Permit Y' CITY OF TIGARD MECHANICAL PERMIT
2,r.
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00302
Date Issued: 06/23/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102D600100
Jurisdiction: Tigard
Site address: 8840 SW BURNHAM ST
Subdivision: Lot: 0
Project: Verizon
Project Description: Demo duct, relocate VAV box, re- connect to existing duct.
Owner: FEES
VERIZON NORTHWEST INC Description Date Amount
PO BOX 152206
IRVING, TX 75015 Permit Fee 06/23/2009 $113.90
Plan Review 06/23/2009 $28.48
PHONE. 12% State Surcharge - Mechanical 06/23/2009 $13.67
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222
PHONE: 503 - 462 -4822
FAX: 503 - 462 -6555
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $156.05
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 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: a ,/v c_ )j) Permittee Signature: A / / ,,
Call 503.639.4175 by 7:00 a.m. for an inspection that business .. .
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
Received
111 II City of Tigard Date/By: ��, Permit No.: 1 4 .46 /1
q 13125 SW Hall Blvd., Tigard, OR 97223 `
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: . :i Other Permit
T I G A R D Inspection Line: 503.639.4175 Date Rea.': t: IM S See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
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: $ 5e6c9
RESIDENTIAL-EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description p Qty. I Ea. 1 Total
' JOB SITE INFORMATION AND LOCATION . Heating/cooling \
Job site address: (� D'' �% Air conditioning or heat pump
(/ o . 5b1) e,,,e_ i '1 (requires site plan showing placement) 14.00
Cit /State /ZIP: 77G9/L!J c� ,,
Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name: j Furnace 100,000+ BTU ( ducts/vents) 17.90
v �"f d 4,17. Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
c1` /,U , lit?- ( 7) S/,( /e 7 Si / 7Z» e4/ /err; Residential boiler (radiator or
hydronic) 14.00
__
,�E�T't/T i✓ r,Yl/ 77/C-7 t -" . Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: 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
.O&VC „) GT - A rg - 1/411 AUX 7 We. 6e444 /GZ7 Flue vent for water heater or gas
fireplace 10.00
cam'/ Sii'w - A - //r.24 , . Log lighter (gas) 10.00
• Wood/pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER ❑TENANT Chimney/Iiner /flue /vent 10.00
Other: 10.00
Name: l/ /21JtA- l4 n0.iter Environmental exhaust and ventilation
Address: Range hood/other kitchen
.....1m) .B 4/,t4» 4 . equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
El_ APPLICANT ' ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: f/
/NL • Fuel piping
Contact name: Alele. 7/,, /y . $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
/�� SE �/ /l , C Gas heat pump
City/State /ZIP: , xip Q , 972.9 2 Wall /suspended/unit heater
Phone: (6 ) F ( ) Water heater
°� l �� 6S-7s-3— Fireplace
E -mail: 14d44 e_ fl/ /Gleiwcor�, CO•” Range
f CONTRACTOR Barbecue
Business name:
Clothes dryer (gas)
..'7C A 413D 7/t---"- Other:
Address: MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 9 7 State surcharge (12% of permit fee)
o6--0 + � TOTAL PERMIT FEE j CS
Authorized signature: /J
y This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
\� Fee methodology set by Tri -Count Building Industry Service Board
Print name: A4.-6,41/ �� Date � /7_C/9 �' y y g �'
I'\ Building \Permits\btEC- PermitApp doe 01/19/07 440-46I7T ( I /02/COM/WEB) SS . 3O