Permit CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00166
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/15/2011
Parcel: 25101 DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 165
Project: Workflow One Subdivision: 72ND AVE OFFICE BUILDING Lot: 0
Project Description: Mechanical for TI.
Contractor: AMERICAN HEATING INC Owner: PNWP LLC #2
1339 SE GIDEON ST BY PACIFIC NW PROP LTD PTNSP
PORTLAND, OR 97202 PO BOX 2206
BEAVERTON, OR 97075
PHONE: 503 - 239 -4600 PHONE:
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/15/2011 $173.44
Class of Work: ALT Type of Const: Plan Review 04/15/2011 $43.36
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 04/15/2011 $20.81
Stories:
Project Valuation: $3,900.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 - HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 - HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $237.61
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1 or 1.80' 32.2344. A ^ - //// Issued By :' .� Permittee Signature: •
' �� e�
Cal yr• .r < .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 Other Permit: �� 1 o Ol I I(1 l �l 0v1
III • City of Tigard c 1 »ateBy: Received Ll Permit No.: , l / ,
13125 SW Hall Blvd., Tigard, OR 97R\ 1 � �� '' -- ` Plan Review
= Phone: 503.639.4171 Fax: 503.5980 0 ' `� j L if _
Ins Line: 503.639.4175 ‘\R r ` Da teBy:
Inspection
T I G A R D P /\ �`1 Date Ready/By: H See 'age 2 for
Internet: www.tigard- or.gov G\ . k Q\ \I` 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, he ,and profit.
CATEGORY OF CONSTRUCTION Value: $ Vf
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling "Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION _ Heating/cooling
Job site address: 1 ' 5 3 ` J 5 � i (1 �j� Air conditioning
a 1 ^ (requires site plan showing placement) 46.75
City/State/ZIP: -1---1 a af 6 O e_ Furnace 100,000 BTU (ducts/vents) 46.75
t r (S"),0 Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: `' Project name: �� .n 0 k-X Heat pump 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
( DESCRIPTION OF WORK j Water heater _ 23.32
V A QA.', C ( ��1 ( ) ( ,O � a ( ) 0 L(Q/J FFlu f vent l for water heater or gas 33.39
4 ,.' `` all I fireplace 23.32
c:1_, c:1_, aft A �--1 uNV as ve to t � J G (� l A /i t I ci cl
(J t Log lighter (gas) 23.32
o-i t- • Wood/pellet stove , 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 23.32
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
LJ APPLICANT CONTACT PERSON Attic /crawlspace fans 2332
Other: 23.32
Business name:, i Al t =,(At , Fuel piping
Contact name: -V 1 can ,� $14.15 for first four; $4.03 for each additional
Address:
1'3 ( , 1 --, (LQ_ ' ' �� Gas heat etc. m
pump
City/State/ZIP: Cp iid l ` A .. a. (5 Wall/suspended/unit heater
Phone: (5� a3 LkXo U ID Fax: : ( ,9.C1;-1 03 IS Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: ^ ^ Alb Icr
Clothes dryer (gas)
■tY l J
i
Address: I'33C.1 Se ( C ; , ' Other:
MECHANICAL PERMIT FEES*
City/State/ZIP: 1 " o (4 C ] Subtotal
Phone: () _ (t 0 0 Fax: () 'a„34t:1 03 $ Minimum permit fee ($90.00) 1 7 , Ill
Plan review (25% of permit fee) 14 k
CCB lic.: 33 ( 3 5 State surcharge (12% of permit fee) , I 1
yA.�� / - TOTAL PERMIT FEE ,'}3 )-. (A
Lyneytt4._ / " "' ] This permit application expires if a permit is nat obtained within 18fl
Authorized si g n � at � ur � e: days after it has been accepted as complete.
Print name: E, t N ► �� t/"" ' 1 wl &V\ Date: 4--- I C ( ( * Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permitstsi c.p rmitApp.doc 10/01/09 440-4617T (11 /02/COM/WEB)
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