Permit CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00103
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/11/2011
Parcel: 1 S134AA01800
Jurisdiction: Tigard
Site address: 10220 SW NIMBUS AVE K12
Project: Westside Economics Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project Description: Push /pull 3 ton RTU
Contractor: WILLAMETTE HVAC Owner: ROBINSON, CONSTANCE A &
3075 SW 234TH AVE. #206 ROBINSON, LYNN ET AL
HILLSBORO, OR 97123 BY KG INVESTMENT MGMT
10240 SW NIMBUS AVE #L3
PORTLAND, OR 97223
PHONE: 503 - 628 -6841 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/11/2011 $263.41
Class of Work: ALT Type of Const: Plan Review 03/11/2011 $65.85
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/11/2011 $31.61
Stories: Info Process /Archiving - Sm Sheet (up to 03/11/2011 $7.00
11x17)
Project Valuation: $7,000.00
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 $367.87
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 Noti ion Ce Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direr uestions to OUN• by • i g %.2.232.1987 or 1.800.332.2344.
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Issued y: � ` Permittee Signature:
7/ -
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 Applicati CEIVED FOR OFFICE, USE ONLY
City of Tigard Received
Date /By: /J Permit No.: 00 //� -4 ; 13125 SW Hall Blvd., Tigard, OR 97223 MAR 1 2011 Plan Review z� / Other Permit: tv
Phone: 503.718.2439 Fax: 503.598.1960 Date /By: oo
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: orris 116 See Page 2 for .
Internet: www.tgard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
fir,. GONiMEf2CIAL FEE ,SGFI>EDCiI E_ °— IISE CAECKI IS f
TY O W O € : ''' ° ,
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $7,000.00
v: .:,..,:,, • CATEGORY;:OF,CONSTRUCiIO
TN , ,> `k°«.:
:ca ., • :.. >,. ;:_ <.- :. �: �.� r<, .::,, ,,.:w >., • " .. ..:��. .EtC .,. . ., <Y .. , .a,t;�• .. 3J„ ,, ., , ,F... .,s� :�� �t3Ti S *� "'• ��,:
_ . , � = <, , RES1DElVTIAL E ,
^:, :, , ' , � , , _...,, Qs�.�P�MENT "I S YS T EMS;F E E -._ " .<s�,
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
"" '� ., S E` -, O M ON AND''• : ;z
::..,. JOB ITINF > R.. AT;,a, '.,. ; [ OGAT ,, rr ,:,.
,H Heating/cooling:
� Air conditioning
Job site address: 10220 SW Nimbus Ave (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City/State /ZIP: Tigard OR 97
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: K 12 Project name:Ir12.'''. (/t. Y ..— �I� & o � i 1 ` ft. Heat pump
(requires site plan showing placement) 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: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
,x;F; H i ,, 5,: 4d ft
��'.H, . :: bESCRIPTION .OF,- :,W,ORK � �� ^�;, Water heater 23.32 -' .
push /pull 3 ton RTU Gas fireplace 33.39
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
❑` OWNE12 ` ,,;t, ;'i ❑ =EN A144 W Chimney/liner/flue/vent
„ . < �w... Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
_# !:i'� "' " <" Attic/crawlspace fans 23.32
'i'��`� ❑;APPLICANT :�.. `, � =® <- .CONTA " °>; =sE:`;� P
....•. . � �:. ..,,,�, .�:,, " .. ,,,,,,,�,,; �....
Business name: same as below Other: 23.32
Fuel piping:
Contact name: • $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
' N
� • .:, Barb
COT?RACTUR�, x:; -: Barbecue
Business name: Willamette HVAC, LLC Clothes dryer (gas)
Other:
Address: 3075 SW 234 Ave Suite 206 414 %'•MEGHAIVICAL°PE MIT FEES* „, A:
City /State /ZIP: Hillsboro OR 97123 Subtotal
Phone: (503) 628.6841 Fax: (503) 848.2597 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: 56951 ✓ State surcharge (12% of permit fee)
g 1 \/ n (� ^ ( - TOTAL PERMIT FEE (
Authorized signature:
/ , ' C � This permit application expires if a permit is not obtaine within 180
days after it has been accepted as complete.
Print name: michael malstrom Date: 3/11/11 * Fee methodology set by Tri- County Building Industry Service Board
I \Building\Permtts \MEC- PermitApp doc 09/09/10 440 -4617T (11/02 /COM/WEB)