Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00144
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2013
Parcel: 2S113AB01400
Jurisdiction: Tigard
Site address: 7358 SW DURHAM RD
Project: Coram -Marin Michalczylt Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30
Project Description: Extend gas line to roof top unit heater 119'
Contractor: ALL FUEL INSTALLATION & SERVICE LLC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 69 ATTN: N PIVEN
TROUTDALE, OR 97060 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 674 -2350 PHONE:
FAX: 503 - 674 -2693
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/18/2013 $90.55
Class of Work: ALT Type of Const: Plan Review 03/18/2013 $22.64
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/18/2013 $10.87
Stories: Info Process /Archiving - Sm $0.50 (up to 03/18/2013 $0.50
11x17)
Project Valuation: $1,164.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $124.56
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
ah tfliat Issued By: At Permittee Signature: �-P�uC'4 TIa I
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.
Mechanical Permit Application CE�D r FOR OFFICE USE ONLY
City Tigard 1�� .. DateBy 31 I S ( S _L)0( �W-
Ci of Ti and y; Permit No.: g /3
14
13125 SW Hall Blvd., Tigard, OR 97223
..., Plan Revi ��I
Phone: 503.718.2439 Fax: 503.598.1960 MAR 18 2013 DateB l'�� PIE Other Permit:
TIGARD Inspection Line: 503.639 Date Reary /By: Juris. // ® See Page 2 for
Internet: www.tigard - or.gov CITY OFTIGARD Notified/Method: V (Q Supplemental Information
BUILDING DIVISIO
TYPE OF WORK 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: $ \ 1 69 • 0 v
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling 1:1 Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: S t, 1I u /L u 64 it 11 - (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: °', ; 1 u ,t9 a (' 1 a LI Furnace 100,000+ BTU (ducts/vents) X 54.91
Suite/bldg. /apt. no.: Project name: 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
1 11 Gas fireplace /insert 33.39
}
C X Il tl' \ t h ti 4 f u O - 4 1 i. lf\ -P / 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 RI TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: L rt. tti - MA f h V\ 1 O t. C Z'I Environmental exhaust and ventilation:
Address: l Range hood/other kitchen
S to t h .) equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (5 o) 3 51 C1$ 3 Fax: ( ) toilet compartments, utility rooms) 23.32
. 5Q APPLICANT 181 CONTACT PERSON Attic /crawlspace fans 23.32
( 1 `1 Other: 23.32
Business name:
`kA 'I t45�N AVtun 4 Si' rut' cc _ LPL Fuel piping:
Contact name: L r , L C ^ $14.15 for first four; $4.03 for each additional
Address:
Fumace, etc. 11
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
(Toll ) l i t C1 3 ( ) Water heater
Phone: l 1 Fax:
Fireplace
E -mail: c1/4\ti Q` a c wncgst . r,ti Range
CONTRACTOR L Barbecue
Business name: A 1 ` Fv,z ` 1 q" ti 4 J A Q Se Ulu C (. (, L Clothes dryer (gas)
Other:
Address: ?0 by Cp MECHANICAL PERMIT FEES*
City/State/ZIP: - 1 . i
Subtotal
1 C � N ` I �, 1 f u r Minimum permit fee ($90.00)
Phone: (S 0 3) (Q 1 LA - ; 35-0 Fax: ( ) 1I - d 10 C 3 Plan review (25% of permit fee)
CCB lic.: t ( 0 9 0 3 State surcharge (12% of permit fee)
TOTAL PERMIT FEE /ta_tt- �
‘7 - : — This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: I-1 t U � . E C uvK p Date: 31 ‘ `6 I a 0 (3 . Fee methodology set by Tri- County Building Industry Service Board
I - \ Building \Permits\MEC- PermitApp doe 03/07/12 440 -4617T (11 /02 /COM/WEB)
4 *CORL llr ,,M 1 fu jeLT
specialty infusion pec hY on services
An Apria Healthcare Company
Maria Michalczyk, MA, RN
Branch Manager
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Tel 503.684.3046 • Cell 503.351.9823 • Fax 949.639.6847 i - I
Email Maria.Michalczyk @coramhc.com Web coramhc.com ' 1 `I ;1 O
7358 SW Durham Rd V
Portland, Oregon 97224
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