Permit CITY OF TIGARD MECHANICAL PERMIT
.71
COMMUNITY DEVELOPMENT Permit n: MEC2010 00437
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/01/2010
Parcel: 2S 101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 200
Subdivision: TRIANGLE CORPORATE PARK Lot: 2
Project: HeafthNet
Project Description: Relocating ducts and Grilles.
Owner: FEES
GK TRIANGLE CORPORATE PARK III L Description Date Amount
BB# 73- 1771- GK1130, CBRE, PO BOX 2096
WARREN, MI 48090 Permit Fee 09/01/2010 $601.71
12% State Surcharge - Mechanical 09/01/2010 $72.21
PHONE:
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202
PHONE: 503 - 239 -4600
FAX: 503 - 239 -7038
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 $673.92
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 of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. I
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Issued By: Permittee Signature: J /��
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.
V
Mechanical Permit Application iolz OFFICE USE ONLY
City of Tigard Re . EZIINFAM
III n 13125 SW Hall Blvd., Tigard, OR 97223 RECEIVE y / �" ��
Phone: 503.639.4171 Fax: 503.598.1960 Pl an R eview
Date/By: Other Permit: 4 /
T i C. A Kr) Inspection Line: 503.639.4175 O Date ReaedyBethod: y: ® See Page 2 for
1 �
Internet: www.tigard - or.gov SEA ��o Notifid/M Supplemental Information
TYPE OF WORK CM O 1 1 � I oN COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
El New construction [t] Addition /alterationr���llfYtCfli" D PI 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: $ +). ( I( ) J
RESIDENTIAL EQUIPMENT / JYSTEMS FEES*
❑ 1- and 2- family dwelling Q ommercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - famil ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / 32 .2.1 51A/ (0 S - ' /3 r• kV 4 )/ (re qg Aiconditioning
uires site plan showing placement) 46.75
City /State /ZIP: T ��JJ
i , .01 r C.I JJ a g 17223 Furnace 100,000 BTU ( ducts/vents) 46.75
e� H �hn e 7` '
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Proj 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 -
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
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
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
✓
J 1 Other: 23.32
Business name: A m e r- 1 G aJ r7 /"I a G L / / / ✓! q Fuel piping
r Contact name: f� r ei cJ M A h G k e S + C /^ $14.15 for first four; $4.03 for each additional
I> // / Furnace, etc.
( Address: / 33 9 s E (O I U e O ri S Gas heat pump .
0— r . City /State /ZIP: for* /a , I U t'? 2 97 Z 02.. Wall/suspended/unit heater
Phone: (5o3)23 ,OO Fax: :(5o3)23'7 -703 Water heater
I %" Fireplace
v E -mail: Range
CONTRACTOR
r� TOR Barbecue
Business name: A rn e r 1 c 0 0 !� ea) ' r I Clothes dryer (gas)
Other:
Address: X33 c7 5 E (2 I (: J e 0 el 5 MECHANICAL PERMIT FEES*
City /State /ZIP: ?Or+ land 0R c117202 Subtotal (Q0 tt '7(
Phone: (5o3) 239- 000 Fax: (503 ) 2 $ Minimum permit fee ($90.00)
7 Plan review (25% of permit fee)
CCB lie.: 33 135 State surcharge (12 %ofpermit fee) 704. a1
TOTAL PERMIT FEE (6,1),
�JQ �,J This permit application expires if a permit is not obtained within 180
Authorized signature: /"+� / � G days after it has been accepted as complete.
I3 /►�l es f I - - _
Print name: pr/G ,4 C /" 1 Date: �I f Fee mg thodology set by Tri- County Building Ind try Service Board
(/ / 1 \`
I: Building (Permita(MEC- PermitApp.doc 10/01/09 440- 4617T(II /O2ICOM/WEB) \ 1 � � t . -757. I l
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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 $1 00.00 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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