Tri -COUmy Awlding Industry Service Board
l:\ Building \PermitS\MEC- kermitAApp,doa 09/0980 2