Permit r ��
" III OF TIGARD MECHANICAL PERMIT
4. - COMMUNITY DEVELOPMENT Permit #: MEC2010 -00582
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2010
Parcel: 2S101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 320
Project: Golsan Scruggs Subdivision: Lot: 0
Project Description: Mechanical for TI. Moving grills.
Contractor: KEVIN FITZPATRICK PAINTING INC Owner: HILLTOP BUSINESS CENTER LLC &
3155 SW 234TH AVE STE A HUNZIKER LLC
HILLSBORO, OR 97123 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503- 649 -6422 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/16/2010 $145.81
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/16/2010 $17.50
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $3,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $163.31
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 at 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 -0090. You may obtain a copy of the rules
or direct questions 0 •'Z C by calling 503.232. • :00.332.2344.
Issued By: �, _ 'ermittee.Signature:
Call 5;�� by 7:00 a.m. for the next available inspection date.
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 OFFICE USE,ONLY
City of Tigard Received Date/By: ij 1 j� / U , Pennit No.: , (U _ .
° 13125 SW Hall Blvd., Tigard, OR 97 _
G = Plan Review
Phone: 503.639.4171 Fax: 503.598. Date/By: Other Permit: .1 / '
I I G A R D Inspection Line: 503.639.4175 Date Read B See Page ' f r
DU
VON 1 010 Ready /By: e
B
Internet: www.tigard - or.gov 6 L pn Notified /Method: Supplemental Information
TYPE OF WO QF � COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
�!� OW Mechanical permit fees* are based on the value of the work
❑ New construction [ Addition/alterati ent performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ P (
Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ ` j 1 rJ, G CJ
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling (Commercial /industrial ❑ Accessory building
V \ For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 73 2„6.-) f & /--4., 1 e ` 3 Z 0
Air conditioning
(requires site plan showing placement) 46.75
City /State /ZIP: / i5 4 r d > 97c Z 3 Furnace 100,000 BTU (ducts /vents) 46.75
3 ZG Project �r/ Caoe ,,5 T I Furnace 100,000+ BTU (ducts /vents)
Suite/bldg./apt. no.: 64.06
Pro ect name: L Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
L ^ Hydronic hot water system 23.32
7 tt'! ! f / C J ) / J /��j/ ✓1 ry S e-j in/ 194"X 94" r Residential boiler (radiator or
n e /e 7Z <4 J- L UN 7 J , l er hydronic) 23.32
�C 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
I / Gas fireplace 33.39
�
" /t�vr 5 r. ((s Cje-coty v'- c)r 1-r e 1.✓ TT 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
Chimney /liner /flue /vent 23.32
ROPERTY OWNER ❑ TENANT Other: 23.32
Name: k06r', 5 C1 (Cl/1 /--y,� c f t � ,V•. Environmental exhaust and ventilation
co l / / Range hood/other kitchen
Address:
2/ 3 (� AV r-✓ 4 ✓NI e- 1^t✓CZd equipment 33.39
City /State /ZIP: H, ///c,‘10 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (5 )C L/ _ 75 / Fax: ( ) toilet compartments, utility rooms) 23.32
C1 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
{ J ^ Other: 23.32
Business name: J < ' ( 6 /' vv ( eC i , t^CG, / Fuel t in
P�P g
Contact name: , C)Urs
/ /� ,...--k $14.15 for first four; $4.03 for each additional
3 2 i 5 ;E ' // / /r-r b/1/d p Furnace, etc. _
Address: rt t/— Gas heat pump
City /State /ZIP: lJ6,1 �, �' .t W/ 1-- .q e ,CY Wall /suspended/unit heater
Phone: (`3C0) G-/ 3 7 3 7 c 1 Fax: : (9 ) Cci 3 -7 7y(-7 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: r , C , C LA PG t t t q J Other:
Address: P 3/‘--5 - 6 - � 1./ 7
2 � ,�
- -/1 MECHANICAL PERMIT FEES*
'f(( L,� r _, /',j 7/ 2
Q £ - '3 Subtotal t(
City /State /ZIP: ,}.-/, / rim � �'V� � � I
SCJ3) g - C Fax: ( ) • Minimum permit fee ($90.00)
• Phone: (5-03 Plan review (25 /° of permit fee)
CCB lic.: S. 1 7(7 - dt5 11 State surcharge (12 °/n of permit fee) 17 5 0
TOTAL PERMIT FEE 3 1
This permit application days after it expires has been if a perm accepted it is as not compl obtai ete.
ned within 180
Authorized signature: G -�
P
Print name: CC, ,^ el"-�_ Date: //// 6 - * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permits'MEC- PermitApp.doc 10/01/09 440 -4617T (II /02 /COM /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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