Permit CIT OF TIGARD
. -.:
MECHANICAL PERMIT
� =0 COMMUNITY DEVELOPMENT
PERMIT #: MEC2008 -00348
TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2008
PARCEL: 2S 113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: OREGON STATE BAR
Project Description: Fan powered box for reception area. Project Value: $3,000.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 3 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Owner: FEES
OPUS NORTHWEST Description Date Amount
1500 SW FIRST AVE STE 1100
PORTLAND, OR 97201 [MECH] Permit Fee 7/3/2008 $95.50
[MECPLN] Plan Rev 7/3/2008 $23.88
[TAX] 12% State Surch 7/3/2008 $11.46
Phone: Total $130.84
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 462 -4822
FAX 503- 462 -6555
Reg #: LIC 50897
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued =. : _ ,�,� / / �L ,/ Permittee Signatu j ��
Call 503.639.4175 by 7:00 a.m. for inspections 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.
a 1 D , r n ,•. ; " t *1 �+' , r.4. a'� , ..e ,,t 4,4 .'. , h 7 `, �' t " ,c ,•�a "„ "G
Mechanical Permit Application -, • ∎ OR OFFI CE , USE c1ca ,r ONLY Y
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_` City of Tigard Date/By: Received Permit No.: I t eC g 3fg
1 114
13125 SW Hall Blvd., Tigard, OR 97223 v
Plan Revr• N Other Permit:
Ph one: 503.639.4171 Fax: 503.598.1960
C (
D ate/By.
T I G 'A R'D Inspection Line: 503.639.4175 Date ' ad /By: tuns: Internet: www.ti ard - or. ov Notified/Method: S See Pent l I nr
--
g g Supplemental Information
TYPE OF - COMMERCIAL FEE * - SCHEDULE .— USE CHEC
❑ New construction al Additio /alteratio /r placement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION . Value: $ 3��, Q
' RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial ' dustrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION . ; Y1S Heating/cooling
•
Q� r D Air conditioning or heat pump
Job site address: s (p0 � 3 ) 0 er'x f s 1 f2 (requires site plan showing placement) 14.00
City /State /ZIP: C (.Ct/t't0 Furnace 100,000 BTU (ducts /vents) 14.00
r Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Pro' t name
d Y J(?ti\ l /) a 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
•
/ Q Q- Gas fireplace 10.00
ram �3JPJJ, f JC)7t Flue vent for water heater or gas
O, p . . /i. ID re � -b l � fireplace 10.00
C� Log lighter,(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
ROPERTY OWNER ❑ TENANT Other: 10.00
Name: P tl /aa Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City /State /ZIP: 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
,I ,.1n /� r Other: 10.00
Business name: T'i Vt t , v ... 0 .-- Fuel piping
Contact name: lz.„YLQ l V Q_v- vie,- $5.40 for first four; $1.00 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
Clothes dryer (gas)
Business name: 41---ti 0_, t Other:
r
Address: 5 . �- St i IA )(K-/ MECHANICAL PERMIT FEES* •
City /State /ZIP: E" I L. Lwn 1)-1r C.A., O t lm Subtotal
/ / ` / Minimum permit fee ($72.50)
Phone: (7 / �) 10,� _ Li-D_ Fax( J ) ya,D_ 6653
Plan review (25% of permit fee)
CCB lic.: .60' 1 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: � / MI This permit application expires if a permit is not obtained within 180
I/l Q�L/�� iVt�'d days after it has been accepted as complete.
Print name: .h f t -2--' O tor so in Date: 712_10 • Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permits\MEC - PermitApp.doc 01 /19/07 440- 4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
.Tota1`Valuation :. Permit. Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2
CITY OF TIGARD 0
BUILDING DIVISION. y . . PERMIT #: MEC 00a-OU348 •
13125 SW Hall Blvd., Tigard, OR 97223:.. DATE ISSUED: 7/3/2008
Phone: (503) 639 -4171 .11411 H1�li,l
Inspection Requests (24 Hrs.): (503) 639 - 4'175 gh!*- F d �., •
INSPECTION WORKSHEET FOR DATE, 2(131 1)09 TIME: 7 :00AM PAGE: 5
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 200 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE.. LOT #: TYPE OF USE:
PROJECT NAME: OREGON STATE . .
DESCRIPTION: Fan powered box for reception area. ,Project Value: $3,000.
OWNER: OPUS NORTHWEST, PHONE #:
CONTRACTOR: HVAC INC PHONE #: 503
Inspection Request Scheduled For: Date: 211312009 Pour Time:
Code # Inspection Description . Confirm # Contact # Mess.• -
699 Mechanical final 080536.01'. • 503-459-9226 ; - lot Urz
Corrections /Comments / Instructions:
•
•
- -) y
0 PASS ' i "ARTIAL APPROVAL 111 CANCEL 0 NO ACCESS
Mr pall CALL FOR INSPECTION 7 . AD D ITIONAL FEES ASSESSED
Inspector: _ 4 � � - - Date:. L.- Phone #: (503) 718- Z
® .