Permit CITY OF TIGARD MECHANICAL PERMIT
a
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00188
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/15/2009
Parcel: 2S114AA00200
Jurisdiction: Tigard
Site address: 16285 SW 85TH AVE 403
Subdivision: DURHAM HALL BUSINESS PARK Lot: 0
Project: Souper Natural Pepper Heads
Project Description: Extension of existing gas line with (6) outlets.
Owner: FEES
SHIPMAN, W H LIMITED Description Date Amount
BY NORRIS & STEVENS INC, 621 SW Permit Fee 05/15/2009 $72.50
MORRISON STE #800 Plan Review 05/15/2009 $18.13
PHONE: 12% State Surcharge 05/15/2009 $8.70
Contractor:
LOOMIS HEATING & COOLING
15811 SE HAWTHORNE CT
PORTLAND, OR 97233
PHONE: 503 - 253 -7990
FAX: 503- 257 -2328
Type of Use: COM
Class of Work: ALT Type of Const: VB
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 $99.33
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 6 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 wor not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fo • the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0101 ou may obtain a copy if the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/ I Issued By: ` ` l 41 , , I \ + Permittee Signature: ' y/ ,
Call 503.639.4175 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 proje
Approved plans are required on the job site at the time of each inspection.
SJrt, •% N QiL o
Mechanical Permit A licatio FOR OFFICE USE ONLY
CENED Received tt��
City of Tigard Date/By: le, D - e '- Permit No.: lie , /SlV
y: s, V O
III • 13125 SW Hall Blvd., Tigard, OR 97223 7
_ Phone: 503.639.4171 Fax: 503.598.1960 APR 3 0 2009 Plan Review D/. ` 1 Other Permit:
Date/By:
T I G A R D Inspection Line: 503.639.4175 Date Ready :y: 0 See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: f !6%' Supplemental Information
BIJU.DINC DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction U Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
o
Value: $ `�
CATEGORY OF CONSTRUCTION CJ
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling q 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
Job site address: / ep. f Air conditioning or heat pump
/ 6 ) g S 5 W ZS Q Q 0 __ 1; 7 /O "3 (requires site plan showing placement) 14.00
City /State /ZIP: ' Furnace 100,000 BTU (ducts /vents) 14.00
T, r n.g.1-3 n2 9
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: ` :.2 OPAIIIIi
�_ _ :. o s /..� Gas heat pump 14.00
Cross street/directions to job site: atia U G /1. 0 � f / Z Duct work 10.00
� I Hydronic hot water system 14.00
14 1 /i Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: 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
�l / O CL _ Gas fireplace 10.00
) = X 7k) 5 I e l P Q t t lJ e, LAY ( T S Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent _ 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
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:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range ,'
CONTRACTOR Barbecue
s'
Business name: L 1-1- Clothes dryer (gas)
h el a il. S 1F ATI a 6 9L rQ0 t-; x: Other: • Z
Address: ' 5t /1 S 1= (. r, t4 D n fr 1K C,-)--- r MECHANICAL PERMIT FEES*
City /State /ZIP: I ) a Zrl� 1) /L 172'73
Subtotal
Minimum permit fee ($72.50) 7 5T)
Phone: (S O > ) ) 2 5 ° 3 -7990 Fax: ( go, ) 2s 7. 2'3 2 0 6 Plan review (25% of permit fee) 1$ , I i
CCB lie.: ( / i& State surcharge (12% of permit fee) _
,>
TOTAL PERMIT FIfjE qq . '3
Authorized signatur
This permit d ys after expires if a permit is not obtai has been accepted as complete. wrthin 1
° � -1 _ __ _
Print name: 33 Ir .) Lb a Ss Date: ti _ 7T - b 9 * Fee methodology set by Tri- County Building Industry Service Board
\
I:\Building\PermitsMEC- PermitApp.doc 01/19/07 440- 4617T (11 /02 /CO 1 M /WEB)
P -
Mechanical Permit Application - City of Tigard .
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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