Permit CITY OF TIGARD MECHANICAL PERMIT
` ! COMMUNITY DEVELOPMENT Permit#: MEC2013-00515
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/11/2013
Parcel: 2S114AA00200
Jurisdiction: Tigard
Site address: 16285 SW 85TH AVE 410
Project: River City NW Mechanical Subdivision: 1993-078 PARTITION PLAT Lot: 2
Project Description: Install mini split system to add a/c and heat.
Contractor: RIVER CITY NW MECHANICAL LLC Owner: WH SHIPMAN LIMITED
19201 SE TETON AVE BY NORRIS& STEVENS INC
TUALATIN, OR 97062 621 SW MORRISON STE 800
PORTLAND, OR 97205
PHONE: 503-591-9950 PHONE:
FAX: 503-536-6615
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/11/2013 $130.46
Class of Work: ALT Type of Const: Plan Review 09/11/2013 $32.62
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 09/11/2013 $15.66
Stories:
Project Valuation: $2,500.00
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: 1
Appliances
Vent Fans: Vent Systems: Total $178.74
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notif Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ued By: ` _` Permittee Signat y
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
To: Page 2 at 3 2013-09-10 21:58:31 (O MT) From: Art Anooraon
Mechanical Permit Applic:
nt-. Da a 9 // �roI{ }111(.1. SE ONIX eyed:City of Tigard rF
O/S'�s7'r 13125 SW Hall Blvd.,Tigard,OR 97223 S E P 1 0 2 013
I. Phone; 503.639.4171 Fax: 503.598.1960 iffl pthmPermit
11c;,�RI) Inspection Line: 503.639.4175
Internet: www.tigard-or.gov CITY OF TIGARD H ` : '"'g Supplemental See Page 2 for
BUILDING flIVISI®RI Information
TYPE OF WORK • • COMMERCIAL'FRE* SCHEDULE - USE CHECKLISr.
(]New construction ❑Addition/alteration/replacement Mach rrrical permit fees'are based on the vel of the work
❑Demolition ❑Other: mechanical Indicate the value(rounded to the nearest dollar)of all
mechanical materials.equipment,labor,overhead,and profit.
CAT'- OF CONSTRUCTION Value:$°Y• RES1DENTI4L.FQUIPNIENT/SYSTEMS.FEES.,,::
1-end 2-family dwelling 4!a,. . ,rnercial/ndus-trial ❑Accessory building
For special information use checklist
❑Multi-family • Master builder ❑Other:
Description I Qry. I Ea. I Total
JOB SITE INFORMATION. AND LOCATION - .. • • . . Heating/cooling
lob site address:16285 SW 85th Avenue Air conditioning
(requires aim Ian showing plmement) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000 BTU(duea/veres) 46.75
ii n/�t2 et J Furnace 100,000+BTU(duetWcma) 54.91
Suite/bldg./apt no.:410 I Project name:/C W Hear pump t 61.06
Cross street/directions to job site: �e( o9:-A//[' ' it work 23.32
Durham and Hall Blvd. Hydronic hot`''rater system 23.32
w Residential boiler(radiator or
o
/ / ltydmnie) 23.3X 2
Unit heaters(fuel-type,not electric),
in-wall in-duct,suspended,etc- 46.75
Flue/vent for any of above 23.32
Subdivision
L Lot no..
....:i.
Other: 23.32
Tax map/parcel no.: Other feel appliances
DESCRIPTION OF WORK Water heater 23.32
Install Mini Split system to add AC and Heat to office other:dace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log Iixbter(pos) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 _
l PROPERTY OWNER Chimney/liner/flue/vent 23.32
0 TEN2�NI'' : 23.32
4° Name:W.H.Shipman LTD Environmental exhaust and ventilation
Address: Kegau-Pahoa Range hood/other kitchen
equipment 33.39 •
City/State/Z.1F:KegauHI96749 Clothes dryer exhaust 33.39
Phone:(503 )320-1317 Fax:( )
Single-duct t ,bitter o
. i utility morns) 23.32
• 111,APPLICANT 1] CONTACT'.PERSON• .... Attic/crawlspace fans 23.32
Other. 23.32
Business name:River City NW Mechanical LLC Fuel piping
Contact name:Keoni Simpson (1/9-XL"9- $14.15 for first four$4.03 for each additional
s '4 Address:19201 SW Teton Ave 9)7/--?3,—/y6 � F ace'ctcm
Gas heat pump
city/staterzLP:Tualatin,OR 97062 Wall
/stlspended/und heater
Phone:(503 )594-9950 I Fax::(503 /536-6615 Water heater
Fireplace
E-mail:master @rivercitynwmechanical.com
Range
CONntAcroR Barbecue
Business trance:River City NW Mechanical Clothes drier(gas)
— Other .
Address:19201 SE Teton Ave . W.CJ AI Ar4. 1 iT.F•g g.*.;- ::':s:_
• "
•
City/State/ZIP:Tualatin,OR 97062 Subtotal
4 Minimum permit fee($90.00)
Q.) Phone:(503 )591-9950 i I Fax:(503 )536-6615 Plan review(25%of permit fee)
CCB lie.:199619 4///b//c State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Authorized signature: Thin permit application expires ire permit is not obtained within 180
days after it boa been accepted at eowptetc.
Print name:Keoni Simpson [ pate:6_14-13 I ' Fee methodology ectby TA-Calmly Bonding Industry SenseBeard
M BeuildingU a ci4.MEC-Penmulpp.dec 10/01/09 44046171 t 1lo21COMlwt1q
To: Page 1 of 3 2013-09-10 21'59:31 (OMT) From: Art Andaman
FAX COVER SHEET
TO
COMPANY
FAX NUMBER 15035981960
FROM Art Andersen
DATE 2013-09-10 21:59:10 GMT
RE Mechanical Permit
COVER MESSAGE
Thanks,
Karla Anderson
Andersen Heating, Inc.
karia@andersenheating.com<mailto:karla @andersonheating.com>
971-239-1466
•
97/ - 5-69 - / 2-`(,)
WWW.MYFAX.COM