Permit u CITY OF TIGARD MECHANICAL PERMIT
I III It COMMUNITY DEVELOPMEN Permit #: MEC2011 -00107
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/17/2011
Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 16655 SW 72ND AVE 300
Project: Food Sales West Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Replacing (1) existing RTU and installing (1) RTU.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: PACIFIC REALTY ASSOCIATES
PO BOX 241 15350 SW SEQUOIA PKWY #300
DUNDEE, OR 97115 PORTLAND, OR 97224
PHONE: 503 - 691 -9699 PHONE: 503 - 624 -6300
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/17/2011 $538.21
Class of Work: ALT Type of Const: IIB Plan Review 03/17/2011 $134.55
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/17/2011 $64.59
Stories: Info Process /Archiving - Lg Sheet (over 03/17/2011 $2.00
11x17)
Project Valuation: $17,500.00 Info Process /Archiving - Sm Sheet (up to 03/17/2011 $18.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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: 2 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 2 Vent Systems: Total $757.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 4 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 thel rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You play obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. I
Issued By: Permittee Signature: r ` ' r
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 (SE oyl.v
_
City of Tigard Received -
ayi Date/By: / Permit No.: _
IIIII
• 1 SW Hall Blvd., Tigard, OR 97223 NEB Plan Review G j/ •
Phone: 503.718.2439 Fax: 503.598.196061 Date/By: _ IA i I Other Permit: & nat) — 00()?-0 I I n It I Inspection Line: 503.639 Date Ready/By: y: ® See Page 2 foo r
Internet: www.tigard- or.gov nR ` , Notified/Metho , /
/ Supplemental Information
/ V/ / f9' C...--
TYPE OF WORK F ' COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
c� N � r : f?1.x,1S`� Mechanical permit fees* are based on the value of the work
❑ New construction 'p Addition /alteration /repl performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ,.' ❑ Other: mechanical materials, equipment, labor, overhead, • s profit.
Value: $ l
_
CA EGORY OF CONSTRUCTION RESIDENTIAL EQUIPME / EMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: f ;- S� -2 2A-4 (requires site plan showing placement) 46.75
City /State /ZIP: /
/ ' v
Furnace 100,000 BTU (ducts/vents) 46.75
� f G/
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: v Project re901 c (.j� 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
4//ba ill 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:
DESCRIPTION OF WORK Water heater 23.32
®�� 1 t l� J Gas fireplace 33.39
/ �/ (/ & Flue vent for water heater or gas
a id< fireplace 23.32
Log lighter (gas) 23.32
&7 Wood/pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: ,G /"77 Environmental exhaust and ventilation:
Address: Pt(i.
y 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
) M APPLICANT CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: /�& 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: (f6 ) y t/ 1/ Fax: : ( ) Water heater
E -mail: : /u 7L � `� / /1 j �) ti, , L,f7� Fireplace
G-�l Range
CO CTOR Barbecue
Business name: 414 Clothes dryer (gas)
Vi/ Lj/ Other:
MECHANIC PERMIT Address: / T FEES*
City /State /ZIP: evr y' o✓ 67 7! / ' Subtotal
n) Fax: Minimum permit fee ($90.00)
Phone:
( 3 f ) ) f ( ) Plan review (25% of permit fee)
CCB lic.: ( 7 / -06 _ State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: C--'(// p l Date: (1 j * Fee methodology set by Tri -County Building Industry Service Board
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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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