Permit CITY OF TIGARD MECHANICAL PERMIT
'l Y COMMUNITY DEVELOP Permit #' MEC2011 -00473
Date Issued 10/26/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 parcel 2S101 CB00400
Jurisdiction Tigard
Site address 12700 SW HALL BLVD D
Project Oregon Aqua Farms Subdivision 2007 -064 PARTITION PLAT Lot 1
Project Description Run 300' of gas line from meter main to connect to water heaters
Contractor OWNER Owner TCTPI LLC
4260 GALEWOOD ST, STE A
LAKE OSWEGO, OR 97035
PHONE PHONE
FAX
FEES
Specifics' Description Date Amount
Type of Use COM Permit Fee 10/26/2011 $207 21
Class of Work ALT Type of Const Plan Review 10/26/2011 $51 80
Occupancy Grp Occupancy Load 12% State Surcharge - Mechanical 10/26/2011 $24 87
Stories
Project Valuation $5,000 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 $283 88
Hoods Comm Incinerators
Wootlstoves Gas Fireplaces Required Items and Reports (Conditions)
Clothes Dryers Other Mech Units
Gas Outlets Other Desc Tankless
Duct Work Water
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 e .ire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION Oregon law requires yo to follow he rules adopted by the Oregon
Utility Nohficatio- e - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0rel Yo may obtain a copy of the rules
or direct quest' ins to OUNC is calling 32 1987 or 1 800 332 2344
Issued By ( /�y / Permittee Signature
Call 503 639 4175 by 70000 as 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 Date/By USA=
No r2ee w-o0 73
IN 13125 SW Hall Blvd , Tigard,OR 97223 Plan Review
Ill Phone 503 718 2439 Fax 503 598 1960 Date /By Other Permit
TI GARD Inspection Line 503 639 4175 Date Ready /By ram ® See Page 2 for
Internet www Tigard - gov Notified/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
\ Mechanical permit fees* are based on the value of the work
❑ New construction [ NAddition /alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit
Value $ 5t7.-*n
CATEGORY OF CONSTRUCTION RESIDENT IAL EQUIPMENT /SYSTEMS FEES*
❑ 1 -and 2- family dwelling Commercial /industrial ❑ Accessory building For special infornralron use checklist.
❑ Multi -family ❑ Master builder ❑ Other Description Qty I Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling.
Air conditioning
Job site address I a�� J� 4ALL C)LV (-, (requires site plan showing placement) 46 75
^n Furnace 100,000 BTU (ducts /vents) 46 75
Q. City /State /LIP A l ci ",--1a� Furnace 100,000+ BTU (ducts /vents) 5491
K
Suite/bldg /apt no f) — Pr R _. Project name SRei Op Heat pump
(requires site plan showing placement) 61 06
q �.. Cross street/directions to job site Duct work 23 32
r
e rl \&) S to "all r DlVd) i� all 14UU R e sd n tial bo water r aditt 2332
t. C Residential boiler (radiator or
hydronic)
heaters 23 32
Um 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
— V Tax map /parcel no Other fuel appliances:
4 DESCRIPTION OF WORK Water heater 9-, 23 32 C 44 63
s Gas fireplace 33 39
�
I vx4," 1E0 ( MPiI -i h , i ror11r((.(i� flue vent for water heater or gas
ev fireplace 23 32
"� 1.1 l�') Log lighter (gas) 23 32
Wood/pellet stove 33 39
2 _ _i � - i t . . 1i--
w•
4 ' ' / 4 Wood fireplace /msert 23 32
cTX�' �n..i _(! (JAY ✓P.l st a.ft
El PR PERTY OWNER ❑ TENANT/0 l 4 Chimney /hoer /Flue/vent 23 32
J Other 23 32
Name Environmental exhaust and ventilation:
dress C cLAAAC Range hood/other kitchen
equipment 33 39
City /State /ZIP "\ Clothes dryer exhaust 33 39
-1 3 Phone exhaust (bathrooms,
Phone ( ) Fax ( ) toilet compartments, utility rooms) 23 32
`' Attic/crawlspace fans 23 32
p APPLICANT V 0 TACT PERSON _ P
Business name C) ftC 6 0,A.1 A 04, •/: 2nd Lit Other 23 32
�� � _
/
Contact name va/� i l i rOals J' Fuel piping: 514 15 for first four; 54 03 for each additional
4 � DO c 1 J L- Furnace, etc
Address � 1fJ l� cA. v1 �j l �' I Gas heat pump
City/State/ZIP � c✓r� OIL o,��i i Wall /suspended/unit heater
Phone 3) `- -13- -? 06- I Fax ( ) Water heater 'a.. }L4- J5
E -mail r L l Range
G� .G e+ ) Ci.' �y "'b� • CJ-� Range e
CONTRACTOR Barbecue
Tismess name /1 u) EP- Clothes dryer (gas)
C Other
Address MECHANICAL PERMIT FEES*
City /State/ZIP Subtotal
Phone. ( ) Fax ( ) Minimum permit fee ($90 00) g(�� �..1 q O
Plan review (25% of permit fee) (p
CCB lie State surcharge (12% of permit fee) �, .
'TOTAL PERMIT FEE ^
Authoroed s ii This permit application expires if a permit is not obtained within 180
Jays after it has been accepted as eomplete. r.
T
A
Print name Date (L7/ 7 4 0 `I I ' Fee methodology set by In- County Building Industry Service Board. 8
I iB n
wlding4Penits ttEC- PermitApp doe 09/09/10 440 -4617T (1I /02/CDMRVEB) /•
a
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 $10000 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.
1 \guiding \Pemtns \MEC- PermitApp doe 09/09/10 2
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