Permit Ph ` q CITY OF TIGARD MECHANICAL PERMIT
s :; COMMUNITY DEVELOPMENT Permit #: MEC2010 -00068
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/16/2010
Parcel: 2S112DD00701
Jurisdiction:
Site address: 15800 SW UPPER BOONES FERRY RD, STE# 400
Subdivision: OREGON BUSINESS PARK II Lot:
Project: Watson Chiropratic
Project Description: Add (2) new supply grills, (1) return air, and outside air for existing air handler.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee 02/16/2010 $84.41
12% State Surcharge - Mechanical 02/16/2010 $10.13
PHONE: 503 - 624 -6300
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115
PHONE: 503 - 691 -9699
FAX: 503 - 691 -8556
Type of Use:
Class of Work: 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 $94.54
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 btain a c y the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: f-} n� 3.
Q \r �. Q )J Permittee Signature:
�LJI� Call 5 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 Applicati y w , › 1 - F r � -� ` ° ; T - �.a. "'
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Received
Ci of Tigard P N o
° 13125 SW Hall lvd., Tigard, OR 972 Date By: E. r 0 • f ��r
ti Plan Review coca:
Phone: 503.639.4171 Fax: 503.598.1960 //��
Inspection Line: 503.639.4175 FEB 16 2010 Date/By: Other Permit: �CJ� WVaii
,l I (i • A Il I� p Date Ready/By: l l C9 /// ® See Page 2 for
Internet: www.tigard-or.gov C4 OF IGARD Notified/Method: Supplemental Information
TYPE OF WORMD��G DIVISION.
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.
CA EGORY OF CONSTRUCTION Value: $ -1 0
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ommercial /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
f i P 1 2 1 n_/ Air conditioning
Job site address: 1J I , p� r � (j � (requires uires site plan showing placement) 46.75
City /State /ZIP: )1/A i/� or Furnace 100,000 BTU (ducts /vents) 46.75
/ �,�j // /I Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: � Project name: ('J4-1 Or ��� st Heat pump 61.06
Cross street/directions to job site: �/ (/ Duct work 23.32
�� _ Hydronic hot water system 23.32
�.e �/ /GJ /�/�N!/ 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
( j/ ,'i -4 - c l y C� Flue vent for water heater or gas
/ 7 / fireplace 23.32
0 /2 , ---4 rf� -"'' Log lighter (gas) 23.32
�2S / / (--34/1-"; Wood/pellet stove 33.39
/ " Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
At PROPERTY OWNER ❑.TENANT Other: 23.32
Name: /)k fi'l Environmental exhaust and ventilation
Address: Range hood/other kitchen
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 /erawlspace fans 23.32.
/ Other: 23.32
Business name: 0)-/46._ Fuel piping
Contact name: L ( y 1 L t /1-7 ,---- $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
�, ' 7 Gas heat pump
City /State /ZIP: . 4 no // .0/(/- 7 7/, 4 Wall /suspended/unit heater
// ,/ t Water heater
Phone: ('a)) / X / ' � g 007,, / Fax: : ( ) Fireplace
C, L
E -mail: 6,,, /,/. Cam/ /4 4 fgy jl jl Range
CONTRACTOR / Barbecue
Business name: /y 1✓ 4 G Clothes dryer (gas)
�! Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: / -) ( Z L., State surcharge (12% of permit fee)
I-) TOTAL PERMIT FEE 9 -94
Authorized signature: This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
Print name: G L - � // T I.+._�- Date: /1 /4p// v * Fee methodology set by Tri- County Building Industry Service Board
I:\Building \Permits \MEC- PermitApp.doc 10/01/09 440 -4617T (1 1 /02/COM/WEB)
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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