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Permit
Ph x w k. CITY OF TIGARD MECHANICAL PERMIT q 11 COMMUNITY DEVELOPMENT Permit #: MEC2010 00366 ` Date Issued: 07/27/2010 -2T f GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S 102AA01100 Jurisdiction: Tigard Site address: 12047 SW PACIFIC HWY Subdivision: Lot: 0 Project: Tigard Auto Stop - Brake Team Project Description: TI - (2) unit heaters, (3) electric unit heaters and demand ventilation w /fan. Owner: FEES TIGARD AUTO STOP PARTNERS Description Date Amount 2829 RUCKER AVE STE #100 Permit Fee 07/27/2010 $288.70 EVERETT, WA 98201 Plan Review 07/27/2010 $72.18 PHONE: 503 - 796 -2887 12% State Surcharge - Mechanical 07/27/2010 $34.64 Contractor: OREGON HEATING & AC PO BOX 241 DUNDEE, OR 97115 PHONE: 503 - 691 -9699 FAX: 503- 691 -8556 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 -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 $395.52 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 day of issuance, or if warkis suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the rego Utilit otification Center. os les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a py her s or erect questions to OUNC calli g 56 .246.6699 or 1.800.332.2344. 0 I ued By: _ / 4 i 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. Mechanical Permit Application I (iz of l icE US :UNL • Received Ill City of Tigard Date/By: No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1 1/ • Phone: 503.639.4171 Fax: 503.598.1960 Date/By: ' rA Other Permit: II(' A It D Inspection Line: 503.639 Date Ready Juris: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information • . TYPE OF WORK . COMMERCIAL FEE* SCHEDULE - USE CHECKLIST • ❑ New construction [ Addition/alteration/replacement 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: $ RESIDENTIAL EQUIPME / SYSTEMS FEES* ❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total (7 ,08e7 JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 4..L__6,-7/5— �j /,, / Air conditioning 5 f& fll/' f v - (requires site plan showing placement) 46.75 City /State /ZIP: 0,- 111 Furnace 100,000 BTU duds /vents) 46.75 ' 1 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Pr name: ��4-el"-1,- Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 G"O.LM 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 0. 1/1.4 7 Gas firepla 33.39 • l�'' � IP �"' Flue vent for water heater or gas -2-- U y4� �gi+4'c4't L l igh 23.32 Log lighter (gas) 23.32 • , e,�,e -, . (A/14 1-g ' - t: - Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32 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 Business name: /�] w u Other: 23.32 V Nlti r i Fuel piping Contact name: / 4 L , ' ( $14.15 for first four; $4.03 for each additional Address: `�f Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater Phone: (co", ) ear 1 Vi /f Fax: : ( ) Water heater ` Q Fireplace E-mail: /► (s - f © o F e tt 1�-6 . c/ 0-1-.--, Range - CON C T OR • Barbecue Business name: 0 l>1- Clothes dryer (gas) Other: Address: PO f� 2)-11 MECHANICAL PERMIT FEES* • City /State /ZIP: Q� w � or 1) )( Subtotal Phone: (�j S "✓ de /LC +" Fax: ( ) / Minimum permit fee ($90.00) )) Plan review (25% of permit fee) CCB lic.: I 1 ..2 State surcharge (12% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: C,,,,,- ) days after it has been accepted as complete. Print name: - (`t' - 1 0 Dater /Zj5 / 1! d * Fee methodology set by Tri-County Building Industry Service Board I:\Building\Permits \ [NEC- PermitApp.doc 10/01/09 440-4617T (11 / / / / 07/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. 1: \Building\Permits\MEC- PermitApp.doc 10/01/09 2 Building Division Over- The - Counter (OTC) Mechanical Permit T i c n u Check List Description of Project: Tt GENERAL INFORMATION Class of Work:* /k ix Floor Furnace: Evap. Coolers: Type of Use:* � L Unit Heaters: Vent Fans: Occupancy Group: Vents w/o AppL: • Vent Systems: Stories: 1 Boilers, Comp, Heat Pump, A /C: Hoods: Fuel Types: 0 - 3 HP: Domestic Incinerator. ELC / GAS / NG / OIL / OTHER 3 - 15 HP: Com. /Ind. Incinerator. Max Input: BTU: 15 - 30 HP: Repair Units: Fire Dampers: 30 - 50 HP: Wood Stoves: Gas Pressure: H / M / L >50 HP Clothes Dryer. No. of Units: Air Handling Units: Other Units: Furnace <100k BTU: <_10,000 CFM: Gas Outlets: Furnace ?100k BTU: >10,000 CFM: Notes: INSPECTIONS 1 FEES DUE Post /beam mechanical $ n Permit Fee Gas line $ .v, Y State Surcharge Mechanical rough -in $ 72 A Plan Review Fee Fire damper $ Additional Permit Fee Duct work $ Additional Plan Review Fee Smoke detector $ Investigation Fee Investigation inspection $ Misc. Fee Misc. inspection $ Hourly Rate Fee Final inspection $ Hourly Rate State Surcharge $ ‘3 Total Fees Due OTHER PERMITS REQUIRED Building Electrical Plumbing Site Work *OPTIONS: • TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo; FND = foundation; FPS = fire protection system; NEW := new OTR = other (use for fences; decks, retaining walls, signs, awnings or canopies); REP = repair. I:\Building\Forms \OTC - MEC.doc 09/22/06