Permit CITY OF TIGARD MECHANICAL PERMIT
II q Permit #: MEC2011 -00129
g COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/08/2011
Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 16655 SW 72ND AVE 400
Project: Micro Interconnects Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Add (1) new RTU, replace (1) RTU, ductwork and gas lines.
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 04/08/2011 $703.31
Class of Work: ALT Type of Const: Plan Review 04/08/2011 $175.83
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 04/08/2011 $84.40
Stories:
Project Valuation: $24,000.00
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: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $963.54
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 foil the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in • • - • e . -0010 through OAR 952 - 001 -0090 ou ma ain opy of the rules
or direct questions to 0 C by calling 503.232. : r c c
Issued By rmi' ignature:
Call 503.6 "" •y 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 2 �} FOlz OEPIC. I s1: OyLv
14 City of Tigard 2 ECEIVED DateB p1 �7 PermitNo.: /l % i t /� �Dla�
• 13125 SW Hall Blvd., Tigard, OR 972 Plan Rev
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
1 1 t i A It I) Inspection Line: 503.639.4175 1 F; R 2 9 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF RRIPOIN(i DIVISION 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, labof, overhead, and profit.
Value: $ / fr" /)
CA ORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SISTEMS 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. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
1
Air conditioning
Job site address: (45 t Lj 1 f' Vi #W (requires site plan showing placement) 46.75
City /State /ZIP: t / v / Furnace 100,000 BTU (ducts/vents) 46.75
�l f Y / Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: m Je/i /,ry/,/�7 Heat pump
site p Ian showin placement) g P
_ 4 (requires 61.06
Cross street/directions to job site: Duct work 23.32
,O 44"'i' 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:
DESCRIPTION OF WORK Water heater 23.32
/� ,,, I if f Gas fireplace 33.39
( �L✓ /` Flue vent for water heater or gas
h f / in1� fireplace 23.32
{ /�! Log lighter (gas) 23.32
( fi Wood/pellet stove 33.39
R Wood fireplace /insert 23.32
PROPERTY OWNER I ❑TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: /J�y �t/ �(4 ' Environmental exhaust and ventilation:
Address: // ! �� / J 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
/APPLICANT A CONTACT PERSON Attic /crawlspace fans 23.32
Business n Other: 23.32
Fuel piping:
it
Contact name: C' It
)�t, $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: (�,'3 Q�V2/ Fax: ( ) Water heater
G� l / Fireplace
E -mail: l f N f � i �l , UI I t eift Range
[� CONTR Barbecue
Business name: A Clothes dryer (gas)
P7) 6-1, ^ , , ! / Other:
Address: (�'` MECHANICAL PERMIT FEES*
City/State /ZIP: t ii)4 r. /. C .7 14 l 0- Subtotal
Phone: (95) s� g In 5.3 Fax: ( ) 1� Minimum permit fee ($90.00)
✓ Plan review (25% of permit fee)
CCB lie.: 17 21 '7 4e State surcharge (12% of permit fee)
+ 2 TOTAL PERMIT FEE (p :5-1 Authorized signature: �/ This permit application expires if a permit is not obtained wi in 180
C days after it has been accepted as complete.
Print name: __ P4 .4 L411 )4- IJ / Date: 50/// * Fee methodology set by Tn- County Building Industry Service Board
I:\Building\Permits\MEC Permit .doc 09/09/10 440 /WEB
APP 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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