Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00017
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2012
Parcel: 1 S134DD00100
Jurisdiction: Tigard
Site address: 10587 SW TIGARD ST 77
Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: Install (4) ductless heat pumps in units 77, 78, 79 & 80 .
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
11x17)
Project Valuation: $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:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Ouct 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 OU by calling 503.232.1987 or 1.800.332.2344.
Issued By: � Permittee Si nature: y ' � 1 74 ' 9 d/lf /51-7°/2 L / i7 770/N/
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.
Mechanical Permit Applicatioi ECEIVED e/
FOR OFFICE USE ONLY �^ /
III City of Tigard , Date/By: �� PermitNo.: 1.-4 Age d Ott/ /7
13125 h 1 n e SW Hall Blvd., Fax: 503.598.1960 97223 1 3 201 Plan Review, ® ,
Phone: 503.718.2439 Fax: 503.598.1960 JA Plan : * Re � Other Permit:
- T I G A -R D Inspection Line: 503.639.4175 TIGARD Date Ready/By: funs ® See Page 2 for
Internet: www.tigard- or.gov CITY OF DI VISION Notified/Method: ./ f 4 Qd Supplemental Information
BUILDING +� pp
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction p Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ / 0 9-g),. a ds
CATEGORY OF CONSTRUCTION RESIDENTIAL.EQUIPMENT / S FEES*
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
Ef Multi- famil ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 05 S iv Ti4 11.. 0 5 I tAN,Ts 7 7 7g 7Q (requires site plan showing placement) 46.75
/ ! t Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: /I 604-1) 0 77 to 3 gd
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg./apt. no.: Project name: n f ( Heat pump
w /ND MILL ifaiMeNr (requires site plan showing placement) I + 61.06
Cross street/directions to job site: v 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:
DESCRIPTION OF WORK Water heater 23.32
} Gas fireplace 33.39
.. its I( S/ru 1.t Zc,a.f I/ ✓C r�jn S S f .2 Flue vent for water heater or gas
e? Acil e ( A q tin f'5 CI 415 fireplace 23.32
del L / Log lighter (gas) 23.32
QG1/'(f S . a/f-Y�'t' (.�+'I t 9 tfdeG�` T) Sb-vG/V✓' Wood/pellet stove 33.39
/
t,5,' /V v C�i�' ctll�✓'G�d�1 �,a'>tLu Wood fireplace /insert 23.32
NI PR OWNER jv! ❑ TENANT
Chimney/liner/flue/vent 23.32
� D Other: 23.32
Name: \/tM 4 51 g)L►+A S Environmental exhaust and ventilation:
Address: j 0 3, 9 5 ij -7 S
Range hood /other kitchen
33.39
City /State /ZIP: 7/e1A49 02 0 � JA 3 Clothes dryer exhaust 33.39
/ Single -duct exhaust (bathrooms,
Phone: ( 5 A31. >- 7 q56 Fax: ( ) toilet compartments, utility rooms) 23.32
g- APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
of �/� � L /� Other: 23.32
Business name: I,I-d e 1 65 „ >GG. Lis )DR' / n IfeA' 6'41l/ Fuel piping
Contact name: J 000, 7/ - A) SCIlleC 0 $14.15 for first four; $4.03 for each additional
Address: 7(6 CI O. 1441k• S Furnace, etc.
_ 2 5 Gas heat pump
City /State /ZIP: I--n.) p �N 't r i j t� �� . ) 7 t Wall /suspended/unit heater
Phone: ( 5 0 ) (, ®G ... 9 t;�S Fax: : ( $37 - cc 7 Water heater
l Fireplace
E -mail:
til d�\ gNtna vv e '(tt& (A O' \ r) M �i 51-/€ /e • CO , Range
CONTRACTOR r 1 Barbecue
Business name: Clothes dryer (gas)
l r+. l �c w � pl. S
Other:
Address: n 5 . N, MA-1N S-r MECHANICAL PERMIT FEES*
City /State /ZIP: (_ n or q ` i �j 0 q ' Subtotal
�/V �j' � O " 7 Minimum permit fee ($90.00)
Phone: ( Sp
'3 666- e Fax: ( 5, ) cg 3 657d_ Plan review (25% of permit fee)
CCB lie.: ir1 f) .a a- State surcharge (12% of permit fee)
TOTAL PERMIT FEE 75 7 fo
Authorized signature: i ��� T his permit application expires if a permit is not obtained within 180
(' days after it has been accepted as complete.
Print name: 1 ONA 11t`AA/ Ma k A- p t_'(,1, 0 Date I / 15 / a 0 / * Fe me th odology set by Tri- County Building Industry Service Board
1:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -4617T (11/02 /COM/WEB)
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.
1: Building \Permits\MEC- PermitApp.doc 09/09/10 2