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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2010 -00035 ;TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01 /22/2010 Parcel: 1S136DD05300 Jurisdiction: TIGARD Site address: 11850 SW 67TH AVE, STE# 100 Subdivision: TIGARD TRIANGLE COMMONS Lot: 13 Project: Spec Space Project Description: Add (3) supply ducts and diffusers, add (3) return grills, relocate supply and return grills. Owner: FEES PNWP LLC #2 & Description Date Amount PNWP LLC, 6600 SW 105TH AVE #175 BEAVERTON, OR 97008 Permit Fee 01/22/2010 $158.09 12% State Surcharge - Mechanical 01/22/2010 $18.97 PHONE: Contractor: AMERICAN HEATING INC 1339 SE GIDEON ST PORTLAND, OR 97202 PHONE: 503 - 239 -4600 FAX: 503- 239 -7038 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 - 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 $177.06 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 Notific. '• Center. ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct • iestions to OUNC b' calla • • 03 ;6.6699 or 1.800.332.2344. �j Issued c : � � � / Permittee Signature: „ b 2 f G G/ / — 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. i . P 1.,, - ■" , l►d i „ � 3 .1 - ` irE r, pia 7, Mechanical Permit Applicat'r ,� � , oa IcL4u o� r �� ,� , I r, I q� :li � ; ib ( ' • " , ..r, City Of Tigard ! � ; I VF ' DateBy: Received 14 0 4, Permit No.: /e J i0 - op 1 3125 SW Hall Blvd., Tigard, OR 97223 ^ .• Plan Review Phone: 503.639.4171 .. N Other Permit: I® Ph 5036394171 Fax: 503598196JA tV P Date/By: I I c n It b'' Inspection Line: 503.639.4175 4 4 2010 Date Ready/By: Juris: El See Page 2 for u a' Internet: www.tigard- or.gov Cl Notified/Method: Supplemental Information RUI CITY OF TIGARD TYPE OF BOG UIIf!:S'topj COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction , ddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ 33 I RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist. El Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: // $5n 5vv 627 74- h A V e Aiq conditioning (requires ste pl r✓ (requires site plan showing placement) 46.75 City /State /ZIP: ' ”r- QA ? "722 3 Furnace 100,000 BTU (ducts /vents) 46.75 / � Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: & Uq — �-/ l 4 ✓1 Heat pump 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 AdO 3 ( Sv pp /y cJve 7 5 a'' � ek II() s e r 5 Flue vent for water heater or gas cc/ _/ 3 re 7 3 1 / / 1 Log lighter 23.32 U Log lighter (gas) 23.32 r'e /0C a fe Supply + r f j r; 11 5 Wood/pelletstove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 ❑ PROPERTY OWNER ❑ TENANT Other: 23.32 Name: 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 /crawlspace fans 23.32 Other: 23.32 Business name: A / f f eat. /,I T G Fuel tin Pp g Contact name: Brc M G n c . 4 e s l e ' $14.15 for first four; $4.03 for each additional Address: 339 SE COI t� C C' Furnace, etc. Gas heat pump City /State /ZIP: POr't / O1f 77202 Wall/suspended/unit heater Phone: (5013) 239 - y(o00 Fax: : (5 03) 23 9 - -7O3 g Water heater Fireplace K E -mail: Range 1 CONTRACTOR • . • Barbecue , : /) n % Other: Clothes dryer (gas) Business name /'Tl�?er'(.LG/1 t °Cf �1 �-✓ Address: / 3 3 c SE to / C/ co, J �" .. • MECHA PERMIT FEES* City /State /ZIP: / o f146 d © R 972 o 2 , p Subtotal ( 503) 239 ' /(o(20' ( 5o3 ) 23 9-703 v Minimum permit fee permit fee ��5g,m9 Phone: Fax Plan review (25% of permit fee) .e " CCB lic.: 33 135 State surcharge (12% of permit fee) // . 9 7 TOTAL PERMIT FEE # 177. Ap 1/ Thi permit application expires if a permit is not obtained within 180 Authorized signature: S days after it has been accepted as complete. Print name: g' j y6/ i / 4/7Ch 65 7 / Date: J 1 2 1 / / 0 * Fee methodology set by Tri- County Building Industry Service Board / I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (11 /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. I:\ Building \Permits\MEC - PermitApp.doc 10/01/09 2