Permit IN ,� CITY OF TIGARD MECHANICAL PERMIT 11 • COMMUNITY DEVELOPMENT Permit #: MEC2011 00487
Date Issued: 11/01/2011
TIGARD 13125 SW Hall Blvd ,Tigard OR 97223 503 718 2439 Parcel: 2S113A600300
Jurisdiction: Tigard
Site address: 16037 SW UPPER BOONES FERRY RD 165
Project: Spec Space Subdivision: FANNO CREEK ACRE TRACTS Lot: 38
Project Description: HVAC modifications for TI.
Contractor: JNB MECHANICAL INC Owner: OREGON STATE BAR, THE
3315 NE 112TH AVE A40 -41 16037 SW UPPER BOONES FERRY RD
VANCOUVER, WA 98684 TIGARD, OR 97224
PHONE: 360 433 - 9439 PHONE
FAX: 360 433 - 9439
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/01/2011 $428 99
Class of Work: ALT Type of Const: Plan Review 11/01/2011 $107 25
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/01/2011 $51.48
Stories:
Project Valuation: $13,200.00
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 $587.72
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
applicab •• • , 'irk will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
iss ce, or if work is s •ended for more the 180 days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon
ility Notification Center T∎ . e ules 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 . .:Ilin.: i •32 1987 or 1 800.332.2344.
Issued By: I • I e I /� , ,! e 4./ Permittee Signatur ' �—
\ 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 of Tigard Received Date /By /�7 / l/ Permit No /te,a/ .....0 ; 7
IN u 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review !!
Phone 503 718 2439 Fax 503.598 1960 Date By Other Permit ,oao,7�o g
T I G A R D Inspection Line 503 639 4175 Date Ready /By Juns El See Page 2 for
Internet www.tigard -or gov , i1 0 ` .\\ Notified /Method Supplemental Information
TYPE OF WO* ' «rtiC%n re2 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
�.- At .,:v..,` Mechanical permit fees* are based on the value of the work
'
❑ New construction Addition /alteratio repllkement,4�' performed Indicate the value (rounded to the nearest dollar) of all
❑Demolition 0 Other: .., . � mechanical materials, equipment, labor, overhead, and profit
^` ��A Value. $ (3, 7.bb -
CATE OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea Total
JOB SiTE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: / 6O 3 — 3. 50 um, p e.l Q0d.✓t B -S 1" ezo1, - 1 tCt. (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: - „.„.... t d it q 3 ZZ 9 Furnace 100,000+ BTU (ducts /vents) 54 91
Suite /bldg. /apt. no.: 1 1,5 Project name: n (1 a ( tQ i � bS Heat pump
S (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
\ \ 7i \ V Gas fireplace 33 39
:, cI d a f , n ,� I 6 V % 0 Y e e. i J/ 6 4_ Lk T 5 )., ; L `.r o •,, Flue vent for water heater or gas
l� �1-- N V if \ (Q \ l b . fireplace 23 32
Lo: Ii • hter as 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: , Environmental exhaust and ventilation:
Address. Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23 32
❑ APPLICANT ` ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other 23 32
Business name: �
�I � { F' Q -C-LG —■ 1 Cos, , Fuel piping:
Contact name: To SO v— ( (\ ∎ s $14.15 for first four; $4.03 for each additional
Address: 3315" N G j /Z ,, d- ,41/4_ ; / 4/ -1/4 Furnace, etc
Gas heat pump
City /State /ZIP: V Ox-xn C t j 4 o 2 Wall /suspended /unit heater
Phone: (360 i f'? S _ 9 6-7. Fax :: (3 ) 01 33 9t431 Water heater
Fireplace
E - mail: 3,- Sn a :3ttib on e c G - c.Ofri
Range
g
CONTRACTOR Barbecue
Business name: SA (A ft A (1 Clothes dryer (gas)
Other
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal /ale. Q
Minimum permit fee ($90.00) -----
Phone: ( ) Fax: ( )
Plan review (25% of permit fee) 07.g
CCB lic.: 1 9 61 c 0 State surcharge (12% of permit fee) - 5t • Y r
� TOTAL PERMIT FEE 5g7. 7
l yL This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: Tj!)lks.e\ 1 l 1 r V c Date: i0/0,8/ f i * Fee methodology set by Tri- County Building industry Service Board
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lding\Perns \MEC- PernutApp dot; 09/09/10 440- 4617T (11 /02 /COM /WEB)