Permit •i
•
,! CITY OF TIGARD MECHANICAL PERMIT
ii
"` COMMUNITY DEVELOPMENT Permit #: MEC2012 -00033
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2012
Parcel: 1 S134DD00100
Jurisdiction: Tigard
Site address: 10621 SW TIGARD ST 17
Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: Install (4) ductless heat pumps in units 17, 18, 19 & 20.
Contractor: THE HEAT PUMP STORE Owner: RICHARDS, JAMES E & SHARON S
985 N MAIN ST BY NORRIS & STEVENS
INDEPENDENCE, OR 97351 621 SW MORRISON ST #800
PORTLAND, OR 97205
PHONE: 503 - 606 -9165 PHONE: 503 - 624 -9856
FAX: 503 - 837 -0572 .
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 01/20/2012 $360.41
Class of Work: ALT Type of Const: VB Plan Review 01/20/2012 $90.10
Occupancy Grp: R-2 Occupancy Load: 12% State Surcharge - Mechanical 01/20/2012 $43.25
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 01/20/2012 $4.50
Project Valuation: Misc Pro
1 $10,452.00 Misc Administration Fee 01/20/2012 $4.50
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 4
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: 4
Appliances
Vent Fans: Vent Systems: Total $502.76
Hoods: Comm Incinerators: -
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: r 954-1(17—iL— Permittee Signature: _ �' ��,4G. Cey,-/
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Application* 1 C 7IV D FOR OFFICE, USE ONLY . -
' .....-.4 �Y " Received
Cites, of Tigard Pe rm it No.: ti ,C�_erD 53
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: J '/$ / la - i� i
Plan Rev1e
a lb Phone: 503.718.2439 Fax: 503.598.1960 ) A N 1 3 201 Date/By: l�r�la
Ins ection Line: 503.639.4175 y
T f c_ A R U" p Date Ready T : 7w i: ® See Page 2 for
/
s ,'::`��` `� Internet: www.tigard- or.gov CITY OF TIGARD Not /%1- (� / /a- Supplemental Information
BUILDING DIVISION I
TYPE= OF W OR K = COMMERCIAL ", F EE* SCHEDULE USE CHECKLIST Fr
Mechanical permit fees* are based on the value of the work
❑ New construction II Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY O F,i CONSTRUCTION • • ' - = r - �, EMS S * ' ' " '
Value $ ( //
. - - -- . RESIDEN' S YS ' I NE
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
[Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
,. ; JOEL SITE INFORMATION, AND . LOCATION
° eaten coo mg:
? --� _ _ � - ...: Air conditioning
Job site address: / 0 6 a ( 5 i (awkii.0 5 j �1�t C� f 7 1f( et o�C� (requires site plan s placement) 46.75
j
1 ► Furnace 100,000 BTU (ducts /vents) 46.75
j
City /State /ZIP: l t 6AI -17 0 R■ 77 ga 3 (
F urnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: W I N D t l (.L APR/file/Vic Heat pump r
(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: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESC RIPT ION ' OF 'WORK. Water heater 23.32
}� 1 Gas fireplace 33.39
:2 / 1( S/l'tt) jai `Zoi,x /,ic 11,1 S 5 ,kJ` if ,,t t p Flue vent for water heater or gas
- e c■c� e r 9 L. fl ,1-5 t �G t S fireplace 23.32
` / L / � / Log lighter (gas) 23.32
QG I r?5,' . O/f4'✓ imi r g tr�(islfir 't sh'vG/V✓ -e Wood/pelletstove 33.39
/ / fireplace /insert 23.32
t.5i /V v r C/i'�l ��P/'t 6�kL� Wood
.- PR ERTY OWNER ❑ -TE '
Chimney /liner /flue /vent 23.32
Other: 23.32
Name: (i M d x Si rcA) Z-10 9 5' Environmental exhaust and ventilation:
Address: v t-� Range hood /other kitchen
I (� l s (�btA2p 5 l equipment 33.39
City /State /ZIP: ' ,0,29 o2 ? 1 ja 9 Clothes dryer exhaust 33.39
u Single -duct exhaust (bathrooms,
Phone: (y 3) Aa'T r- 7'56 Fax: ( ) toilet compartments, utility rooms) 23.32
. APPLICANT, - ' .. . • ; ❑ : CONTA(Ti, PERSON , Attic /crawlspace fans 23.32
Business name: L S� AJ(I 5 An - l l L //� Other: 23.32
' o% /Y . 0 ile1?C� / l7E/i7 U Fuel piping:
Contact name:
J G 6 ' 7(- 14-i') 0 .5cil1C %Lt. 0 $14.15 for first four; $4.03 for each additional
Q Furnace, etc.
Address: I 5 it)* Mil k " 5 Z Gas heat pump
Cit /State /ZIP: 1 -+\J17 .-- P ( , N 5 $j(C 0 t� �� . , f t Wall /suspended/unit heater
Phone: ( 5.0) 6 G .- q(LS Fax: : (5.C2)) 631.- o£ .7 Water heater
L � Fireplace
E - mail' •JaA�y vim ctv` @ \ >pJ .50y' I e -co Range
CONTRACTOR- Barbecue
j Clothes dryer (gas)
Business name:
( i i-63 7 A Other:
Address: ? Al MA i 5.7 ., - MECHANICAL. PERMIT FEES *... -
City /State /ZIP: p -p Dr NL L., 0 G IJ z Subtotal
V ` I �7f Minimum permit fee ($90.00)
Phone: ( to3 604 y Fax: ( 7 3) fa 37- 65 7 Plan review (25% of permit fee)
CCB lie.: or] ,- State surcharge (12% of permit fee)
TOTAL PERMIT FEE 60A
Authorized signature: i ' �� This permit application expires if a permit is not obtained within 180
g days after it has been accepted as complete.
Print name: 1 c,vfr e f4 / 1/10 SLAT e't t, 0 Date: i/ I 3 /200- * Fee methodology set by Tri- County Building Industry Service Board
1:\Building\Permits\MEC- PermitApp.doc 09/09/10 440 -4617T (I1 /02 /COM /WEB)