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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00179 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/24/2009 Parcel: 2S112AD01000 Jurisdiction: Tigard Site address: 7007 SW CARDINAL LN 135 Subdivision: Lot: 0 Project: North American Trade Project Description: Separate gas line and ductwork for TI. Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee 04/24/2009 $186.50 #300 12% State Surcharge 04/24/2009 $22.38 PHONE: Contractor: PHONE: FAX: Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Occupancy Load: Stories: Fuel Air Handlers Fuel Types: Natural Gas Units < 10000 cfm: Gas Pressue 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 $208.88 Hoods: Comm Incinerators: Required Items and Reports (Conditions) Woodstoves: Gas Fireplaces: Clothes Dryers: Other Mech Units: Gas Outlets: 1 Other Desc: 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 ithin 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the ru - . . . opted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. Y may .btain a copy of s Ario r Issued By: -�. • Permittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that busin- . - day. 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 `'"i"� eceived ermt No.: FOR OFFICE USE ONLY City of Tigard ` i ? zr j Pi n . n II 13125 SW Hall Blvd. Tigard OR 97223 sate/By: Y `�`CC2 O n179 . q Plan Review Phone: 503.639.4171 Fax: 503.598.1960 APR 2 4 Date/By: Other Permit: _ g 2009 TI GARD Inspection Line: 503.639.4175 Date Ready /By: Juris' ® See Page 2 for Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information RUl_p1Nr D (1 � .. TYPE OF WORK _ COMMERCIAL ,FEE* SCHEDULE - USE CHECKLIST ❑ New construction Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • CATEGORY OF CONSTRUCTION Value: $ 7 -� VO ° `' , RESIDENTIAL EQUIPMENT,/ SYSTEMS FEES* , ❑ 1- and 2- family dwelling ommercial /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 or heat pump Job site address: 7 } f zorI .-,O 1U, GL_ ,.v15 (requires site plan showing placement) 14.00 City /State /ZIP: Furnace 100,000 BTU (ducts /vents) 14.00 . ,�/ _Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: ` Project name : o l h/ 1 4M92-1C-.44) / D p p Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: I Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 ,� ,,i �C, *�^ ,{ Z- q Gas fireplace 10.00 Sgfr .t 5' `J T-/ A? C 'i ,Nv 3 7w 5 Log lue vent for water heater or gas .15 ©/ e:-. /L: e2 �.:ri k /N9 /i0 &A.JI s l 10.00 Log lighter (gas) 10.00 ,newt' - "7? - 0C- - 6 - .5 (MCI) / (y ))& 7 ) Wood /pellet stove 10.00 / /JJ Wood fireplace /insert 10.00 ROPERTY OWNER . I • ❑ TENANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: c . ) , u 5 � Environmental exhaust and ventilation • Address:! Range hood/other kitchen equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) � j �y - &3 Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON . Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: ✓ 6/ $5.40 for first four; $1.00 for each additional Address: -p°�� � ,5_, Furnace etc. Gas heat pump City /State /Z1P: Wall /suspended/unit heater . Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Business name: 65 f/ /f�,,i /yi' lhi�Bv/e_.9 Clothes dryer (gas) Other: Address: / / 5 0 - 5 - $ t/ 2/ MECHANICAL PERMIT FEES* City /State /ZIP: <z tYkidlYt j eL X70/5 Subtotal � Minimum permit fee ($72.50) Phone: ' ) �S,�,� ` /s'c c• 6 I Fax: 6a - 1) Co 3 � .1pZS Plan review (25% of permit fee) CCB lic.: // 7 25. 1 . a- [ . 1 ( State surcharge (12% of perniit fee) G /c TOTAL PERMIT FEE Authorized signature: , � This permit application expires if a permit is notobtained within 180 days after it has been accepted as complete. Print name: 0 -C-�� `� t Date: * Fee methodology set by Tri- County Building Industry Service Board 1: \Building \Permits \MEC- PermitApp doc 01/19/07 440 -46I7T (11 /02 /COM /WEB) 030-2 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information . Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2