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Permit CITY OF TIGARD MECHANICAL PERMIT 0 • COMMUNITY DEVELOPMENT Permit #: MEC2009 -00324 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/10/2009 Parcel: 1 S136AD04301 Jurisdiction: Tigard Site address: 11475 SW PACIFIC HWY Subdivision: • Lot: 0 Project: Project Description: Replace rooftop (2) rooftop units like for like. Owner: FEES SEE YOU LATER PROPERTIES LLC Description Date Amount 11475 SW PACIFIC HWY TIGARD, OR 97223 Permit Fee 07/10/2009 $353.00 Plan Review 07/10/2009 $88.25 PHONE: 12% State Surcharge - Mechanical 07/10/2009 $42.36 Contractor: ROSE CITY REFRIGERATION HTG & AIR PO BOX 19207 PORTLAND, OR 97280 PHONE: 503 - 636 -5371 FAX: 503- 655 -4669 - Type of Use: COM Class of Work: ALT Type of Const: VB Occupancy Grp: A -2 Occupancy Load: Stories: Fuel Air Handlers Fuel Types: Natural Gas 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 $483.61 Hoods: Comm Incinerators: Required Items and Reports (Conditions) Woodstoves: Gas Fireplaces: 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 issu e, or if wor c uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon U ' qty Notification Center. T . - rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules r direct questions to OU by c= Ilin.: 03.246.6699 or 1.800.332.2344. sued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m. for an Inspection that business day. 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 Applicatio ( , \,.,., _ FOR OFFICIO: US[. ONLY ig:9 Received City of Tigard , Date/By ') EZEMP 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review r �1. Phone: 503.639.4171 Fax: 503.598.1960 DatrlBy: � f � 71 `w Other Permit: ® Inspection Line: 503.639.4175 JUL 0 2 2009 Date Ready/By: Elm ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information CITY OF TIGARD TYPE OF W -DING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST • Mechanical permit fees* are based on the value of the work ❑ New construction J Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit Value: $ //. 9,55 DO ' CATEGORY OF CONSTRUCTION / RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling f Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: U Air conditioning or heat pump ��7 7 . ` / Pot G / c ,4 (requires site plan showing placement) 14.00 City /State /ZIP: / /7 a r D't tO o< 9 7 � 3 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 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 p / Gas fireplace 10.00 iC -epti e .P "Pp 7 Ar Un i lc Flue vent for water heater or gas fireplace 10.00 I) 7, 5 5 /--e/ /--e/ /A c 2 co 7,5 7‘.vi) Log lighter (gas) . 10.00 2) /0 f n / /4.c c Ai/ - -( 7. S ft2n Wood/pellet stove 10.00 Wood fireplace /insert 10.00 1ff PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 10.00 Other: 10.00 Name: T e -C- r +h..V" Environmental exhaust and ventilation I Range hood/other kitchen Address: //e../ 7 S s Li) pa_c r -p. C 1`I•.t, equipment • 10.00 City/State /ZIP: 7,1 4 - ck 0 ' 7 2 2 ? Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (yo 3) 'V'19 - b 99 Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 / l / Other: 10.00 Business name: ,05 ,'4e f /iif7 e- Art F uel piping. Contact name: r j � zsO $5.40 for first four; $1.00 for each additional Furnace, etc. Address: /2.0 4 y /f2o 7 Gas heat pump , City/State /ZIP: 0 4; 7 ,," t ) e 97210 Wall /suspended/unit heater Phone: (SO 3) 65--c-_ y6 /_ 5 , Fax: : (� 6SS' 3) - 4/ Water heater 4, y Fireplace E -mail: W Range CONTRACTOR Barbecue Business name: "eose G 54 /7/46,717,,, Other: Q ,jam Clothes dryer (gas) O Address: /L:).0 /3 � 9 ?o 7 MECHANICAL PERMIT FEES* City/State /ZIP: F e--(-t c ____ 4 (, 0 . c72aFO Subtotal Minimum permit fee ($72.50) Phone: (3) 63 (.. 53 7 / Fax: (503) c 1 f6 � Plan review (25% of permit fee) CCB lic.: 61 3 .2. 5 State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within ISO / days after it has been accepted as complete. I Print name: �` � /,/ ) roll I Date: 7/ z /O 9' • Fee methodology set by Tri -County Building Industry Service Board I:\ Building \PermitsVMEC- PermitApp.doc 01/19/07 440-4617T(II /02/COM/WEB) - Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. • I:\Building\Permits MEC- PennitApp.doc 01/19/07 2