Permit
n CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2010-00080
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/23/2010
Parcel: 2S 101 AC01300
Jurisdiction: Tigard
Site address: 7105 SW HAMPTON ST
Subdivision: Lot: 0
Project: Kaizer Dental
Project Description: Install (2) a/c cooling splits, and demo existing ductwork in telecom room.
Owner: FEES
KAISER FOUNDATION HEALTH Description Date Amount
PLAN OF THE NORTHWEST #838, ATTN: Permit Fee 02/23/2010 $360.41
GENERAL ACCCOUNTING 11TH F, 500 NE 12% State Surcharge - Mechanical 02/23/2010 $43.25
PHONE:
Contractor:
HEINZ MECHANICAL INC
2615 NW ST HELENS RD
PORTLAND, OR 97210
PHONE: 503-220-0855
FAX:
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 $403.66
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 forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 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 ApplicatiolECEIVED o • o e
Received
City of Tigard Date/By: PermitNo.: -00 TO
13125 SW Hall Blvd., Tigard, OR 97223 FEB 2 3Z M Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
e Inspection Line: 503.639.4175 D Date Ready/By: lulls: 0 See Page 2 for
Internet: www.tigard-or.gov CITY 0 TIGAR NotiNotified/Method: Supplemental Information
BUILDING DIVISION
TYPE .OF'WORK. COMMERCIAL 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: $ $10,452.00
CATEGORY OF CONSTRUCTION
- - -
RESll)ENTIAL EQUIPMENT. / SYSTEMS'FEES*
❑ I- and 2-family dwelling ® Commercial/industrial ❑ Accessory building -
For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND' LOCATION Heating/cooling
Job site address: 7105 SW Hampton St Air conditioning
(requires site plan showing placement) 46.75
City/State/ZIP: Portland Oregon 97223 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: Telecom Improvements Heat um 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot waters stem 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
23.32
DESCRIPTION OF WORK Water heater
Gas fireplace 33.39
Install two A/C Cooling Splits in the Telecom Room and Demo Existing Ductwork in Flue vent for water heater or gas
the New Telecom Room fireplace 23.32
Log lighter (gas) 23.32
Wood/ pellet stove 33.39
Wood fire lace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other: 23.32
Name: Kaiser Permanente Environmental exhaust and ventilation
Range hood/other kitchen
Address: 500 NE Multnomah St 12th Floor
equipment 33.39
City/State/ZIP: Portland Oregon 97232 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICANT ® CONTACT PERSON. Attic/crawls ace fans 23.32
- - - -
Other: 23.32
Business name: Heinz Mechanical Inc. Fuel piping
Contact name: Brian Wheeler $14.15 for first four; $4.03 for each additional
Address: 2615 NW St Helens Road Furnace, etc.
Gas heat um
City/State/ZIP: Portland Oregon 97210 Wall/sus ended/unit heater
Phone: (503) 220-0855 Fax:: (503-2) Water heater
Fireplace
E-mail: brianw@beinz-mech.com Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: Heinz Mechanical Inc.
Other:
Address: 2615 NW St Helens Road MECHANICAL PERMIT FEES
City/State/ZIP: Portland Oregon 97210 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 220-0855 Fax: (503) 220-0260 Plan review (25% of permit fee)
CCB lic.: 43866 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized Signature: days after it has been accepted as complete.
Print name: Brian Wheeler Date: 2/22/10 * Fee methodology set by Tri-County Building Industry Service Board
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