Permit CITY OF TIGARD MECHANICAL PERMIT
, x- COMMUNITY DEVELOPMENT Permit #: MEC2011 00404
•
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/09/2011
TIGARD Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 110
Project: Sterling Communications Subdivision: PACIFIC CORP CENTER BLD 9 Lot:
Project Description: Install 13' of 1" gas line from new meter to 150 kw stand -by generator.
Contractor: AGAPE GASWORKS LLC Owner: PACIFIC REALTY ASSOCIATES LP
8940 SE CLINTON ST ATTN: N PIVEN
PORTLAND, OR 97266 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 570 -9722 PHONE:
FAX: 503 - 775 -1007
FEES
Specifics: Description Date Amount
Type of Use: COM Mechanical Permit - COM 09/09/2011 $90.00
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 09/09/2011 $10.80
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $0.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $100.80
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 b• the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-000.0. You may obtai a cop, of the rules
or direct questions to OUNC b calling 503.232.1987 or 1.800.332.2344. .
Issued By: Permittee Signature: an 4 ', _
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. J �
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 Applicat 4 a "CEIVED FOR OFFICE USE ONLY
City of Tigard Received /� 4111 permit No.'
" 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: 7 � �." �t- t�20 / / A
Phone: 503.718.2439 Fax: 503.598.1960 E P 0 9 2011 Plan Review
Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Ready/By: lur s: See Page 2 for
Internet: Notified/Method: ® www.tigard or.gov CITY OF TIGARD Note R Re/ B Supplemental Information
BUILDING DIVISION 7 / C�
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: $ / !IC)C) :06
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling Jac ommercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
_(. Air conditioning
Job site address: r! t'7 1-/ — "l �,-�- 110 (requires site plan showing placement) 46.75
City /State /ZIP: �� --i-1 d 0 (� q c3 p \ ' ? Furnace 100,000 BTU (ducts/vents) 46.75
c� Y'. r� ,( ) Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: <7 .{ - c ' d , , Heat pump
1 .. — ) t I. (requires site plan showing placement) 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 Water heater 23.32
/' v t� C )6 /So KL ` Gas fireplace 33.39
(�-C� j I r�P �`(!� �� ^� r f UV Flue vent for water heater or gas
r fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
��PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
.�� Other: 23.32
Name: _ Pa C.--! ., _ I< ,.\-�— Environmental exhaust and ventilation:
Address: C- `` C \_,... (( / � ii Range hood/other kitchen
�l I 1 r( �� \ �� 7 �'y IL lu equipment 33.39
City /State /ZIP: � 77 A b (' v Clothes dryer exhaust 33.39
Phone: Fax: Single -duct exhaust (bathrooms,
( ) ( ) toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: //�� / I Other: 23.32
/'IG t' t) ( 1 Fuel piping:
7 ' � �� 7 Ll�L t io
v 1 / \ p'p'
Contact name: a i w^ ( 4 c �l (e 6 c. C — $14.15 for first four; $4.03 for each additional
/,, j {- Furnace, etc.
Address:
l J �'5 Gas heat pump
City /State /ZIP: f t i (•, - A p t r / 0 -� - 77' 6 �� Wall /suspended/unit heater
Phone: (3 ) ( ) S _ 1 7 Fax:: ( ) Water heater
E -mail: Fireplace
j ' n �"^P (" O V 1 - .c i `� a `� ' Y -- k -,c J • C � ''�Y� Range
CONTRACTOR I Barbecue
Clothes dryer (gas)
Business name:
Other: /
Z�rl•H-C q- `'-n r
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) «B, 0-Z)
Plan review (25% of permit fee) I fiD
CCB lic.: i ) ( i jg- State surcharge (12% of permit fee) ,.
TOTAL PERMIT FEE
∎-1_!' This permit application expires if a permit is not obtained within 180
Authorized signature: o •
days after it has been accepted as complete.
Print name: jol ,fie 5 L _ LA I,.1C.e yl h (' )., Date: 9 .-,a )) * Fee methodology set by Tri- County Building Industry Service Board
/VQ i CPC) I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -4617T (I 1 /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. J.
Note: All new commercial buildings require 2 sets of plans.
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