Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00527
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/29/2010
Parcel: 1S 134AA01800
Jurisdiction: Tigard
Site address: 10200 SW NIMBUS AVE G1
Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project: Potters Hands
Project Description: Remove old 5 -ton gas pack and replace with new one.
Owner: FEES
PRINCIPAL LIFE INSURANCE CO. C10412 Description Date Amount
C/O KG INVESTMENT MGMT, 10240 SW
Permit Fee 10/29/2010 $319.61
NIMBUS AVE #L3 Plan Review 10/29/2010 $79.90
PHONE: 503 - 598 -9980 12% State Surcharge - Mechanical 10/29/2010 $38.35
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR #130
TIGARD, OR 97223
PHONE: 503 - 620 -5643
FAX: 503 - 681 -0793
Type of Use: COM
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: B Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas 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 $437.86
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OU C by calling 503.246.... -4 ±_ ��.. --
Issued By: / i Permittee Signature:
Ca I .639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
OCT/26/2010/TUE 08:30 AM FAX No, P, 002
Mechanical Permit ApplicatRECEIVEn FOR 0 FF1C E t1SE, °NEN'
Lif Received i
Date/BY: 0 26 /0 d
II City of Tigard I q 13125 SW Hall Blvd. Tigard, OR 97223 . -.-
^ C I 2 6 2010 pl.,,Revi.:„Itwjair:frim
. .
• • - • Phone: 503.639.4171 , •
Fax; 503.598.1960J Date/By: MfAvl_W ,../4 Other Pennit
_
Ins Line: 503.639.4175
T 1 GARD Date Ready :y: J...45 FZ1 See Page 2 tor
Internet: www,tigard CITY OF TIGARD Notified/Method: 10 If2.47/16 ; pee- Supplemental Information
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Mechanical permit fees* are based on the value of the work
o New construction Al Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition 0 Other: mechanical materials, equipment, labor yerhel profit.
.;':•:i;P.;!'-i.T.'.P.V,::'-...;:.::::$,;,,:!li'..1',.:i:',':::*iieklyrniiiiiiyik-463yglitilditi614,:::VN.;•••Ti.'Nli...:•,:.4.',;;:;,:.,, Value: $ 0 4 1 Z__ .--,
El 1- and 2-family dwelling jg COmmerCial/industrial I:I Accessory building
For special information use checklist.
1: Multi-family 0 Master builder 0 Other:
Description 1 Qty. 1 Ea. I Total
':..'. i'' difeigibWiltiklAi .4fitiR Heating/cooling
Air conditioning
Job site address: j(„,3 2_,00 stA) Ni ; leVX tA. s 4ve. (requires site plan showing placement) 46.75
City/State/ZIP: T 1 ‘ i cur Or 9 Z., Z.- 3 Furnace 100,000 BTU (ctuctsivents) 46.75
Furnace 100 000+ BTU (ducts/vents) 54.91
uit .Idg./apt. no.: 6-2 li .roject name: • els 1.1, s Heat pump 61.06
Cross street/directions to jOb site: 'J., ic , i F e, r( Nt ,,.% , 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 r any of above 23,32
Subdivision: Lot no.:
Other: • 4Q/C4,/lf_,- 1 1 23.32
Tax map/parcel no.: Other fuel appliance
f'mii'i111,,,`:'Ali,••'.,‘„ii:;•,:,, tyti*otiatiVaiM:; Water heater 23.32
•.,
%:•.,'1!:.1.:•:„'n:.1..,....r:!:N,.. 4,1, ' ,.. .,,,.......,......- ,2 , l•ri, 1-.- ,.i!Z.1:' .. Gas fireplace 33.39
12 e..rn ov c, c I c( S -1-o/N earl I 1 6 ?a. k. ,
Flue vent for water heater or gas
f 23.32
Gt.^ C ( repiC.C-€. i'-s- IN intk..) S 41 6-c.-+5 -,,t_1(,,. f
Log lighter (gas) 23.32
Wood/pellet stove 33.39 .
Wood fireplace/insert 23.32
'''''•'•••- • •' • • ---'" - 7'`'-'s:;i'ssi's.;4;",:i‘i'!',7moTi•LT4'..2i ,.. Chimney/liner/flue/vent 23.32
•''''••••-• -• 1 •‘---• -• Principal Life Insurance Co. C10412 23. _
C/O KG Investment Management
Name: ' '-•"' '''' ' ' -' • ' Other:
Environmental exhaust and ventilation
Range hood/other kitchen
Address: 10240 SW Nimbus Ave. Suite 13 _ equipment 33.39
City/State/ZTP; Portland, Or. 97223 Clothes dryer exhaust 33.39
(503)598 Single-duct exhaust (bathrooms.
Phone: ( ) toilet compartments, utility rooms) 23.32
4 . 0 ; 1:00(..ii .17 '..:••:fi:l' !:A.; Attic/crawlspace fans 23.32
_
Other 23.32
Business name: Fuel piping
Contact narne: S14.15 for first four; S4.03 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater , _ _
Phone: ( ) I Fax: : ( ) Water heater
, Fireplace _
E-mail: ,..,' fk...(54,3 .4101 i' 41/. ?.40 F Range
.•:.....2;.:•:.,i;::;,iiii.,.. ,•:n-1:-. t ::'::::.0"••;:q' ' • :::., ; ',' ' . ." 1 ': 2 :: ,: :*.Ti...i' Barbecue
Business name: specialty heating & Cooling, Inc. Clothes dryer (gas) .
Other. .
Address: 7500 SW Tech Center Drive #130 ..-:1.:.;!...t'''.:::...'.:•:.::-.7:',!..:.*010itg**it:F,X0k:::..-.••••7.:•.:.....,
City/State/ZIP: Tigard, Or. 97223 . Subtotal
Minimum permit fee ($90.00)
Phone: (503) 620-5643 Fax: (503) 681-0793 _ Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee),
(-4-...----' Th -
TOTAL PERMIT FE'Sfi 37 ,
Authorized signature: (,/L&.___9- 714,
This permit application expires If a permit is not obtained within 180
--1---1_-- Th days after it bite been accepted as complete.
Print name: Andrea Dripps Date: ( () 1 ,x..,L, / , 0 * Fee methodology set by Tri.County Building Industry Service Board
LouiiciintaPemtheasEc.nsrmitappooe tom me 440.4617T (1 I /02/COM/WEI))
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