Permit CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2015-00078
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Data Issued: 09/08/2015
Parcel: 2S112AB02000
Jurisdiction: Tigard
Site address: 14344 SW MILTON CT
Project: Bonita Water Pump Station Subdivision: BONITA INDUSTRIAL PARK Lot: 2
Project Description: HVAC system for a new water pump station.
Contractor: ROBERT LLOYD SHEET METAL INC Owner: CITY OF TIGARD
4485 INDEPENDENCE HWY 13125 SW HALL BLVD
INDEPENDENCE, OR 97351 TIGARD, OR 97223
PHONE 503-838-3863 PHONE: 503-639-4171
FAX: 503-838-3964
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/03/2015 $3,543.11
Class of Work: ALT Type of Const: VB 12%State Surcharge-Mechanical 03/03/2015 $425.17
Occupancy Grp: U Occupancy Load: Plan Review 03/03/2015 $885.78
Stories:
Info Process/Archiving-Lg$2.00(over 03/03/2015 $14.00
11x17)
Project Valuation: $132,000.00
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 $4,868.06
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Pump works
Duct Work: and vents
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 1 344.
Issued By: d _ -e ittee Signature:
OP' '
Cal 03.639.4175 by 7:00 a.m.for the next available inspe ion date.
This permit card shall be kept in a conspicuous place on the job site un it completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard w EES �'`Permit No.: v• 13125 SW Hall Blvd.,Tigard,OR 9
Phone: 503.718.2439 Fax: 503.598 Datle/By: .f- `L 1 a=her Permit: / �� +
Inspection Line: 503.639.4175 ?PS Date Read = r• See Page 2 for
TIGARD 'Memel: www.tigard-or.gov ¶: 812 Y Y t
Notified/Method: ffiiIIIIMSupplemental elemental Information• ,■ 16111/452 , m 11
. •••, •,- • - .• • .TYPE'OF Hr t ` , co 1'Fw DIAL FEE* SCI)fE1)Lil E'�tUSF,.CB CICLIS7
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/atte n replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$132,0{!0
:. .; pt 1k.GO121' OT CONS'!'RiiioiON
R.Fr DESTIAI,OrrIPMENT L S1'S1EMS'FEES*. .
0 I-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description [ Qty. I Ea. ( Total
JOB,SITE INFORMATION'AND LOCATION :, heating/cooling:
Air conditioning 46.75
Job site address:14344 SW Milton Court Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR, 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name:Bonita Pump Station Duct work 23.32
Cross street/directions to job site:North of Bonita Drive 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
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
' DESCRIPTION•OF \YORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Installation of new HVAC 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
Other: 23.32
❑ PROPERTY iOWNER,1 I ,•?.❑ TENANT• Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/7.1P: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspacc fans 23.32
®;APPLICANT , ..<'.,. Other: 23.32
. ,. , . . �.eoNT,�cr'rERSOl�
Business name:Robert Lloyd Sheet Metal Inc. Fuel piping:
$14.15 for first four,$4.03 for each additional
Contact name:Kyle Hanson Furnace,etc.
Address:4485 Independence Hwy Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Independence,OR,97351 Water heater
Phone:(503)838-3863 Fax::(503)838-3964 Fireplace
Range
E-mail:kyleh@rlsm.net rlsm.net Barbecue
. . . .. CONTRACTOR ::• Clothes dryer(gas)
Business name:Robert Lloyd Sheet Metal Inc. Other
,; :, > MECHANICAL PERMIT'FEES*;"
Address:4485 Independence Hwy Subtotal $3543
City/State/ZIP:Independence,OR,97351 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)838-3863 1ax: 503)838-3964 State surcharge(12%of permit fee) $425
CCB lie.:62476 / TOTAL PERMIT FEE $3968 ,
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 Tri-County Building Industry Service Board
Print name:John Lloyd Date:2/5/2015
I:lnuilding U'ermits'MEC_PermiiApp_040113 dac 440-4017'1'(11/02/COM/WEI3)