Permit CITY OF TIGARD MECHANICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: MEC2010 -00477
T t G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/08/2010
Parcel: 2S101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY
Subdivision: FARMERS INSURANCE Lot: 0
Project: Triangle Pointe
Project Description: Shell - Phase 2, lobby and restroom upgrades, 2nd floor.
Owner: FEES
TRIANGLE POINTE LLC Description Date Amount
901 NE GLISAN ST #100 Permit Fee 10/08/2010 $14,925.27
PORTLAND, OR 97232
Plan Review 10/08/2010 $3,731.32
PHONE: 503 - 297 -8791 12% State Surcharge - Mechanical 10/08/2010 $1,791.03
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222
PHONE: 503 - 462 -4822
FAX: 503 - 462 -6555
Type of Use: COM
Class of Work: ALT Type of Const: IB
Occupancy Grp: B Occupancy Load:
Stories: 4
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm: 69
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: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $20,447.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units: 1 BUP Bolts in Concrete
Gas Outlets: Other Desc:
Duct Work: 69
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
iss •r i • ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
ility Notification Cente . Those • les 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 OUN • call g 03.246.6699 or 1.800.332.2344.
Issued By: 11
vet fi / Permittee Signature: / � / ..I
Call 503.639.4175 by 7:00 a.m. for an inspection that business • .10!
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 Applicati ( FOR OFFICE liSl (I NI.1
City of Tigard I'�ECE'IVE� Re e d q /D Permit No.: J 1t ! Ave. C 6'V7 0/9 a 13125 SW Hall Blvd., Tigard, OR 97223 l
Plan Revie • • i • r
C Phone: 503.639.4171 Fax: 503.598.1960 :� a v 2 a 1 U Date/By: , if 'O I o (O Other Permit: p �fb �/ U 0� �•
T I GAR D Inspection Line: 503.639 Date Ready/By: luris: ® See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/M� 1! \ id 377 =( Supplemental Information
BUILDING DIVISION 11 - OTT
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El New construction SI 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: $ S'�l i "l VO • '09
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. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: \' '3 S W \O s .i-vx p \ �, f{ Air conditioning or heat pump
_ _ 1 (requires site plan showing placement) 14.00
City / State/ZIP: A c\cwV l ON?_ 11 '_3 v _Fumace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: I Project name: f �) 1� / f7 V ID p iV4- SV V ( Gas heat 100,000+ BTU ( ducts/vents) 17.90
'- . - " "` 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: I 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
n`' Gas fireplace 10.00
�1y� S k(U� �� �1 \A AA I v 1 �/ r �) S Flue vent for water heater or gas
C , 1 S , i fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent
10.00
❑ PROPERTY OWNER I 0 TENANT Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State/ZIP: 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: • a A V i r l� ' �� Fuel pipi
Contact name: - _ R k o` . t — $5.40 for first four; $1.00 for each additional
1 - Furnace, etc.
Address: 1 l ib Ci S�� r I O V V �" Gas heat pump
City /State /ZIP: ' 1 1W Dlvlt\� 'Q 01--)---3.---?!--01--)---3.---?!--- Wall /suspended/unit heater
Phone: (S \4\j 41 - y)/ Fax: : ('s3) 4 b' \ ( Water heater
Fireplace
E -mail ' � D�y apV�v (� (A� Lbr l V� Range
CONTRA OR Barbecue
Business name: I A A ) p c , s - v , V Clothes dryer (gas)
Address: I �' D ( r' /\,x } MECHANICAL PERMIT FEES*
City /State /ZIP: t WI J W /0 v � X Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB Iic.: c0 vcn State surcharge (12 %ofpermit fee)
'n Q IT
Authorized signature: 1 1 0 � 1 , v l ( At This permit application e pi OTAL if a pe r mit isI not obtained
F EE within 180
_ Ail after it has been accepted as complete
Print name: b I $� 1 /19/07 r , Date: '��
• Fee methodology set by Tri-County Building Industry Service Board
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