Permit '4
W CITY OF TIGARD
. MECHANICAL PERMIT
ill COMMUNITY DEVELOPMENT Permit #: MEC201000009
TIGARD' 13125 SW Hall Blvd., Tigard:OR 97223 503.639.4171 Date Issued: 01/08/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9702 SW WASHINGTON SQUARE DR F10
Subdivision: Lot: 0
Project: Sprint
Project Description: Replace VAV and ductwork for TI. No plan review required per Dan Nelson.
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 Permit Fee 01/08/2010 $204.14
12% State Surcharge - Mechanical 01/08/2010 $24.50
PHONE:
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 $228.64
Hoods: Comm Incinerators:
Woddstoves: 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 • • • '` - •ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopt by the Oregon
Utili otification Center. •o = les are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may btain co of the rules
o sired questions "to OU • • cal'ng 503.246.6699 or 1.800.332.2344.
I sued By: I, / /Oa I L L� . 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.
l v � II , 1 i w 1�r4er a ° = dti T 1� ij1 T' ' `t ,, I :,q �� I , 7^' J. 9 • : I Vdechanical Permit Application , fi „u . - 7 + ),r ,!' i � !FO R,O VEICLM U SG ONL,v ° ,. � '' °" C " ;?
s' Re
City of Tigard Date/By. / ego Permit No.:
° 131 25 S W Hall Blvd:,
,T Olt .97223 REC d'X9
IIIII
Plaii Review
a D ateB � ,. d�
Ph 503.639.417:1 Fax: 503:598.1960 Other Permit: p (� ZQ�O Y u . ����.g
In'spechon Line: 503.639.4175 JAN O Q , Dat Read B Juris: 0 See Pa e2.for
T tGfiRD Ready /By: 1
Internet: www.tigard- or.gov Notified/Method: Supplementalanformation
CITY OF TIGARD ,
TYPE, "OF wo flL ING DIVISION =' ''COMMERCIAL FEE *''SCHEDULE - ,USER.CHECKLIST
Mechanical permit fees* are based on the of the work
El New construction Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all .
El Demolition
Other: mechanical materials, equipment; Tabor, overhead, and profit.
' '' CA )EGORY'DE CONSTRUCTION'. � � Value: $ �t_t�
_ . ,.
RESIDENTIAL _ ; EQUIPMENT / SYSTEMS':FEES* "`'
❑ 1- and 2- family dwelling Comrnercial/iridustrial ❑ Accessory building , .
For special information use check list.
❑ Multi - family ❑ Master builder ❑ Other: Description p Qty. I Ea. I Total
• JOB SITE`iINFORMATION AND LOCATION ,, • 1 Heating/cooling
Job site address: 77 fi #- Air fires ite p
(requires site plan showing placement) 46.75
t /
City /State /ZIP: 1 .4,, // / Furnace 100,000 BTU (ducts /vents) 46.75
7 Cam' 5 Furnace 100,000+ BTU (ducts /vents) 54.91.
Suite/bldg. /apt. no.: Project name: ��� 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 _ • , _ DESCRIPT ION OF WORK Water heater 23.32
' I n ' 1 /
Gas fireplace 33.39
bf lg' , V 4 U apt) (jflyf �az, i / j Flue vent for water heater or gas
f ( fireplace 23.32
Log-Iighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
P' ® PROPERTY. OWNS t ' Chimney /liner /flue /vent 23.32
o „r R, .: ®TENANT';, .' Other: 23.32
Name: Environmental.exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
.City /State /ZIP: Clothes, dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) _ Fax: ( ), toilet compartments, utility rooms) 23.32
ace
• "` APPLI ' . " "' .Attic /crawls fans 23.32
w ❑ CANT ; , , , iCONTACTPERSON : .,: P
Other: 23.32
Business name: bill �.
Fuel / �` t piping
Contact name: l 7 /l 114 ,4 A --h /' - $14.15 for first four; $4.03 for each additional'
Address: l 6 Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: Fax: Water heater
(SU3)� r� yy ( ) L Fireplace
Email: f�lL4.7L d� '' G, „7 )K t -v' Range
h , ( CONTRACTOR' -e Barbecue
Business name: Clothes dryer (gas)
Dom, l Other:
U
Address: 7) ( v1 / '3e7 • M ECHANICAL _PE RMIT'_FEES *' i
City /State /ZIP: w� 7 ,..z a c / C Subtotal
Phone: (f ) ,7ZJ 245'3 F ax: (5, S L,� 7 -7,..
Minimum permit fee ($90.00) A /r
Plan review (25% of permit fee) .0-•—
CCB lic.: / 2// ! j � State surcharge (12% of permit fee) a e/, TOTAL PERMIT FEE age • Of
This permit application expires if a permit is not obtained within 180
Authorized Signature: days after it has been accepted as complete.
.Print name: - (_ 1 , t___.,„ 7kLL2C__ 617
Date: //5/16' * Fee methodology set by Tri- County Building industry Service Board
,
:\Building\Permits \NEC- PermitApp.doc 10/01/09 440 T•(r1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
TotalYaluation I° :. Termit Fee ;, n =
$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 $1.00.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.7,1 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