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Permit CITY OF TIGARD MECHANICAL PERMIT II COMMUNITY DEVELOPMENT Permit #: MEC2011 -00486 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/10/2011 .TIGARD Parcel: 2S113AB00600 Jurisdiction: Tigard Site address: 16125 SW 72ND AVE Project: St. Judes Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30 Project Description: Installation of new RTU and ductwork. Contractor: DELUXE FUEL OIL INC Owner: PACIFIC REALTY ASSOCIATES LP 1013 NE 62ND ATTN: N PIVEN PORTLAND, OR 97213 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 287 -6688 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 11/10/2011 $601.71 Class of Work: ALT Type of Const: Plan Review 11/10/2011 $150.43 Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 11/10/2011 $72.21 Stories: Info Process /Archiving - Lg Sheet (over 11/10/2011 $4.00 11x17) Project Valuation: $20,000.00 Info Process /Archiving - Sm Sheet (up to 11/10/2011 $2.00 11x17) 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 $830.35 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 fo •w the rul= - adopted by the Oregon Utility Notif . • . - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. ou m. • .tain a copy of the rules or direct estions to O \ C by c . ng 93.232.1987 or 1.800.332.2344. Issued y: ( i / Perm ittee Signature: ) Call 503.639.4175 by 7:00 a.m. for the next available inspectio . a This permit card shall be kept in a conspicuous place on the job site unti omp -tion of the project. Approved plans are required on the job site at the time of • : ch i pection. Mechanical Permit Applicat' 1 I �. FOR OFFICE USE ONLY II City of Tigard kt Date/By 17�OM PermitNo.: weia.,2 /• 4/8, . q 13125 SW Hall Blvd., Tigard, OR 97223 i Phone: 503.718.2439 Fax: 503.598.1960 Date/By: PlanReview � , � I l r� Other Fermat TI G A R D Inspection Line: 503.639 NOV o 20 Date Read •: Ja ris El See Page 2 for Internet: www.ti ardor. ov Notified/Metho � k / g g Supplemental Information _ CITY OF TIGARD c . , f+Gf2 �n!�! • TYPE OE ORItiJiN Ui'�"" °'It . ® % / ■ R - L' _:.--.7 E* S = 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 rofit. CATEGORY OF CONSTRUCTION - . ". Value: $ ,7nop�, RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I. Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: / 2 7 �/ Air conditioning Job site address: J , � ` 4 7 )f 2 (requires site plan showing placement) 46.75 City/State/ZIP: ! Furnace 100,000 BTU (ducts/vents) 46.75 l/ id �` ^ Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: I Project name: J 1'q • � Heat pump (requires site plan showing placement) 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 Subdivision: I Lot no.: Flue/vent for any of above 23.32 Other: 23.32 _ Tax map /parcel no.: Other fuel appliances: ' - DESCRIPTION OF WORK` Water heater 23.32 l f JJ II __�^ Gas fireplace 33.39 /2l // /7�C © 17 J /.ids Flue vent for water heater or gas 901 i !!!/// fireplace 23.32 Y ' / rj �/ Log lighter (gas) 23.32 Wood/pellet stove _ 33.39 Wood fireplace/insert 23.32 ❑ PROPERTY OWNER - - , TENANT` - Chimney/liner /flue /vent _ 23.32 f i , J Other: 23.32 Name: ) / Environmental exhaust and ventilation: Address: / _ n Range hood/other kitchen equipment 33.39 City/State /ZIP: /r. Y Clothes dryer exhaust _ 33.39 Phone: ( ) Fax: Single -duct exhaust (bathrooms, ( ) toilet compartments, utility rooms) 23.32 . '1.8,, APPLICANT . ' ' ' ❑ CONTACT 'PERSON - Attic /crawlspace fans 23.32 Business name: i Other: 23.32 A / . / f A / i t Fuel piping: Contact name: " pia it, [ $14.15 for first four, $4.03 for each additional AL Address: 1�/ � Furnace, etc. - /9 Gas heat pump City /State /ZTP: , / �` 1` • Wall/suspended/unit heater Phone - - , i Fax:: (p ) , , I Water heater i Fireplace E -mail: Range CONT'CTj©R Barbecue Business name: ala r e)/, if-b/./ /mo f � Clothes dryer (gas) Other: Address: �� ?/ a J / I MECHANICAL'PERMIT "FEES* City/State /ZIP: - k' ( • Subtotal Minimum permit fee ($90.00) Phone: Fax: ( r �� �y _ � Plan review (25% of permit fee) CCB lie.: y / State surcharge (12% of permit fee) TOTAL PERMIT FEE A-44 This permit application expires if a permit is not obtained within 180 Authorized signature: / U / -�� // days after it has been accepted as complete. " - - - - -- I r._._. * Fee methndolnov set by Tri- County Rnildino Industry Service Rnard