Permit q CITY OF TIGARD MECHANICAL PERMIT
�F'! : COMMUNITY DEVELOPMEN Permit #: MEC2009-00648
T1. 'r 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/17/2010
Parcel: 2S 101 AC00400
Jurisdiction: Tigard
Site address: 7095 SW GONZAGA ST
Subdivision: Lot: 0
Project: NATIONAL SAFETY BUILDING
Project Description: HVAC for new office building.
Owner: FEES
NATIONAL SAFETY COMPANY Description Date Amount
17010 SW WEIR RD
BEAVERTON, OR 97007 Permit Fee 02/17/2010 $1,058.91
Plan Review 02/17/2010 $264.73
PHONE. 12% State Surcharge - Mechanical 02/17/2010 $127.07
Contractor:
TOWN & COUNTRY HEATING INC
6101 NE 127TH AVE SUITE 200
VANCOUVER, WA 98682
PHONE: 360- 892 -8280
FAX: 360- 256 -5886
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Occupancy Load:
Stories: 2
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: 3 Vent Systems: Total $1,450.71
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 4 Other Desc:
Duct Work: 1
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. n
Issued By: a_41. 1 -' :. �. ` Permittee Signature: , I \ n ^ App
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 'YJ N
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 FM USE ONLY : • :'
City of Tigard �CE � Received y: ` g t9 Permit c2€o' 8
, ° 13125 SW Hall Blvd., Tigard, OR Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ! Other Permit Q
Date /By: �∎ Z I V b u_p,Ree9 4°077
TJ , D Inspection Line: 503.639.4175 DEC 0 8 2009 Date Ready/By: / luris: RI See Page 2 for
Internet: www.tigard- or.gov / Notified/Method: A' (� Supplemental I format" .n
CITY OF TIGARD o , / se / - i , .. , - i :-rr ✓-- di--.
TYPE WILDING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
New construction ❑ Addition/alteration /replacement 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: $ 3? / 003
i RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - and 2 family dwelling '{/] Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
_Description Qty. Ea. Total _
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: 70a - S I G 0 N 2 AGA (requires site plan showing placement) 46.75
City/State/ZIP: /State /ZIP: Fumace 100,000 BTU (ducts /vents) 46.75
LL,,� � QQ Fumace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: 0 /JAN_ H'p'f Ty htz. 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
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
.- 07/t.SZ/, 7 L 2C/G7 A-64/c CO/ Flue vent for water heater or gas
fireplace 23.32
//) p /7 5/ -- /»CJr/ 6(l G// / CX/ ■-• A,fT/. r( cl U Log lighter (gas) 23.32
O/t/ /6/y(c: /14O 7/ n, ? /2,i 0/ 6_ L�G OG % /GAv Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
PROPERTY OWNER I ❑TENANT
Other: 23.32
Name: N.6/ 7 tL / C `., C J P Environmental exhaust and ventilation
Address: j✓ Range hood/other kitchen
701.0 5 kvZ )2 2 a equipment 33.39
City /State /ZIP: /3 eAvVill Div e/L 9 J y Clothes dryer exhaust 33.39
Phone: 2 _ Fa x: Single -duct exhaust (bathrooms,
(S 3) FY( Y� U ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
5ir7k Fu piping
Contact name: 5'k- Y h � $14.15 for first four; $4.03 for each additional
di/-/v
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: _ 6 Clothes dryer (gas)
to ' 6-- CGU / %/\ / /L/ �'/f. Other:
/ • Address: & /1i 7) 7y /4- * I 2-c),2 MECHANICAL PERMIT'FEES* . '
City /State /ZIP: tV A/c 0 0L 4 4._ t-.4 . gt�68L 3 Subtotal 4051/.`1/
Phone: ( —1 :2 / / r� • ' ,, Fax: ( Minimum permit fee ($90.00)
Plan review (25% of permit fee) A( 7�
CCB lic.: - G� /o State surcharge 12 of permit fee
/ / TOTAL PERMIT FEE / i '41s?".Z 1 -
This permit application expires if a permit is not obtained within 180
Authorized signature
days after it has been accepted as complete.
— 47)(.:7771 ` �
Print name: V� ,L Date: . 03 `Z * Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 10/01/09 440 -46t7T (1 I /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.
1•\Building\Permits\MEC- PermitApp.doc 10/01/09 2
CITY OF TIGARD hh c A-0-(XX A-0-( Le
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 u " agUN�ii�� j � l ' I 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3 blio TIME: PAGE:
SITE ADDRESS: -7 CLASS OF WORK:
SUBDIVISION: �V LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #: rl i- pi ID
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
a't01, (0 1.51,y)-5 (,,w C 0
Corrections /Comments /Instr tions: /
40
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cY-i,fre__..--Z_ -c' 7i . 3 - /6 - i _477 ,
b l/t- ci — ki/ & ( C-e,.4 I `S
n PASS n PARTIAL APPROVAL n CANCEL . n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: D ate: ' - / Phone #: (503) 718- � a