Permit CITY OF TIGARD MECHANICAL PERMIT
13 , COMMUNITY DEVELOPMENT Permit #: MEC2012 -00348
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/05/2012
Parcel: 1S126DC04601
Jurisdiction: Tigard
Site address: 9970 SW GREENBURG RD
Project: Eprint Subdivision:.AGE AT FOREST GLEN CONDO PHA, Lot: 6
Project Description: Replace existing 5 -ton RTU
Contractor: ANCTIL HEATING & COOLING Owner: O'DAY, SUSIE & BRIAN LIV TRUST
4320 N WILLIAMS AVE BY O'DAY, FRANCIS B /SUSAN A TRS
PORTLAND, OR 97217 9970 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503 - 281 -0752 PHONE:
FAX: 503 - 282 -5722
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/05/2012 $207.21
Class of Work: ALT Type of Const: Plan Review 07/05/2012 $51.80
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 07/05/2012 $24.87
Stories: Info Process /Archiving - Sm $0.50 (up to 07/05/2012 $5.00
Project Valuation: $4,950.00 11x17)
Fuel Air Handlers
Fuel Types: 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 $288.88
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 - - - • _ nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or d' -ct questions to O C • c- lin• 503.232.1987 or 1.800.332.2344.
Iss ed By: , • /. z � ``�•� / Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection te.
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 OFFICE USE ONLY
Received
City of Tigard �� '' Date/By: 4 Permit No. L t 2 - 00334,
Phone: 503.718.2439 Fax: 503.598.1960
III
13125 SW Blvd., Tigard, OR 97223 S Hall B d , g 9 3 JUL Plan Review ► Other Permit:
0 2012 DateBy • !4 E�
TI G A R D Inspection Line: 503.639.4175 Date Ready /By: Juris• El See Page 2 for
Internet: www.tigard - or.gov CITVOFTIGARD Notified/Method: Supplemental Information
TYPE OF W B RK I�NG DIVISION 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.
Value: $ 4,950
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 9970 SW Greenburg Rd (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: E -Print 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: 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
Push / Pull like for like 5 ton roof top unit. Using existing curb. Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
El PROPERTY OWNER ® TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: E -Print Environmental exhaust and ventilation:
Address: 9970 SW Greenburg Rd Range hood/other kitchen
equipment 33.39
City /State /ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
(503)684-2679 Fax: Single -duct exhaust (bathrooms,
Phone:
( ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Anctil Heating and Cooling Other: 23.32
Fuel piping:
Contact name: Brian P Murphy $14.15 for first four; $4.03 for each additional
Address: 4320 N Williams Ave Furnace, etc.
Gas heat pump
City /State /ZIP: Portland, OR 97217 Wall /suspended/unit heater
Phone: (503) 281 -0752 Fax: : (503) 282 -5722 Water heater
Fireplace
E -mail: brian@anctilhvac.com Range
CONTRACTOR Barbecue
Business name: Same as Above
Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 8897 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
r �� Thi perm expires if a
Authorized signature: �' days application after it has been accepted permit is as complete. not obtained within ISO
Print name: Brian P rph Date: 7 - - 2012 • Fee methodology set by Tri- County Building Industry Service Board
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