Permit a CITY OF TIGARD MECHANICAL PERMIT
II I o COMMUNITY DEVELOPMENT Permit #: MEC2009-00300
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/25/2009
Parcel: 1 S 136 DD05300
Jurisdiction: TIGARD
Site address: 11850 SW 67TH AVE, STE# 110
Subdivision: TIGARD TRIANGLE COMMONS Lot: 13
Project: Grange Capitol
Project Description: Modify /alter ductwork for additional and new grid relocations. Add (5) supply diffusers,and (8)
return air grilles.
Owner: FEES
PNWP LLC#2 & Description Date Amount
PNWP LLC, 6600 SW 105TH AVE #175
Permit Fee 06/25/2009 $155.90
BEAVERTON, OR 97008 12% State Surcharge - Mechanical 06/25/2009 $18.71
PHONE:
Contractor:
ACCURATE HEATING INC
27350 SW 95TH AVE SUITE 3010
WILSONVILLE, OR 97070
PHONE: 503 - 650 -1229
FAX: 503 - 650 -4845
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 $174.61
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 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 of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /^ d3:0rv--j.(__ Permittee Signature: 7 c
Call 503.639.4175 by 7:00 a.m. for an inspection that business d .
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 OFFICI IJSl O�N�I.Y
R Fr'VE
City of Tigard ateByy: I , Permit No.: •` - 0 0 - 6c0
iii q 13125 SW Hall Blvd., Tigard, OR 97223 ,j U �) 2� 2 2009 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Inspection Line: 503.639.4175
Date/By.
l' 1 L. A It 17 C ITY OF T IGARD Date Ready /By: ling ® Page 2 for
Internet: www.tigard Notifie
BUILDING DIVISIO ` 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: $ $5,750.00
El 1 -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ® Commercial /industrial ❑ Accessory b uilding
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 11850 SW 67 Avenue Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Grange Capital 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
Gas fireplace 10.00
Modify or alter ductwork for additional and new grid relocations. Add (5) supply Flue vent for water heater or gas
air diffusers, and add (8) return air grilles. fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ® TENANT Chimney /liner /flue /vent 10.00
. Other: 10.00
Name: Grange Capital Environmental exhaust and ventilation
Address: 11850 SW 67 Avenue Range hood/other kitchen
equipment 10.00
City /State /ZIP: Tigard, Oregon 97223 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
Other: 10.00
Business name: Accurate Heating, Inc.
Fuel piping
Contact name: Kim Williams $5.40 for first four; $1.00 for each additional
Address: 27350 SW 95 Avenue, Suite 3010 Furnace, etc
Gas heat pump r •
City /State /ZIP: Wilsonville, Oregon 97070 Wall /suspended/unit heater
Phone: (503) 650.1229 Fax: : (503) 650.4845 Water heater
Fireplace
E -mail: service2 @accurateheating.com Range
CONTRACTOR Barbecue
Business name: Accurate Heating, Inc.
Clothes dryer (gas)
Other: -
Address: 27350 SW 95 Avenue, Suite 3010 MECHANICAL PERMIT FEES*
City /State /ZIP: Wilsonville, Oregon 97070 Subtotal
Phone: (503) 650.1229 Fax: (503) 650.' 844 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 88423 + / State surcharge (12% of permit fee)
I� �! / / /����� TOTAL PERMIT FEE b lu , w
Authorized sign .41W/ // / /'�i��lj��j/ - / � This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: in 1 7 j - /yl f Date: 06.22.09 • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building 'Permits\MEC- PermitAppdoe 01/19/07 440-4617T(11/02/COM /WEB)
'Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total 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.
I: \Building \Permits \MEC- PermitApp.doc 01/19/07 2