Permit p CITY OF TIGARD MECHANICAL PERMIT
1 ': COMMUNITY DEVELOPMENT Permit #: MEC2010 -00410
T [ G AR P 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/17/2010
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 7007 SW CARDINAL LN 105
Subdivision: Lot: 0
Project: Fax Back
Project Description: Install ductless a/c for server room.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 08/17/2010 $232.50
PORTLAND, OR 97224 Plan Review 08/17/2010 $58.13
PHONE: 503 - 624 -6300 12% State Surcharge - Mechanical 08/17/2010 $27.90
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 8 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 $318.53
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 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 o he rules
or direct
C5 ns to • b • C by calling 503.246.6699 or 1.800.332.2344.
Issued B / , 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 FoR offlcl: US ON1.\
v_
G l
City of Tigard Received
Date/By: (} I7 '1 f O Permit No.: H „ , (1) co g! h
:� ' Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review A. V
Phone: 503.639.4171 Fax: 503.598.1960 8 1711 , - Other Permit:
Tic; \ 1 , i , ) Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK 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: $ 5
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: 107
� S, f ��(�� � (requires site plan showing placement) 46.75
City /State /ZIP: -/ / ) 2.Q. Furnace 100,000 BTU (ducts/vents) 46.75
9,47//e/Y- Furnace 100,000+ BTU (ducts/vents) 54.91
�%lr Suite/bldg. /apt. no.: Project name: x h Heat pump 61.06
Cross street/directions to job site: Y Duct work 23.32
7 2
l'4. 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
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
00 0 f 1i' <1., y a (G 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 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
. je APPLICANT jai CONTACT PERSON . Attic /crawlspace fans 23.32
Other: 23.32
Business name: On A U Fuel t in
P�P� 1;
Contact name: C�j, t t r,-i L o 1. 4 0-- $14.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( 53) . 0 1 n f y Fax: : ( ) Water heater
1 Fireplace
E-mail: 0 L g ei/� � /L ..► J we j t ` y Range
'CONT MOR V Barbecue
a. Clothes dryer (gas)
Business name:
Other:
Address: ,t2 ( '-iii 7 � MECHANICAL PERMIT FEES*
City /State /ZIP: / /� � /i � p/ 71 / Minimum permit fee (u btota ) ,Z Sv
Phone: (�3) ('94'x , -p !�7 .---3 � 7 Fax: ( ) y g
Plan review (25% of permit fee) , /3
CCB lic.: r 7 2- 1 7,e, State surcharge (12% of permit fee) R 'I ,QO
19
TOTAL PERMIT FEE 3 g , j3
This permit application expires if a permit is not obtained within 180
Authorized signature:
d ays after it has been accepted as complete.
Print name: ri ,) `,� 'L , ^ f I �'/ J) 7 ) 0 $ Fee methodology set by Tri -County Building Industry Service Board
l Ai J Date: !? /
1:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440-017T( 1 /02/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 $1 00,000.00 $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