Permit "'
- CITY OF TIGARD MECHANICAL PERMIT
Ip
r 5 ; >: COMMUNITY DEVELOPMENT Permit #: MEC2010 00384
Date Issued: 08/03/2010
TIGARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72ND AVE 200
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Sunset Mortgage
Project Description: Relocate grilles
Owner: FEES
PACTRUST Description Date Amount
15350 SW SEQUOIA PIM/Y SUITE 300
Permit Fee 08/03/2010 $201.07
PORTLAND, OR 97224 12% State Surcharge - Mechanical 08/03/2010 $24.13
PHONE: 503 - 624 -6300
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 $225.20
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 �x,80 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted .y the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may o'. = in . opy of the rules
or direc stioQ€ oaU1 C b .11 g 503.246.6699 or 1.800.332.2344.
Iss ed By: ' ... ` � ,
Perm ittee Signature: 1"
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 r c)Hrlc:I. usL t)NI. -
• City of Tigard ECEIVED Date/By: $ . to l p �00
Permit No.:
n 13125 SW Hall Blvd., Tigard, OR 972
lig Plan Review
C -
Phone: 503.639.4171 Fax: 503.598.1960 y : Other Permit:
Date/
B: i G A I , i� Inspection Line: 503.639.4175 Al o 0 3 l 0S Date Ready/By: 1 n�9:
Internet: www.ti ardor. ov S See Page l Information P> g Notified/Method: Supplementalnformation
CIT Q --- DIN AI oN
TYPE OF � I
Y! .COMMERCIAL 'FEE* SCHEDULE — USECHECKLIST
Mechanical permit fees* are based on the value of the work
El New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labo , ovveerrhheeaadd, and profit.
CAT ORY OF CONSTRUCTION
Value: $ ���`�
RESIDENTIAL EQUIPMENT / 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. l Total
JOB SITE INFORMATION AN LOCATION Heating/cooling
/ /® s/ 7 %�'
Air conditioning
Job site address:
lL7l (requires site plan showing placement) 46.75
City /State /ZIP: 1 Or-- Fumace 100,000 BTU (ducts/vents) 46.75
Suite/bldg. /apt. no.:/�/v ProjeEt name: ,�M,�J` Fumace 100,000+ BTU (ducts /vents) 54.91
Sv,L�!�! Heat pump 61.06
Cross street/directions to job site: I Duct work 23.32
07. f ,/� Hydronic hot water system 23.32
./ 3 J am— 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
e)/4;,b4 Gas fireplace 33.39
RA"(
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWNER 1 ❑ TENANT Chimney/liner/flue/vent 23.32
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
\APPLICANT CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: /�� //��
ti i f 14 6, Fuel piping
Contact name: M -ir 1 - i A /(/ $14.15 for first four; 54.03 for each additional
Address: n �� Furnace, etc.
. 2 � Gas heat pump
City /State /ZIP: 4/n q/ ' 2/ WalVsuspended/unit heater
Phone: (j'i S3 66// // '71c -- Fax: : ( ) Water heater
t�//'''� // Fireplace
E -mail: i .% It Il/ / / — v Al Range
CO '' RACTOR Barbecue ,
•
Business name: Clothes dryer (gas)
Other:
S �7� `L
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: r Subtotal A� 07
Phone: 0 ) r 7 — Ki0� Fax: ( ) Minimum permit fee ($90.00)
vv [[ Plan review (25% of permit fee)
CCB tic.: 1 3,/z4, State surcharge (12% of permit fee) gq. 13
TOTAL PERMIT FEE 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: e.i. t u s � i �, 1 Date: pt, ' Fee methodology set by Tri- County Building Industry Service Board
IA Buildineermits \MEC- PermitApp.doc 10/01/09 44 1Tr(II/0 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.
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