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Permit
�' CITY OF TIGARD MECHANICAL PERMIT II 4, COMMUNITY DEVELOPMENT Permit #: MEC2011 -00239 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/01/2011 Parcel: 2S113AB00500 Jurisdiction: TIGARD Site address: 16083 SW UPPER BOONES FERRY RD 105 Project: Metro Multifamily Housing Association Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37, F Project Description: Install (3) VAV's, (1) fan and ductwork for new TI Contractor: OREGON HEATING & AIR CONDITIONING Owner: G &S FC LLC PO BOX 241 16083 SW UPPER BOONES FERRY RD, DUNDEE, OR 97115 STE TIGARD, OR 97224 PHONE: 503 - 691 -9699 PHONE: FAX: 503 - 691 -8556 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 06/01/2011 $352.79 Class of Work: ALT Type of Const: Plan Review 06/01/2011 $88.20 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 06/01/2011 $42.33 Stories: Info Process /Archiving - Sm Sheet (up to 06/01/2011 $1.00 11x17) Project Valuation: $10,200.00 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: 1 Vent Systems: Total $484.32 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: VAV's 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 folio th= ul: adopted by the Oregon Utility No ion nt- . Th.se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. ou :y fbtain a copy of the rules or dire questions to OUN cal "nt 13.232.1987 or 1.800.332.2344. Issue By: , /C. ?/ D 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 FOR OFFICE USE ONLY City of Tigard : � Received Y'/ �a l Permit No.: L `C erJ C n w/1 o0 -39 I , 13125 SW Hall Blvd., Tigard, OR 97 1, 3 E l VE Plan Review ► � Phone: 503.718.2439 Fax: 503.598.1960 l ^ Date/By: il ` r a� Other Permit: T I G A R D Inspection Line: 503.639 JUN 1 2011 Date Ready/BT Juris. El See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information CITY OF Tyr Aflr'i TYPE OF1,( jiAlra nil l ILnt COMMERCIAL FEE* SCHEDULE — USE CHECKLIST — ° . • , +1 vt v 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, laboroverhead, j i and profit. Value: $ (0 ) vi/v CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling A 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: ) n Air conditioning Job site address: ( ("Q'J t uppty f»nrg (requires site plan showing placement) 46.75 City /State /ZIP: t //ll , ! Furnace 100,000 BTU (ducts /vents) 46.75 4� VY Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: 016 Projtct name: N M N A Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 (Weil /Oi/(/t G 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 /N< t / Gas fireplace 33.39 b ` " S (k � ) Flue vent for water heater or gas P A (`� ( fireplace 23.32 J� J Log lighter (gas) 23.32 ( 1 lit Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER . ❑ 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 APPLICANT r CONTACT PERSON Attic /crawlspace fans 23.32 Business name: 0t / A i Other: 23.32 r/ Fuel piping: Contact name: n GI 1 �~ - 1 - v i \A 4 2_ $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: (64 ) c Z Fax: : ( ) Water heater / Fireplace E -mail: C (I (�L 0 RA T1^ 1Aad 11' 1 Range CONTRACTOR Barbecue Business name: eTl t A L Clothes dryer (gas) p � ) ^ v l / Other Address: .(3_5(., l MECHANICAL PERMIT.FEES* ' City /State /ZIP: O e ` ' L L Subtotal Phone: (�) S 3 vC�1 F ax: ( ) Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: ''7 Z' UP State surcharge (12% of permit fee) ,, �? TOTAL PERMIT FEE Authorized signature: This p ermit application expires if a permit is not obtained within 180 C..- days after it has been accepted as complete. Print name: CA ,,,,r L, Date: (a( t l l * Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -461 (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. I:\ Building \Permits \MEC- PermitApp.doc 09/09/10 2 II Building Division Over- The - Counter (OTC) Mechanical Permit TIGARD Check List Project Description: APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: Occupancy Group: Type of Construction: *Type of Use: Oregon Specialty Code: Number of Stories: FUEL FURNACES Type: Furnace < 100K BTU Furnaces >= 100K BTU Gas Pressure: Roof Top Unit (RTU) Tons Floor Furnaces Unit Heaters Vents without Appliances Air Conditionin: Heat Pum. Mir AIR HANDLERS HOODS Units <= 10000 cfm Type 1 Hood Type 2 Hood Units > 10000 cfin Grease Duct 1 Hour Shaft Fire Wrap APPLIANCES Boiler (BTUs) Vent Fans Gas Line Solid Fuel Fireplace/ Clothes Dryers Gas Outlets Woodstove Duct Work Gas Fireplace Fire /Smoke Dampers Other Mechanical Units — Describe: • Total Project Valuation: $ ID 2 FEES DUE $ ?-} Mechanical Permit Fee $ Plan Review $ 4-2.,`D 12% State Surcharge $ Info Proc /Arch, Lg (over 11x17 $2.00) $ ( , ©() 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: $ 45M-32—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 •