Permit CITY OF TIGARD MECHANICAL PERMIT
I I 2 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00391
Date Issued: 09/02/2011
TIGARLf 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S101 DCO3900
Jurisdiction: Tigard
Site address: 7150 SW SANDBURG ST
Project: Progressive Insurance Subdivision: Lot:
Project Description: Relocating existing grills and installing new supply grills and ductwork.
Contractor: MILLENNIUM HVAC INC Owner: PROGRESSIVE CASUALTY
2723 NE 159TH CIRCLE INSURANCE COMPANY
RIDGEFIELD, WA 98642 REAL ESTATE NOTIFICATIONS
CLEVELAND, OH 44101
PHONE: 971 - 235 -3699 PHONE:
FAX: 360 - 546 -0512
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/02/2011 $78.27
Class of Work: ALT Type of Const: Plan Review 09/02/2011 $19.57
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 09/02/2011 $9.39
Stories:
Project Valuation: $750.00
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 $107.23
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 by the Oregon
Utility Notification 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 direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
• /tom AP . .1 -.
Call 503.6 " ' , y 7:00 a.m. for the next available ins ■ -ctio' date.
This permit card shall be kept in a conspicuous place on the job site ntil c.mplet . of the project.
Approved plans are required on the job site at the time .f e. h inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
��
Date/By: Permit �� J
City of Tigard `
� Y ,., I� ii _
13125 SW Hall Blv Tigard,OR 97223 Plan Review
' � 0 ' Phone: 503.718.2439 Fax: 503.598.19 c, D ateB
Ins Other Permit: 4� ` 1 1O
Inspection Line: 503.639.4175 \
Date/By:
T I G AR D p �,� Date Ready/By: El See Page 2 for
Internet: www.tigard - or.gov V Notified/Method: Supplemental Information
C3` ' ) 4 '`° COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
TYPE OF WORK Q 01
�tJG Mechanical permit fees* are based on the value of the work
❑ New construction ddition/alteratiorD't ent performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: liS mechanical materials, equipment, labor, overhead, and profit.
Value: $ •
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling)ommerciaUindustrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea, I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: l 5' M , /'Z t � S (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: �.
l e �j ' %'t. Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: j � sl
Project name: Heat pump
(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
Gas fireplace 33.39
.�Li 5f'-7 /1 e)Vi ,r_ j9 e 6 ) 3 t � e ••r t �(e.s L Flue vent for water heater or gas
0 c� L SJ fireplace 23.32
'!t �CrT` /" 1 /C3Gc?'C >� e---) emit
Log lighter (gas) 23.32
z /" ; ill✓ S" „ 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
Fax: Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
/471:4_,,,4 �,/ Other: 23.32
Business name: e r , r rill r / 1 — / —'C" Fuel piping:
Contact name: v.... -�� , Ls ,-,� $14.15 for first four; $4.03 for each additional
—. ) / Furnace, etc.
Address: '2-7 " E �_ -7 Cllicit _2 Gas heat pump
City /State /ZIP: # g t y v _' -ea 6-1 , 923 6 s% .2_ Wall /suspended/unit heater
Phone: (72/) - 3S '-3 ('e�`.7 Fax: : ( ) Water heater
Fireplace
I
E -mail:
dy 4 tie e..._ 6 > 1 !2 r 1.- Range ,
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
Other:
Address: J t. t ?j' er/zzali�___i MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: 45 706
c /i3 State surcharge (12% of permit fee)
�3
TOTAL PERMIT FEE /per, r
nature: This permit application expires if a permit is not obtained within 180
Authorized signature: j r - �. days after it has been accepted as complete.
Print name: ,6.7`_-74 /rte, Date: `7.---2 1 ` * Fee methodology set by Tri -County Building Industry Service Board
I:\ BuildingWermits \MEC- PermitApp.doc 09/09:1 440 -4617T (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.
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