Permit CITY OF TIGARD MECHANICAL PERMIT
II: COMMUNITY DEVELOPMENT Permit #: MEC2012 -00374
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/19/2012
Parcel: 2S110DD00109
Jurisdiction: Tigard
Site address: 11005 SW SUMMERFIELD DR 8
Project: Brookside Condominiums Subdivision: WILLOW- BROOK -FARM Lot: 15
Project Description: Installation of in -wall a /c.
Contractor: Owner: SUMMERFIELD ASSOCIATES, LLC
BY HSC REAL ESTATE
1500 SW FIRST AVE STE 1020
PORTLAND, OR 97201
PHONE: PHONE: 503 - 684 -1891
FAX:
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee 07/19/2012 $93.62
Class of Work: ALT Type of Const: Vg 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 8 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 questi OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: —
Call 503.639.4175 by 7:00 a.m. for the next available inspe ate.
This permit card shall be kept in a conspicuous place on the job site until c pletion of the project.
Approved plans are required on the job site at the time of each nspection.
* Mechanical Permit Application FOR ()1:1-1( : 1 SF O'\ ► . \
City of Tigard Date/By: -, /7 1 2 y PermitNo.: t f
ii • 13125 SW Hall Blvd., Tigard, OR 972 Plan Revi ` 1 •, , a Permit:
Phone: 503.718.2439 Fax: 5 Dat`/By: r p / iki ( `
Inspection Line: 503.639.4175 Dace Ready y : y; / q /� furls: 10 see Page 2 for
Internet: www.tigard-or.gov
I i c :� is u 7
Doti thu Supplemental Information
JUL 17 2012 .�„_�,
TYPE t e�`�' ��bIIyEROffp1, FEE +�SCBBDULE - USE 1'.
A . � Mechanical permit fees are based on the value of the work
El New construction [� Add ` ,. ��..s.. ,+ :., pit , performed. Indicate the value (rounded to the nearest dollar) of all
a Is mechanical materials, equipment, labor, overhead, and profit
❑ Demolition ❑ Other: Value: $ /a 8S "
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory build For spedal information use checklist
[/]Multi family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address /Mac cA/ 5'v/rlmtv6; /i/ Die, (/iv r 746 00 BTU placement) 46.75 „ents) 46.75
Furnace City/StatelZlP: T� O F9oir Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgJapt. no.: I Project name: Heat pump
(requires site plan showing placement)
Cross street/directions to job site: Dud work 23.32
Hydronic hot water system 23.32
Mu, 'U. Dv r A Oar, / Sv/r/mlt T! P// Pe Residential boiler (radiator or
L ontof /0, # 1 C 7 h dronic
�i/ 6�/ Unit heaters (fuel -type, not electric),
in -wall, in -dud 23.32 , suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances: -
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert 33.39
OPEN (dam// Frame 4., _.,vei4 A2Le 5/ewe J/lfh1I /- Flue vent for water heater or gas
_� `/ L 23.32
Ah'Qni . 4' .' .20 ,A/ '# Pa- Pe let Oa /e f Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23
❑ PROPERTY OWNER / I ❑ TENANT Other: 23.32
Name: SUm ffe / /J Q Sl0(ri»br Lte Environmental exhaust and ventilation:
Range hood/other kitchen
Address:
///75 .51.1, //7 6efow.4.00, Pr /'-f equipment 33.39
City/State/ZIP: -a1. (9,-e , g 7.224' Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (5o3) - /19/ Fax: (03) 66 Y9is toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
p / Other. - 23.32 ,
Business name: ,3• &oh. C a 4 xicve rtia %t, IL 0 Fuel piping:
Contact name: J, _ S14.15 for first four, $4.03 for each additional
Jn� )340 Furnace. etc.
Address: A 3S / J/� rs ?� Gas heat pump
City/State/ZIP: RN , pre 9 72/3 Wall/suspended/unit heater
Phone: (503) 360 - 7035 Fax: : (503 ) .2 n- 9,023 Water heater
Fireplace
E -mail: 7 gossA 11,ic i,./iu41 Cr) //7s-A/ • /tape/ Range
CONTRACTOR Barbecue
Business name: �j /� Clothes dryer (ias)
54 f As I �" 0 � ��tr //(1DN Other
Address: -
MECHANICAL PERbfT FEFS*
City/State/ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: /9982 R State surcharge (12% of permit fee)
/ / TOTAL PERMIT FEE 42/
This permit application expires if a permit is not obtained within 180
Authorized signature: ` v� days after it has been accepted as complete.
J
Print name: p Ai/ / /I // B. / I Date: 7-/3 -/ 2 • Fee methodology set by Tri-County Building Industry Service Board
1 :'OuildingWamits\MEC-Pemi' •p.doe 07/07/12 440- 4617T(II102/COM/WEB)