Permit (5) CITY OF TIGARD MECHANICAL PERMIT
II 11 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00535
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/27/2010
Parcel: 2S101 BB01400
Jurisdiction: TIGARD
Site address: 12060 SW GARDEN PL, BLDG# 5
Subdivision: PARK 217 Lot: 0
Project: Expressions Printing
Project Description: Relocating (2) grills.
Owner: FEES
GVA KIDDER MATHEWS Description Date Amount
ONE COLUMBIA STREET SUITE 950
Permit Fee 10/27/2010 $69.06
PORTLAND, OR 97258 12% State Surcharge - Mechanical 10/27/2010 $8.29
PHONE: 503 - 221 -9900
Contractor:
OREGON HEATING & AIR CONDITIONING
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 691 -9699
FAX: 503 - 691 -8556
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $77.35
Hoods: Comm Incinerators: Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may o tain a opy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1 .800.332.2344.
Issued By: ' - Permittee
Call 1 3.639.4175 by 7:00 a.m. for an inspection that business day.
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 rule OF ICI: 'Isl.: (NI.V
City of Tigard �� Date/By: V J� Permit No.: / , � v_ f �
:� ° 13125 SW Hall Blvd., Tigard, OR 97223 �� Y
Phone: 503.639.4171 Fax: 503.598.10' �j Plan Review Other Permit:
� Date/By: M _
i Line: 5036394175
'�
1 - � t A i , 1
Inspection Lne: .. °' Date Ready/By: ® See Page 2 for
Internet: www.tigard OC 91 1 Notified/Method: Fr Supplemental Information
TYPE OF WORK 0V i 1SlO� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
c l� �� Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteratio nt performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: B mechanical materials, equipment, labor, overhead, and fit.
C E O R Y OF CONSTRUCTION Value: $ � � ro
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
ID 1- and 2- family dwelling CommerciaUindustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description
Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
n /� 5 � /% [� Air conditioning
Job site address:
//..0&'d & ' (requires site plan showing placement) 46.75
City /State /ZIP: a .�1 - /X , 9 Fumace 100,000 BTU (ducts/vents) 46.75
�� ^^ Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: ' '/ '21 pump v// , . 0 2 Heat p um 61.06
Cross street/directions to job site: Duct work 23.32
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
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
�t1 Q� ✓ J�� S Flue vent for water heater or gas
f fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Ot y/liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
C.,---- Other: 23.32
Business name: O
Fuel piping
Contact name: C-L v\. (-4 - - v,_ $14.15 for first four; $4.03 for each _additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: WalUsuspended/unit heater
Phone: (!f/ -4) p 9 tb 1.--- Fax:: ( ) Water heater
6,444 J / Fireplace
E-mail: UI E (4.az f 1 t b€77-y\ Range
CONTtACTOR Barbecue
lI Clothes dryer (gas)
Business name: D�-
Other:
Address: v 7 ) 7/2-7-17// ' y'/ MECHANICAL PERMIT FEES*
City/State /ZIP: �/ VO 4--C-4. ,/ j / 'C) Ill
--- Subtotal
Minimum permit fee ($90.00) (A. (J(p
Phone: �) a �L Fax: ( ) Plan review (25% of permit fee)
CCB lic.: f ' 7 7) / 7-(0 State surcharge (12% of permit fee) g s PI TOTAL PERMIT FEE - 7' - 1,
/7, This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: C__6,4 vt:77 / Date: ( �
• Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \PermitsU�C- PemtitApp.doc 10/01/09 C- 17T(11 2/COIWWEB)
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.
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