Permit t CITY OF TIGAR® MECHANICAL PERMIT
I
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00325
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/06/2009
Tl C"i1�RD Parcel: 1S135BD00300
Jurisdiction: Tigard
Site address: 9735 SW SHADY LN 104
Subdivision: TIGARD MEDICAL MALL Lot: 0
Project: Tigard Medical Mall
Project Description: Install (2) ton air handler and duct system.
Owner: FEES
MCFADDEN, ARTHUR L Description Date Amount
BY ERIC SKLARZ, 621 SW MORRISON ST STE Permit Fee 07/06/2009 $292.25
#800 Plan Review 07/06/2009 $73.06
PHONE: 12% State Surcharge - Mechanical 07/06/2009 $35.07
Contractor:
WILLAMETTE HVAC
3075 SW 234TH AVE. #206
HILLSBORO, OR 97123
PHONE: 503 - 628 -6841
FAX: 503 - 848 -2597
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: B Occupancy Load:
Stories: 3
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 1 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 $400.38
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 questi t OUNC by calling 503.246.6699 or 1.800.332.2344. rttc.i 01..slir,v12_,
Issued By: 1V 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.
I
Nisechanical Permit Application , F + , ' ` :FOR o _ FFIC US O NLY .,...,..:.:-...-1,..,:::...:;-..:i,-.:-:, I _ ' ; ''
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® Da
i City of Tigard DateB Permit No.: Lc ` • f � 1 „ii. _ "' " 13125 SW Hall Blvd., Tigard, OR 2 Plan Revie \ 4
C Phone: 503.639.4171 Fax: 503.598.1960 0� / I Other Permit.
D a t eBy :1, E a, it, i ` �e 17
T I G A R D ` Inspection Line: 503.639.417 JUL 4X2009
Date Readwly: ® See Page 2 for
-
:C•r Internet: www.tigard•or.gov Notified/Method: . Supplemental Information
CITY OF TIGARD
TYPE OF
RYRiQING 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.
CATEGORY OF CONSTRUCTION Value: $ S14,500.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- 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
Air conditioning or heat pump
Job site address: 9735 SW Shady I.n
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite /bldg. /apt. no.: w' 1 Project name: ` /� Gas heat pump 14.00
Cross street/directions to job site: � Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Install 2 ton air handler and duct system. Flue vent for water heater or gas
fireplace 10.00
Log lighter (pas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
— Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER ❑ TENANT
— Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State/!_1P: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT • • ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Same as below
Fuel piping
Contact name: S5.40 for first four; S1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: ; ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR • Barbecue
Business name: Willamette HVAC Clothes dryer (gas)
Other:
Address: 3075 SW 234' Ave Suite 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro OR 97123 Subtotal
Phone: (503) 628.6841 Fax: (503) 848.2597 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 56951 State surcharge (12% of permit fee)
v I TOTAL PERMIT EE 0. ,�?j
This permit application expires if a permit is not obtain �� within 180
Authorized signature: rr d ays a it has been accepted as complete.
Print name: Michael Malstrom Date: 6/30/09 * Fee methodology set by Tn -County Building Industry Service Board
I:\ BuildingPermits \ME /W
C- PermitApp.doc 01 /19/07 440 -4617T (I I /02 /COMEI) 53q, 38