Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit A: MEC2012 00372
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/19/2012
Parcel: 2S 110DC01000
Jurisdiction: Tigard
Site address: 11165 SW MEADOWBROOK DR 8
Project: Brookside Condominiums Subdivision: WILLOW- BROOK -FARM Lot: 17
Project Description: Installation of in -wall a /c.
Contractor: J BEALS CONSTRUCTION LLC Owner: SUMMERFIELD ASSOCIATES, LLC
1635 NE 53RD AVE BY HSC REAL ESTATE
PORTLAND, OR 97213 1500 SW FIRST AVE STE 1020
PORTLAND, OR 97201
PHONE: 503 - 206 -7035 PHONE: 503 - 684 -1891
FAX: 503 - 288 -9023
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 07/19/2012 $93.62
Class of Work: ALT Type of Const: VB Plan Review 07/19/2012 $23.41
Occupancy Grp: R -2 Occupancy Load: 12% State Surcharge - Mechanical 07/19/2012 $11.23
Stories: Info Process /Archiving - Sm $0.50 (up to 07/19/2012 $1.00
11x17)
Project Valuation: $1,285.00
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $129.26
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 que ' UNC b ailing 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: //
v
Call 503.639.4175 by 7:00 a.m. for the next available inspectio te.
This permit card shall be kept In a conspicuous place on the job site until co Ietion of the project.
Approved plans are required on the job site at the time of each Inspection.
Mechanical Permit Application rc) l: o it i c l : l S I 0\ \ l .,
City of Tigard r ; ` : °' Permit No.: H - ,, , , .. 0 7
IIII
al 13125 SW Hall Blvd., Tigard, OR \ EivE P�R ' ��
Phone: 503.718.2439 Fax: 503.598.19 L
BY: �' � (Z other Permit:
I I u \ 1 . 1 � Inspection Line: 503.639.4175 JUL 1 D R y /B y: ® See Page 2 for
Internet: www.tigard- or.gov V 7 2O�2 Notified/Method 7//;//.3. /' Supplemental Information
e
1 VII a u . _ _ _1!1!.'s , ��='
TYP BN I K Er 5
• a • 1 y 1 p o • M1lERCIAL PEE* SCHEDULE r USE CHECKLIST-
- �D 'VISION chanical permit fees* are based onthe 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: $ /2 8 5• °'
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For specialinform:1ton ereteckliss
Er Multi-family ❑ Master builder ❑ Other: Description I Qty. I En. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
1 Air conditioning
Job site address 1 / 1 6 5 S A / � � n 4 7 i � / ( A l / i t 0 4 4 4 g ;. site , lan .. .' : .lacement 46.75
Furnace 100 000 BTU ducts/vents 46.75
City/State/ZIP:
�, /i/ Or ' 7.22" Furnace 100 000+ BTU ducts/vents 54.91
Suite/bldgJapt. no.: Q Project name: Heat pump 61.06
(requires sit plan showing placement)
Cross street/directions to job site: Duct work 23.32
/ ' p� /,� Y
a Hydronic hot water system 23.32
P 9 I A. rho., / Si ell 01,0 /A, �/ Residential boiler (radiator or
! n . _ , h dronic 23.32
/ 4h
- �' Pw// Anil a Unit heaters (fuel -type, not electric),
-kg&. 1 AS S 67) L ' in -wall in-du •-a ti' etc. 23.32
9� Flue/vent for any of above _
Su y 'vision: I Lot no.: 23.32
Other
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas .lace/insert 33.39
d PE?/ 64,11 i/ frs,ne 4,- Afei4, ,a /0 Sfewww /NfQ //- Flue vent for water heater or gas 23.32
AAA . /14eLti .2O 4# ae Pe I€ Oah f L g lace . 23.32
Lo>; lighter (gas)
Wood/. Ilet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER 1 ❑ TENANT Chimney/liner /flue/vent 23.32
�/� Other. 3.32
Name: SUI9 et /Y�,/ d sror s LLC' Environmental exhaust and ventilation:
/ L Range hood/other kitchen
Address:
// 7 5 S6t/ /rleo�,COlto !! /O,C� Pr/ Se-0 equipment 33.39
City/State/ZIP: Ti .11 _ ,e,.. 9 7224 Clothes dryer exhaust 33.39
3 6 /1 . Fa x: 6 84_ /9fs Single-duct exhaust (bathrooms, r
Phone:
(SO ) (50 3) toilet corn • �� • ents utili rooms 23.32
[APPLICANT ❑ CONTACT PERSON Attic%rawispace fans 23.32
n / Other: 23.32
g
Business name: .7 etvis ( / v0 �iv0ri.%v la0 Fuel
Contact name: 0 f 5 e / 514.15 for first four $4.03 for each additional
Address: j'3 S 4/4.7- 4 -3 Furnace etc.
Gas heat . um • City/State/LP: )))J/ , D/e 9 22/7 Wall/sus. • unit heater
Phone: (>5o3) A60 - 703 5 Fax:: (5503 ) .2 $ - 5;9.23 Water heater
F' •lace
E -mail: 7 BLS idl✓cku i/,u.✓ C 475x/ . / . : e
CONTRACTOR Barbecue
Business name: //� / Clothes . er :
��� ,� AV, �/I�I/(tDA/ der:
Address: MECHANICAL PERMIT FEES
City/State/ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) -I Fax: ( ) Plan review (25% of permit fee)
CCB lie.: /9 1.49 2 8 State surcharge (12% of permit fee)
TOTAL PERMIT FEE / ? °,
Q
This permit application expires if a permit is not obtain within 1g0
Authorized signature: days after it has been accepted as complete.
I Print name: I It • Fee methodology set by Tri-County Building industry Service Board
1: 1BufldingTaminMEC- PermitApp.doc 03 /07/12 440 -4617T (11 /02ICOMIWEB)