Permit (10) 'PI CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PeCOMMUNITY MEC2016-00429
T[G R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2016
Parcel: 2S110DD01000
Jurisdiction: Tigard
Site address: 15950 SW GREENS WAY
Project: SAHLER Subdivision: SUMMERFIELD Lot: 90
Project Description: Replacing existing NC unit. Placement of NC unit must comply with manufacturer's installation requirements.
Contractor: AIR MASTERS HEATING&AIR CONDITIONING INC Owner: SAHLER, DAVID F&NANCY R SAHLER
2858 LIVINGSTON ST NE REVOCABLE INTER VIVOS TRUST
SALEM, OR 97301 15950 SW GREENS WAY
TIGARD,OR 97224
PHONE: 503-244-8880 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 06/14/2016 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 06/14/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 06/14/2016 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y..lmay obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
_ • ��'t-e Signature: ...--...el,Issued By: _11.---."- —
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application ,-.1-;\ FUR c)FFic I: t sl:()NIA�,�
City of Tigard •" Date,ByReceived6 Amps" Permit No.: _ •
13125 SW Hall Blvd.,Tigard,OR to Plan Review
Phone: 503.718.2439 Fax: Other Permit:
���JJJJ Date/By:
I I c.,�R l) Inspection Line: 503.639.417 1 LQ�� Date Ready/By: la See Page 2 for
Internet: www.tigard-or.gov , i `. Notified/Method: Supplemental Information
N 3
,jay. U b0� ,Ps ,rte r +�1ypFM
�y ��pj
r t( .v. T tr " etf d' 1 T'`;:6 V ,, 1`� ,,,,,,..:‘,77.4,..-r. iyyn o7ir Gk rda'l u'4. 41t/L 4t ,
i'etV1t�3 Mechanical permit fees*are based on the value of the work
0 New construction Addition/alter / cement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: . � mechanical materials,equipment,labor,overhead,and profit.
m 7,�-, 7 -: ATEGOItf OF�.�:� CONSTRUCTION A .,..
risValue:$
EQUIPMENT l SYSTEMS F *
El-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
-''.-..IoBiITE*INFORMATION AND LOCATION Heating/cooling:
Air conditioning \ 46.75
Job site address: /S-7,S-0 5 uj �C ti S (-ii ty
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 71&. , O K, , 9 2.z.," Furnace 100,000+BTU(ducts'vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Duct work 23.32
Cross street/directions to job site: 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
Jl/ ,Q }=t )((5'('7 JG_ 4 -C 5y5 fireplace 23.32
l Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
W ER , f : Cl
• , ,- ��-A. _ , ' Environmental exhaust and ventilation:
Name: N 4. Cy 5 L E IC Range hood/other kitchen
equipment 33.39
Address: .S-Ci S-z:), S c4 j c32,e�A I Sco Ay Clothes dryer exhaust 33.39
-
City/State/ZIP:: 7&- , 0 q ` r Single-duct exhaust(bathrooms,
I 2.2,1 toilet compartments,utility rooms) 23.32
Phone:(5/'ir) Z 31 -'15-o Li Fax:( ) Attic/crawlspace fans 23.32
,,'4,4***:,
, r g ., : " , a tori 4-0- ERSON Other: 23.32
��� r �f� .
Business name: Fuel piping:
2 - f�7�2s ffT/�� A-C- $14.15 for first four;$4.03 for each additional
Contact name: RI Cts( ,J Furnace,etc.
Address: Zs,'S Lt,/1,a6 '-la kl S Ai, Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: S ti /C_ al - O I Water heater
Phone:(S-b ) Zggq_ - o Fax::( .r15`
'3) s" a q ( Fireplace
11 Range
E-mail: "'.31- i •L W Barbecue
+. 's R `,x, ` -1 i C, 'o't R-"` h z �' " sn r '` ` Clothes dryer(gas)
�. ,zv.. ,. . —..,!,,,N ,��k. �*ni+C'�C.,.�' , :'.ra�rl,� , .r . "� ..,.�1„ a. z-. �=a
Other:name: �— (t/ �-/✓LJ- _I-T-1,_)6— T Ay�
'' � �AGrkv :' tt Y iti
Address: Z1S�i.1 V%N 6-5-roAi Si- Ne,
Subtotal
City/State/ZIP: ti--{eAA4 t C ( ; '1 7 o I Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(S-63) z/{(1_ �e-) Fax:(Sb3) S-S-S-z g q1 State surcharge(12%of permit fee) f YJ.
CCB lic.: ( 7 5' ca Z`f' l,1/`c/ TOTAL PERMIT FEE taJ,,5c-r/
�
This permit application expires if a permit is not obtained withirvj
days after it has been accepted as complete.
Authorized signature: . r * Fee methodology set by Tri-County Building Industry Service Board
Print name: jai CAA-41(Z t` X44-{,(-O-V Date: /i /(2_,D 1(,p
I:Building,Permits MEC_PermsApp_040113.doc 446-4617 (1102,COMIWEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation; Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\Building\Pennits\M EC_PermitApp_040 I I 3.doc 2