Permit 1 Perm r CITY OF TIGARD MECHANICAL PERMIT
it , ' COMMUNITY DEVELOPMENT
it #: MEC2011 -00116
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/17/2011
Parcel: 2S101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 210
Project: Cornerstone Clinical Services Subdivision: Lot: 0
Project Description: Relocate (14) frilles, install zone dampers.
Contractor: RELIABLE MECHANICAL Owner: HILLTOP BUSINESS CENTER LLC &
13215 SE MILL PLAIN BLVD C -8 HUNZIKER LLC
VANCOUVER, WA 98684 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 360- 693 -7379 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/17/2011 $176.51
Class of Work: ALT Type of Const: Plan Review 03/17/2011 $44.13
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/17/2011 $21.18
Stories:
Project Valuation: $4,000.00
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 $241.82
•
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 No ation - -r. Th.. - ' les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct
'ft
to OU ■ • • calling 50 . 32.1987 or 1.800.332.2344.
Issued 3y: I■ / / Permittee Signature:
N .J....._7 _ kr
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
IrrI City of Tigard Date/By: d ��� Permit No. /�.aQ //
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review l Received '2
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Ins Line: 503.639 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
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: $ CA--e2
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / S YSTEMS F EES
❑ 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: 7 3 C v 75 7c ✓ /--/ 0 7, K ez- (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: ii' rcj CP Furnace 100,000+ BTU (ducts/vents) 54.91
. ( ' Suite/bldg. /apt. no. Project name: t�C�/1 i�/ � Heat pump
00 (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:
Oil) DESCRIPTION OF WORK Water heater 23.32
Move_ 7 t I / : S /1 ,,[J� /� Gas fireplace
foe 33.39
/�t/2� ( ir(�/' 11) L°� C, / -T � C � � Flue vent for water heater or gas
fireplace 23.32
. To 4,� 2 co--r ci.ionr � -/`s CIA r A"I' 5 1- v1_, .
Log lighter (gas) 23.32
Y V► U C l T Wood/pellet stove 33.39
Wood fireplace /insert 23.32
LA PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: &b1..l 4. C t ? t , t^., Environmental exhaust and ventilation:
Address: 2 CO / V (,/ A b � cJ l Range hood/other kitchen
y i r 7 /5 J } Z -1 Cl oth es drry er exhaust 33.39
33.39
City/State/ZIP: 0 ,,2. q./ Clothes dryer
( ) (-16 e3 6 7 Fax: ( )
Single-duct compartments, r (bathrooms, rooms) s, toilet corn artments, utili ro 23.32
4 APPLICANT
0 CONTACT PERSON Attic /crawlspace fans 23.32
�t ' � J ' q f C j / I-6.--C_ 23.32
Business name: / , / �° M e t�'i D� yl, GGy
Fuel piping:
Contact name: f � nI��/s� $1 4.15 for first four; $4.03 for each additional
Address: /3 2/S SE rt / 7 /0lO7• " h) ,(AA_ 7 ! -,3 #5) Furnace, etc
) Gas heat pump
City /State /ZIP: UG .. �� j �� G/' Wall/suspended/unit heater
Phone: (360) 33 y- / y /
Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
P • Clothes dryer (gas)
Business name: eJ , i v- a , f. c ,' 1 5
/ 5 2 3 Other:
3
Address: -4. -A, #.4- MECHANICAL PERMIT FEES*
ity /State /ZIP: H: !! •
/Is_ Subtotal ` ?G -S
Phone: ( _6l7 2 Z Fax: ( ) Minimum permit fee ($90.00) ,--•
Plan review (25% of permit fee) 0.13
CCB lic.: / g9a 3 5/ State surcharge (12% of permit fee) a, I , l
TOTAL PERMIT FEE aye. �e'L
Authorized signature: This p ermit a expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: a to rh - Date: 3/)7/// * Fee methodology set by Tri-County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 09 /09/10 440- 4617T(11/02/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.
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