Permit 111 CITY OF TIGARD MECHANICAL PERMIT
''! COMMUNITY DEVELOPMENT Permit #: MEC2011 -00208
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2011
Tl�'eARI): Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 130
Project: Yecuris Subdivision: Lot: 0
Project Description: TI
Contractor: HYDRO -TEMP MECHANICAL INC Owner: PACIFIC REALTY ASSOCIATES
28465 SW BOBERG RD 15350 SW SEQUOIA PKWY #300
WILSONVILLE, OR 97070 PORTLAND, OR 97224
PHONE: 503 - 582 -8525 PHONE: 503 - 624 -6300
FAX: 503 - 582 -1914
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/13/2011 $2,167.98
Class of Work: ALT Type of Const: Plan Review 05/13/2011 $542.00
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 05/13/2011 $260.16
Stories: Info Process /Archiving - Sm Sheet (up to 05/13/2011 $1.50
11x17)
Project Valuation: $82,300.00
Fuel. Air Handlers
Fuel Types: Units < 10000 cfm: 2
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 $2,971.64
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: HEPA filter
Duct Work: system
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, o • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility . ification 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 dir; t questions to OUNC by • g .03 .1987 or 1.800.332.2344. ��
Issue' By: ' "-� , ' Permittee Signature: ) /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 USE ONLY
Ili City, of Tigard i s El E 1 Date /Bv � 5� A Permit No.: / /I . D O� Q ;
-
q 13125 SW Hall Blvd., Tigard, OR 97223 =. c t_
Phone: 503.718.2439 Fax: 503.598.19N Ay 1 3 2011 Plan Revi e e,�f 1 I
Date /Bye Other Permit:
TI G A R D Inspection Litte. 503.639.4175 Date Rea. • :y: luris. 0 See Page 2 for
Internet: www.tigard- or.gov N otified /Method: S Icmental lnformation
CITY OF TiGA'ia pp
r/I HI ItlM(_ mileinio
""' s '"" ° '"° �' °' COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
TYPE OF WORK
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.
- - _ _ I Value: S $82,300.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - and 2 - family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SiTE INFORMATION' AND LOCATION Heating/cooling:
Air conditioning
Job site address: 15055 SW Sequoia Pkwy (requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: 130 Project name: Yecuris TI Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Cardinal & Sequoia Enter on Cardinal 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 Water heater 23.32
Exhaust and climate control for vavarium including new CRAC, supply& exh fans, Gas fireplace 33.39
Flue vent for water heater or gas
cooling coils, heat pump, humidifier and HEPA filters for Yecuris T.I. fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
® PROPERTY OWNER ❑ TENANT I Chimney /liner /flue /vent 23.32
' Other: 23.32
Name: Pacific Corporate Center Environmental exhaust and ventilation:
Address: 15055 SW Sequoia PKWY # 130 Range hood/oth kitchen •
equipment 33.39
City/State /ZIP: Tigard, OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawispace fans 23.32
Business name: Hydro -Temp Mechanical, Inc.
Other: 23.32
Fuel piping:
-
Contact name: Craig Smit $14.15 for first four; $4.03 for each additional
Address: 28465 SW Boberg Rd. Furnace, etc.
Gas heat pump
City /State /ZIP: Wilsonville, OR 97070 Wall /suspended/unit heater
Phone: (503) 582 -8525 Fax: : (503) 582 -1914 Water heater
E -mail: CraigS @hydrotempmech.com Fireplace
_ Range
CONTRACTOR Barbecue
Business name: Same as Applicant _Clothes dryer (gas)
Other:
Address: MECHHHANiCAL PERMIT FEES*
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: 63907
VAT/ State surcharge (12% of permit fee)
PERMIT FEE '�lar ` +441
This permit application expires if a permit is not obtained Jithin ISO
Authorized signature: " days after it has been accepted as complete.
Print name: ■ 1 U _...2 WV I Date: 511 1 1 * Fee methodology set by Tri County Building Industry Service Board
I: \Building \Permits \MEC- PermitApp.doc 09/09/10 440 -4617T (I I!02 / /WEB)
•
Building Division
T[GARD Over- The - Counter (OTC) Mechanical Permit
Check List
•
Project Description: bill tC-(A--6(37C_A-L_ ( I
`\ _________
APPLICATION SP FIC •
GENERAL INFORMATION \,
*Class of Work: / ,' L. Occupancy Group: `` Type of Co struction:
*T .e of Use: WM . 0 Oregon Spec lty Code: Z.L. (U
Number of Stories:
FUEL FURNACES
IIMENWAMMII — Furnace < 100K BTU Furnaces >= 10 K BTU
IMEMEIFAIMME Roof Top Unit (RTU) Tons
INIMIMINIM011 Furnaces Unit Heaters
IMWMIIM=11 Vents without Appliances Air Conditionin
Heat Pump
AIR H • NDLERS HOODS
ME 10000 cfm 7 Type 1 Hood Type 2 Hood
MEM 0000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLI • CES
Boiler i Vent Fans Gas Line
Solid Fuel Fir- . Clothes Dryers Gas Outlets
Woodstove Duct Work Gas Fi eplace
Fire /Smoke Dampe Other Mechanical Units — Describe: 1)E.F -APL r)5 s..1i
Total Project Valuation: $ ir 4 FEES DUE
$ Mechanical Permit Fee
$ Plan Review
$ 12% State Surcharge
$ Info Proc /Arch, Lg (over 11x17 $2.00)
$ 1, Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Misc. Admin Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff:
Date /Time: $ TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
1:\Building\Forms \OTC - MEC.docx 01/13/2011