Permit a CITY OF TIGARD MECHANICAL PERMIT
.111 sz COMMUNITY DEVELOPMENT Permit #: MEC2010 00447
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2010
Parcel: 1S136AD04000
Jurisdiction: Tigard
Site address: 11527 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Spec Space
Project Description: Grilles and ductwork.
Owner: FEES
PACIFIC TERRACE COMMERCIAL LLC Description Date Amount
C/0 NORRIS & STEVENS, 621 SW MORRISON Permit Fee 09/08/2010 $87.48
SUITE 800 12% State Surcharge - Mechanical 09/08/2010 $10.50
PHONE: 503 - 223 -3171
Contractor:
OREGON HEATING & AIR CONDITIONING
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 $97.98
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 rr eg•n
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of/ e les
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
..111111111111111
Issued By ` �s er -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 roll Ol FIt l: (ist: ONLY
II City of Tigard i ; liffIEFINEE . u W
13125 SW Hall Blvd., Tigard, OR 97223 • . an Review �`
C ' Phone: 503.639.4171 Fax: 503.598.1960 REC Date/By: Other Permit: } U C c f 9 q
Inspection Line: 503.639.4175
Ill . A I , 1 Og g Ready/By: See page 2 for
Internet: www.tigard -or.gov c E p �� D ate .Iuris:
J Notified/Method: II Supplemental Information
TYPE OF WORK CI 1 O �G p S IO ' N COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
11 ``,,11 Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration /repient performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, yerhea , 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 I Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/ f-1) Air conditioning
Job site address: / / �-/ $ ,lj / / / /j (requires site plan showing placement) 46.75
City /State /ZIP: f /�,.th, ac Furnace 100,000 BTU (ducts/vents) 46.75
' , �6`r I Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: f Projectitame: 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
G i / 1 Flue vent for water heater or gas
J fireplace 23.32
fa, ' ,, 4 /) �) Log lighter (gas) 23.32
( / f -1 i'r' Wood/pellet stove 33.39
T `M 't Wood fireplace /insert 23.32
❑ PROPERTY OWNER 1 ❑ 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 e
APPLICANT CONTACT PERSON Ariic /crawlspace fans 23.32
23.32
Business name: , Fuel piping
to
PP g
Contact name: A / 44 514.15 for first four; $4.03 for each additional
Address: l / Fumace, etc.
Gas heat pump
City /State /ZIP: WaWsuspended/unit heater
Phone: (0 ) �G rb 2 Fax: : ( ) Water heater
,y Fireplace
/�
E -mail: . / [0 A&1 1 • r%)/ Range
(�
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
Other:
Address: �J 2 f/ MECHANICAL PERMIT FEES*
City /State /ZIP: v v J 6? ) 4 -- 't %/ / 7// 5 Subtotal
i V (/ Minimum permit fee ($90.00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: ( '2,4 �h State surcharge (12% of permit fee) 1, UM_ 11
TOTAL PERMIT FEE 9 ,qy
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: r 2-=17 Date: V1A) * Fee methodology set by Tri - County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440-4617T /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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