Permit IN CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Pe COMMUNITY MEC2022-00278
Date Issued: 4/19/2022
T 16 A Li.f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CB07400
Jurisdiction: Tigard
Site address: 10470 SW PARK ST 101
Project: Middleton Trust Building Subdivision: 1998-084 PARTITION PLAT Lot: 2
Project Description: Mechanical hydronic system for warehouse.
Contractor: BRUNER PLUMBING Owner: MIDDLETON HOLDINGS LLC
PO BOX 23985 PO BOX 23985
TIGARD, OR 97281 TIGARD, OR 97281
PHONE: 503-484-5105(CELL) PHONE:
FAX: 503-624-2173
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/19/2022 $398.51
Class of Work: NEW Type of Const: VB Plan Review 04/19/2022 $99.63
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 04/19/2022 $47.82
Stories: 2 Info Process/Archiving-Sm$0.50(up to 04/19/2022 $4.50
11x17)
Project Valuation: $12,000.00
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 $550.46
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Boiler for
Duct Work: hydronic
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: / ke' / 0,),A Permittee Signature: 0 —'-
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
j
Mechanical Permit Application
Cites, of Tigard Received
k 7 .)- Permit No.: „l
13125 SW Hall Blvd.,Tigard,OR 97223RECEIVE
[eBy: /' . a�,� �}e
tIaan Revie
IIII 0 Phone: 503.718.2439 Fax: 503.598.1960 ..242.... Other Permit:
' Inspection Line: 503.639.4175 p DateBy: � ��,�--Ga'�f.)ti�S
1 16 A R D p g g APR 7 gOgg Date Ready/By: lures: ® See Page 2 for
Internet: www.ti ard-or. ov f1( 1 L&' ified/Method /-2 .i Supplemental Information
v
TYPE OF WORK t ' OF TIGARD M am, FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
[g New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,�ofit.
CATEGORY OF CONSTRUCTION Value:$ / t�1TE
RESIDENTIAL EQUIPMENT SYSTEMS FEES*
0 1-and 2-family dwelling F..:( Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 2.— 46.75 Cl 3 :5/)
Job site address: /v 4,1w S,t r Par i C fir Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: T3�. ✓ 0 v Furnace 100,000+BTU(ducts/vents) 54.91
•
l JCILL I �VI -ie(/s L /)I�� Heat pump 61.06
Suite/bldg./apt.no.: Project name: 1l T lv` Duct work 23.32
Cross street/directions to job site: poi k j N _ Hydronic hot water system 7....-- 23.32 4(ro,to 4
(/'� Residential boiler(radiator or
2-00 w t— 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 i 23.32 23,32r
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
_ t/✓1 1 fireplace t 23.32 2:3. 32-.
��J /�/vN l C Log Wood/pellet
(gas) 23.32
/f�[ �l �L [�6 ? Wood/pellet stove 33.39
`(,/.( ta LiliAlW S2 , Wood fireplace/insert 23.32
1- Chimney/liner/flue/vent 23.32
ROPERTY OWNER ElTENANT Other: 23.32
Environmental exhaust and ventilation:
Name: j1n(id( ._hi - o5-(-- LLB Range hood/other kitchen
equipment 33.39
Address: f , 0 C z_3 ci ys c, Clothes dryer exhaust 33.39
City/State/ZIP: l� _v 0 e, ( ,7 2s f - l,�S Single-duct exhaust(bathrooms, �t bw
toilet compartments,utility rooms) 2-- 23.32 `[v
Phone:(9. ).-e-/- --SI D j Fax:(SQ ) (i,2_,4-. 2. 7 3 Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: _ 23.32
Business name: Fuel piping:
$14.15 for first four;S4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: Wall/suspended/unit heater Z-- I S. 9', 1 b
City/State/ZIP: Water heater I Ili, 1) f(71-,1-
Phone:( ) Fax::( ) Fireplace
/ Range
E-mail: I/WA ti /,jr' ha wir(�1� 1)3 , (!(,)--2. Barbecue
��� CONTRACTORO Clothes dryer(gas)
Business name: (3ru ie t( k V M1I i t C /rl C— Other:
J MECHANICAL PERMIT FEES*
Address: ( v i o ZT ( 0 _ Subtotal 'Z f 5 ,7-,
City/State/ZIP: 7 Q R. 972d'/- ��6! Minimum permit fee($90.00)
Plan review(25%of permit fee) b b,y Lt
Phone:(,Sd3) 62. -rf.f'3'O Fax:(5( ) C,2_4 -2..173
State surcharge(12%of permit fee) 3` ,
CCB lic.: g I &3-2 TOTAL PERMIT FEE 3 6 Li , 0 7
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: tell r?( 'iv ,/' Date: 3/Z i/j,Z,