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Permit CITY OF TIGARD MECHANICAL PERMIT ; '1 COMMUNITY DEVELOPMENT / Permit #: MEC2012 00482 • TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 647 Date Issued: 09/20/2012 Parcel: 1S135CA02600 4 Jurisdiction: Tigard Site address: 11130 SW GREENBURG RD Project: Good Neighbor Center Subdivision::HERS ADDITION TO GREENBURG HE Lot: 3 Project Description: Replace existing rooftop unit with like kind using existing curb. 10/17/12, reprinted to correct description of work. Contractor: COLUMBIA HEATING & COOLING INC Owner: EAST WASHINGTON COUNTY SHELTER PO BOX 230397 PARTNERSHIP COUNCIL TIGARD, OR 97281 DBA GOOD NEIGHBOR CENTER 11130 SW GREENBURG RD TIGARD, OR 97223 PHONE: 503 - 624 -2704 PHONE: FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 09/20/2012 $398.51 Class of Work: ALT Type of Const: Plan Review 09/20/2012 $99.63 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 09/20/2012 $47.82 Stories: Project Valuation: $12,000.00 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: Heat Pump: Appliances Vent Fans: Vent Systems: Total $545.96 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 No ' enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dir questions to OUNC b -- .ng 503.232.1987 or 1.800.332.2344. • Iss ed By: el 1 / Permittee S e nature: ) , 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. CITY OF TIGARD MECHANICAL PERMIT 111111 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00482 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/20/2012 Parcel: 1 S 135CA02600 Jurisdiction: Tigard Site address: 11130 SW GREENBURG RD Project: Good Neighbor Center Subdivision:-HERS ADDITION TO GREENBURG HE Lot: 3 Project Description: Tear -off and replace existing roof, some flat and some pitched. Contractor: COLUMBIA HEATING & COOLING INC Owner: EAST WASHINGTON COUNTY SHELTER PO BOX 230397 PARTNERSHIP COUNCIL TIGARD, OR 97281 DBA GOOD NEIGHBOR CENTER 11130 SW GREENBURG RD TIGARD, OR 97223 PHONE: 503 - 624 -2704 PHONE: FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 09/20/2012 $398.51 Class of Work: ALT Type of Const: Plan Review 09/20/2012 $99.63 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 09/20/2012 $47.82 Stories: Project Valuation: $12,000.00 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: Heat Pump: Appliances Vent Fans: Vent Systems: Total $545.96 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 Ica ion ter. 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 0 C b calling 503.232.1987 or 1.800.332.2344. Issued By: k 4,% 4 2 Permittee Signature: . ii ii ioraRTib b / Call 503.639.4175 by 7:00 a.m. for the next available insp tion 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 Application City of Tigard Received or e g o /4:91 No.: ie,4504a-tfe 4 6". i . • 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Permit • Plan Review : II Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: • Date/By : Inspection Line: 503.639.4175 • I I G A It I) Date Ready/By: Juris: Si See Page 2 for Internet: www.tigard-or.gov • Notified/Method: Supplemental Information - ' - - - - ' -. -:!-. " -":-• -. . Y l".'"". .- ''''"7, s v& ,i- ,,N -;-,0 .::t ,.: a ' .,-•. Mechanical permit fees' are based on the value of the work i 0 New construction 0 Es.Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of Demolition 0 Other: and. mechanical materials, equipment, labor, overhead, all ' :::4' ... ' ..' :-'''''.-: ' ..- '' ''' .. " 'n ," ;- :•‘ii. ' ' .7 2 , - IA7 i' .. •4 0. ,... AM. 7s - ::., !- .; -- -„!.„,,!...4cREs) , .'- FFES* ..:.:.: 0 I- and 2-family dwelling d er - ornmercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total . - ' : • -,':'.-,: .' :i " -.': !''.- :',: iotikitiMiy: -•''' - , 1:;, 'tli Heating/cooling: . ,.- - -... , ..i.;.. • ■....- ,. ' '. - . '1' k ' w:1, Air conditioning ,---,---- Job site address: 1 t '' ;(17 c1"? \Al - (Wr-,- y 4 ‘1 ,--,, : ., (requires site plan showing placement) 46.75 Furnace 100,000 BTU (ducts/vents) 46.75 City/State/ZIP: `-'-' ';: A I? i,2 7 2-- -----) Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: I Project name: Heat pump • (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 • A • 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 Flue/vent for any of above 23.32 Subdivision: I Lot no.: Other: 23.32 Tax map/parcel no.: Other fuel appliances: . . - • : . ::::5 ":•?: ,,,;', ' .43 - 4 , 414310 , 1 ; Y440 .2 i: j kig4,,. , :41 . 4 : LRS. Water heater 23.32 Gas fireplace 33.39 water heater or gas 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33 • 39 Wood fireplace/insert 23.32 • ' . " " 'n '''' ' 11 - 7 '..'+'' o''''' '' u • ' "' 47 - ''''' ....Ai _' " 7 ',;': - 46,.... ' . '' ". Chimney/liner/flue/vent 23.32 : ' • "1:1 TROPEHtVZO&_, gc ' "e : A ‘ -t.A49"q# qrwe'4 A e . "` ' '' Other: 23.32 Name: 6/-''''' A/&--7/401.0-Cri---) cemf-r Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 33.39 • City/State/ZIP: Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 4: - - t ''.'• El : ; . r ;tritt,47 4 ' 1 '''A . ' . '-'i% . , , , , ?-t:ILF•TST": 1 1:737 . . :,,,,,, t , ,,: reMt r i s"I. - :;_ Attic/crawlspace fans 23.32 Other: 23.32 Business name: Columbia Heating and Cooling, Inc. Fuel piping: Contact name: Marlena Meedom 514.15 for first four; 54.03 for each additional etc. Address: PO Box 230397 Furnace, Gas heat pump City/State/ZIP: 97281 Wall/suspended/unit heater • • - Phone: (503) 624-2704 I Fax: : (503) 598-0270 Water heater Fireplace E-mail: columbhc@teleport.com Range .... : .• ' ': '''''::- ''..;. !', `' .As. '4.4:4L ' - i -, '' '; '''....''.0 r;'::: ';',.:--.•: '::: ., ,:r../51s-,_j • .::::'..i-im" . ..e:r.A , ...i7 k itA.- - '' _, ? -1 • • -7 Barbecue . , • • Business name: Columbia Heating and Cooling, Inc. Clothes dryer (gas) Other: Address: PO Box 230397 . . . . Iiilffrftl'"....*g.0 City/State/ZIP: Tigard, OR 97281 Subtotal 6 5g,51 • Minimum permit fee ($90.00) .------ . Phone: (503) 624-2704 Fax: (503) 598-0270 Plan review (25% of permit fee) c /7. 6 • • CCB lie.: 76359 State surcharge (12% of permit fee) r e ll.f3A,„ TOTAL PERMIT FEE 9 ,q10 - • 7 4' Authorized signature: JA0111/1& k This permit application expires it a permit is not obtained within 180 days after it has been accepted as complete. • . • Print name: Marlena R Meedom Date: • Fee methodology set by Tri-County Building Industry Service Board iABuilding \Permits 1 MEC-PermitApp.doc 09/09/10 440-4617T I II icync•uanupo