Permit CITY OF TIGARD MECHANICAL PERMIT
s. COMMUNITY DEVELOPMENT Permit#: MEC2015-00257
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2015
Parcel: 2S114AA00500
Jurisdiction: Tigard
Site address: 16375 SW 85TH AVE
Project: Clean Water Services Subdivision: 1993-078 PARTITION PLAT Lot: 2
Project Description: Headworks Building-Install new 5-ton split system.
Contractor: ALLIANT SYSTEMS LLC Owner: CLEAN WATER SERVICES
1600 NW 167TH PL#330 2550 SW HILLSBORO HWY
BEAVERTON, OR 97006 HILLSBORO,OR 97123
PHONE: 503-619-4066 PHONE:
FAX: 503-230-9238
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/02/2015 $328.04
Class of Work: ALT Type of Const: Plan Review 06/02/2015 $82.01
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 06/02/2015 $39.36
Stories: Info Process/Archiving-Lg$2.00(over 06/02/2015 $4.00
11x17)
Project Valuation: $9,213.00 Info Process/Archiving-Sm$0.50(up to 06/02/2015 $6.50
11x17)
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 $459.91
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 fo•- •- •.13 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 •r 1.800.332. • 4.
Issued By: � Permittee Signature:
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 1 OR OFFICE USE ONLY
City of Tigard 1` Received
� dJLL AO Alit 5-y/S Permit No. i 7tC'�/S- ���
" 13125 SW Hall Blvd.,Tigard,OR 3 DateBy.
H Plan Review
Phone: 503.718.2439 Fax: 503.598.lf � AV W Date/By: ..- Other Permit:
TIGARD Inspection Line: 503.639.4175 Ftuo Date Ready/By: Juri9: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 571///5 , Supplemental Information
n f4, 17q3hi
TYPE OF WORK , U LERCIAL 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:$$9,213.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-famil ❑ Master builder ❑Other: Description Qty. J Ea. Total
//,/ l5 JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address; ,•0 SW 85th Air conditioning 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
G *� SL'try, Heat pump 61.06
Suite/bldg./apt.no.: Project name:CWS Blower Room AC Duct work 23.32
Cross street/directions to job site: ,.., z kvc-i,k----.3 ,91),, 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: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Install new 5-ton split system. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other: _ 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:Alliant Systems
Fuel piping:
514.15 for first four;54.03 for each additional
Contact name:David Russell Furnace,etc.
Address: 1600 NW 167th Place,Suite 330 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton,OR 97006 Water heater
Phone:(503)572-7761 Fax::(503)230-9238 Fireplace
Range
F-mail:d.russell,,`alliant-systems.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Alliant Systems Other
MECHANICAL PERMIT FEES*
Address:1600 NW 167th Place,Suite 330 Subtotal
City/State/ZIP:Beaverton,OR 97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)572-7761 Fax:(503)230-9238 State surcharge(12%of permit fee)
CCB lic.:153420 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tn-County Building Industry Service Board
Print name:David Russell Date:05/04/15
I:1BuildingWermit*'MEC_PermitApp_040113.doc 440-4617T(I i/02/COMIWEB)
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