Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 00002
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/04/2011
Parcel: 2S1 01 AD03500
Jurisdiction: Tigard
Site address: 6600 SW HAMPTON ST
Project: Quest Diagnostics Subdivision: Lot: 0
Project Description: Mechanical TI
Contractor: AMERICAN HEATING INC Owner: PACIFIC REALTY ASSOCIATES
1339 SE GIDEON ST 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97202 PORTLAND, OR 97224
PHONE: 503 - 239 -4600 PHONE: 503 - 624 -6300
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/04/2011 $291.51
Class of Work: ALT Type of Const: Plan Review 01/04/2011 $72.88
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 01/04/2011 $34.98
Stories:
Project Valuation: $8,000.00
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 $399.37
Hoods: Comm Incinerators: •
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 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 Notifi n Cente . 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 estions to OUNC b a ' • 513.232.1987 or 1.800.332.2344.
f
Issued �- ' f � / Permittee Signature: �r G M L S e �'
Call 503.639.4175 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
1 " City of Tigard C D Date/By: / saw PermitNo.: �7 . _ tlia,z
13125 SW Hall Blvd., Tigard, OR 972 23 C � plan Review a, ^ �
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: A f �� f ahe C p en ni t ' 1 . a, e t/
T I G A Il D Inspection Line: 503.639.4175 J A N 04 l G ',.1 Date Ready/13y: 1 - ® See Page 2 for .
Internet: www.tigard - or.gov �/�j ■/1� Notified/Method: Supplemental Information
. „,,:„.
... _..s ,TY _. ,:: DEWI : . -. r ` Co RCr ` *.S ,,,ULE.— USECHECI± ,IS' -'
Mechanical permit fees* are based on the value of the work
❑ New construction [�] A ddition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
• Value $ 8,OYac
_` : « <.a ''' iORX ' ' '' tiCUNSTRUC'`01 : .. ' tz . - r ` Y RtSilleitI 7 A L)r 011PM }T;$1(ST S, ��,
❑ 1- and 2- family dwelling L ] C ommerciaUindustrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
S s = J B `51 ORtl4AT[()NI ANDlI QCATIOIV i f f ig. o § r Heating/cooling
:a:h+ ... �?f,... . t� _ - r.. t ., _ 4; ', r . , -. r” +..•sCi . ........
Air conditioning
Job site address: Co Co 0 0 5 LA/ )4 hi p - to /1 S (requires site plan showing placement) 46.75
City/State/ZIP: Pa c --- f gel d 0R 9722 3 Furnace 100,000 BTU ( ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: f ` f oe 5' L D iG 4 r l 05 _ ,S Heat pump 61.06
Cross street/directions to job site: ` `J Duct work 23.3
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.3
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75 _
Flue/vent for any of above 23.32
Subdivision: l Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances
7~ r '' r P.s0i 'TI4j io) W0)<tIC` "x. g .,, ?,rF., Water heater 23.32
•
33.39
LL Gas fireplace
re O C q 7 1 n �() C , T [.) V r /c 7L0 `VI �[ G h Flue vent for water heater or gas
to rI/ J p fireplace 23.32
he w T / h o /. Pi 4/4 he W cf ni C p' S t Log lighter (gas) 23.32
(IOC f %e 4 -1-e -' Wood/pellet stove 33.39
• Wood fireplace/insert 23.32
❑)Q RTY . ),WNER a.(,� , ;.r } I ; ; , ,? r ,.. .r y , �.. _ Chimney/liner/flue/vent 23.32
. • , 23.32
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
`� Attic/crawlspace fans 23.32
ti U ' tr 4 r. A I IPMF,V 5 x5 ;,t W W. t A;.a rde ` ii ,2 - Other:
f a` - - -- J k._ , ...., s>, c , �r7^sl r rte. . , r x. t- -n , o.. ir ,A,... 23.32
Business name: �I me r I C. 0 7 n H y e cr f i hi Fuel piping
Contact name: gr tJ / ✓7 c. 17e S - f e e- $14.15 for first four; $4.03 for each additional
/ 3 3 9 1� e 0 r1
Furnace, etc.
Address: S E 6 5 t � a
Gas heat pump
City/State/ZIP: PO r->•- /an d o 97202_ Wall/suspended/unit heater
Phone: (5o3 )23.7- 'y(, 0 0 Fax: : (503) 239 -703 $ Water heater
Fireplace
E -mail: Range .
1i t tr" ;� t w - r - 4 w '+ r. . ,,' 1 i 1 _ a G s
f . Y w '- r i4 w , x- ,. - g.g_gf 4 ?- c Q., `...R, c ' b ?:. r _r �i t.�r ,.. y. a •, to t _ .c ._° Barbecue
w t g•
Clothes dryer (gas)
Business name: /fry) e r l C at f y Col O) I h _ Other:
Address: /33 7 SE tO 1 O r 1 J r , a ` � , S CA A f IO A i RMI7k 0 * , t
4
City/State/ZIP: Po r-1 l cyri J 0 g '17202 Subtotal • 5 `
Minimum permit fee ($90.00) ` '
Phone: (503) 239— L/000 Fax: (503 )23c7-703 8 - Plan review (25%o`'perinitfee) 7 .g
CCB lie.: 3'313 5 State surcharge (12% of ,termit fee) .
TOTAL PERMIT FEE , 3
This permit application expires if a permit is not obtain wit a
Authorized signature: fze ��� G 1 / days after it has been accepted as complete.
Print name: r f X1/1
f? JJ _ I Date: * Fee methodology set by Tri -County Building Industry Service Board
Gi/7G h �5 f G /'
t—r
I:\ BuildingTermits \MEC- PermitApp.doc 10/01/09 440 (11 /07/COM/WEB)