Permit 1 4 CITY OF TIGARD MECHANICAL PERMIT
��' c COMMUNITY DEVELOPMENT Permit #: MEC2011 -00234
Date Issued: 05/27/2011
TBG ARD , 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 16655 SW 72ND AVE 300
Project: Food Sales West Subdivision: PACTRUST BUSINESS CENTER Lot: 29
Project Description: Replace (1) existing 3 -ton RTU
Contractor: OREGON HEATING & AIR CONDITIONING Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 241 ATTN: N PIVEN
DUNDEE, OR 97115 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/27/2011 $212.83
Class of Work: ALT Type of Const: Plan Review 05/27/2011 $53.21
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/27/2011 $25.54
Stories: Info Process /Archiving - Sm Sheet (up to 05/27/2011 $5.00
11x17)
Project Valuation: $5,200.00
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 $296.58
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 o in a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
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 RECEIVED FOR OFFICE USE ONLY
City of Tigard Received I v_ Permit N &C? �7 n7 A s
13125 SW Hall Blvd., Tigard, OR 97223 MAY 27 2011 Date/By: 5 2 7 77 I o K J •
Plan Review
` Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
f I G A R D Inspection Line: 503.639 CITY OF TIGARD Date Read B
Internet: www.tigard- or.gov Ready /By: furls: Ell See Page 2 for
BUILDING DIVISIO' Notified/Method: 77� 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: $ 5 , 2 0
CAT GORY 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 I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: r05 ,5 ?�. heh1 J/ (requires site plan showing placement) 46.75
Cit /State /ZIP: I K� �J ,/ _L� Furnace 100,000 BTU (ducts /vents) 46.75
y /71 �(/f / ()/ Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg./apt. no.: P+fojectnarrte: % ) Heat pump
(requires site plan showing placement) 61.06
Cross str4 y rections 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 Water heater 23.32
t `/f �/ 1�� \ / Q// Gas fireplace vent 33.39
C J .2 ' 'T Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWN AR ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: at, /a� /3 Environmental exhaust and ventilation:
Address: (/� J (!! Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Fax: Single -duct exhaust (bathrooms,
Phone:
( ) ( )) toilet compartments, utility rooms) 23.32
/APPLICANT Jd�' CONTACT PERSON Attic /crawlspace fans 23.32
Business n arlfd : (((��� Other: 23.32
/^� ' �/ Fuel piping:
Contact name: C t rJ"}— vV l ' 44 r;,/,,/L_....--- $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) V/ y(07_, I Fax: : ( ) Water heater
E -mail: J / Fireplace
/�r%G ��� /� 1-ii. ' l.t^ Range
CON C TOR Barbecue
Business name: 0 k A Clothes dryer (gas)
�' (/ J Other: .
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: DI i/ 14-12��i 1i/ 7/l 3 / Colo / ait9i(renl
/Phone: J Minimum permit fee ($90.00) ,. /AZ,
S�J� 2�� Fax: ( )
Plan review (25% of permit fee) ..573,,,z2/
CCB lie.: ( 7 z- 1 `7 5S State surcharge (12% of permit fee) j (
TOTAL PERMIT FEE y�, °/
Authorized signature This permi application expires if a permit is not obtained within 180
l days after it has been accepted as complete.
Print name: '(. / ,' Date: 5:72- * F methodology set by Tri- County Building Industry Service Board
I :BuildingPermits\MEC- PermitApp.doc 09/09/10 440-4 I/ /WEB) 7 / 6 5 /0 '
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.
I:\ Building \Permits\MEC - PermitApp.doc 09/09/10 2