Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00278
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/26/2011
Parcel: 1 S136DA00101
Jurisdiction: Tigard
Site address: 11410 SW 68TH PKWY
Project: PERS Subdivision: PERS SITE Lot:
Project Description: Remove and replace (2) 15 ton cooling units.
Contractor: HYDRO -TEMP MECHANICAL INC Owner: OREGON, STATE OF PUBLIC
28465 SW BOBERG RD EMPLOYEES' RETIREMENT FUND
WILSONVILLE, OR 97070 11410 SW 68TH PKWY
TIGARD, OR 97223
PHONE: 503 - 582 -8525 PHONE:
FAX: 503 - 582 -1914
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 07/26/2011 $9,178.71
Class of Work: ALT Type of Const: IIB Plan Review 07/13/2011 $2,294.68
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 07/26/2011 $1,101.45
Stories: 1 Info Process /Archiving - Lg Sheet (over 07/26/2011 $30.00
11x17)
Project Valuation: $325,000.00 Info Process /Archiving - Sm Sheet (up to 07/26/2011 $112.50
11x17)
Fuel Air Handlers Additional Plan Review 07/26/2011 $200.00
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: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $12,917.34
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: glychol tank
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 ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rule adopted by the Oregon
Utility ■ • ification Cen - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 - 0090. / .0 m- • o stain a copy of the rules
or dir- ct questions to OUNC .y ling . 2.1987 or 1.800.332.2344.
i
Issue. By: y 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 Tigard Ti and Iteceivea Permit No.:
� ', Date By: / _� AIM ! `l( . ?
Il l i r
13125 SW Hall Blvd., Tigard, OR 97223 v..p d t
Phone: 503.718.2439 Fax: 503.598.1960 �. Plan ived w ,ZWISMIN
Date/By: Ea Other Permit:
TIGARD Inspection Line: 503.639 t0 O \� Date Read 0 See Page 2 for
Internet: www.tigard -or.gov � 4 u P \, Notified Method: Supplemental Information
,MERCIAL FEE_* •, _ E USE CIiCIQ.IS'V, w
-` f _ <,m ; , TYPE OF W6i K `s�`� �' _ . t , � .. � . - - - .. - COM • S, - _ CHED UL_'' ,..,: , ._ _
1, t • V' Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration/�replac
El Demolition ❑Other ment performed. Indicate the value (rounded to the nearest dollar) of all
. *.' x mechanical materials, equipment, labor, overhead, and profit.
Value: $ $325,000.00
' '- - W - .CATEGORY OF= CSTRUCTION` a =. , z
- -,- ON _�..,_ R ESIDENTIAL -
u (1UiEMENT / SY
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
Heating/cooling: ' - a ,JOB_SITE INFOIRM.ATION A ND LOC ,r. f "s
-.- - � - _. , w ,'. ----- -,v, n -'.., .- . -- - . 4 R . ' Air conditioning .
Job site address: 11410 SW 68 Parkway (requires site plan showing placement) 46.75
City /State /ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: PERS Data Center HVAC Upg Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Interstate 5 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:
i : f - „' DE OF WORK _ Water heater 23.32
Remove and replace two data center cooling units in the PERS building. New Gas fireplace 33.39
Flue vent for water heater or gas
cooling units will be 15 ton each. fireplace - 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
' , f ® PROPERTY : , L, -,- 4_ -„, : , v „1,,,,,,,,
m ,, u .: ,..,:iii TENANT ` 3-;;( Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Department of Adminisrative Services . Environmental exhaust and ventilation:
Address: 1240 Ferry Street SE Range hood /other kitchen
equipment 33.39
City /State /ZIP: Salem, Oregon Clothes dryer exhaust 33.39
Fax: 503 378 -2093 Sing -duct exhaust (bathrooms,
Phone:
(503)373-2331 ( ) toilet compartments, utility rooms) 23.32
a-
I I ''�APELICANT;. ” ,.,- - ® CONT PERSON - - Attic /crawlspace fans 23.32
Business name: DAS Facilities Division Other: 23.32
Fuel piping:
Contact name: Terry Nunley, Construction Project Manager S14.15 for first four; $4.03 for each additional
Address: 1240 Ferry Street SE Furnace, etc.
Gas heat pump
City /State /ZIP: Salem, Oregon Wall /suspended/unit heater
Phone: (503) 373 -2331 Fax: : (503) 378 -2093 Water heater
Fireplace
E -mail: Terry. Nunley @state.or.us
Range
Gp:. TRACTOR, - _ Barbecue
Business name: �f�d ��` f /14“4....,../ p -7;44..1 /14“4....,../ Clothes dryer (gas)
;V ^ � Other
Address: S � i 1 � `• ^ 0(�� t• iv(E CHANICA`L,AP:ER�YIIT'FEES -767'
City /State /ZIP: lilt (,6--,..- Lg. it O2 q "lo 70 Subtotal
( 5O � � t � _ gS � ( (�,j) a_ - t qt � Minimum permit fee ($90.00)
Phone: Fax: L
Plan review (25% of permit fee)
CCB lie.: 4r , State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
d ays a ft er it has been accepted as complete.
Print name: �a AA .) t .. (_ Date: 6 J4 -- ! J * Fee methodology set by Tri- County Building Industry Service Board
I'\ Building \Permits \MEC- PermitApp doc 09/09 /10 440 -4617T (11 /02 /COM/WEB)
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