Permit CITY OF TIGARD MECHANICAL PERMIT
1 1 . . COMMUNITY DEVELOPMENT Permit #: MEC2009 -00148
Date Issued: 04/06/2009
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101CB00500
Jurisdiction:
Site address: 12670 SW HALL BLVD BLDG 1
Subdivision: Lot: 0
Project: APEX INDUSTRIES
Project Description: Install new t -bar registers and new restroom exhaust. Project Value: $6,200
Owner: FEES
TCTPI LLC Description Date Amount
25977 SW CANYON CREEK RD #J Permit Fee 04/06/2009 $163.10
WILSONVILLE, OR 97070 Plan Review 04/06/2009 $40.78
PHONE: 12% State Surcharge 04/06/2009 $19.57
Contractor:
WILLAMETTE HVAC
3075 SW 234TH AVE. #206
HILLSBORO, OR 97123
PHONE: 503 - 628 -6841
FAX: 503- 848 -2597
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: 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: 1 Vent Systems: Total $223.45
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
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, suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility tification Center.. Tho - les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
Issue By: j ` ` // /� . Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business 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 Applicationp CETVED : , , FOR OFFICE.,USE ONLY
Received Penult No < l �y� I Q
City of Tigard Date /By: 7 ED Q /r - /` A t1
•
: - " 13125 SW Hall Blvd., Tigard, OR 97223 APR '''6 2009 Plan Revi
• Phone: 503.639.4171 Fax: 503 Date /By 4 Fii�' Other Permit:
Inspection Line: 503.639.4175 1i
TIGARD p Data Ready /By:" ___________ El See Page 2 for
Internet: www.tigard- or.gov CITY OFTIG Notified/Method: Supplemental Information
BUILDING DIVISIO I
„','- , :' `,1YPE WORK _ ' COMMERCIAL FEE* SCHEDULE.- USE CHECKLIST
Ill New construction ® Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dolla0 of all
['Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
�., -; ... RY Value: $ $6,200.00
_ - :CATEGO ;OFuCONSTRUCTION . ,,� _,
_ " , , -,RESIDENTIAL'EQUtPMENT % rS I ' S TE M S 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 or heat pump
Job site address: 12670 SW Hall Blvd
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard OR Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name: Apex Industries 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: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
>= ' - , - r 10.00
DESCRIPTIO OF WORK =�`'. ���.' : Water he�te
... Gas fireplace 10.00
Install new t - bar registers, and Install new restroom exhaust. Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
. Wood fireplace /insert 10.00
Chimney/liner/flue/vent
n iner /flue /vent
. Other: ' PROPERTY> OWNER . ' ' - . TENANT -' ...' „ 710.00
Name: 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: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
.. Attic /crawl ace fans 10.00
' APP-LICANT :: ' ' - "`z ❑ '; CONTACT-° PERSON Attic/crawlspace
10.00
Business name: Same `—
F uel piping
Contact name: S5.40 for first four; S1 .00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: _ Range
.. CONTRACTOR' Barbecue
Business name: Willamette HVAC Clothes dryer (gas)
— Other:
Address: 3075 SW 234 Ave Ste 206 .. ' • -MECHANICAL PERMIT FEES* .,
City /State /ZIP: Hillsboro OR 97123 Subtotal
Minimum permit fee ($72 50)
Phone: (503) 628.6841 Fax: (503) 848.2597
Plan review (25% of permit fee)
—
COB lic.: 56951 State surcharge (12% of permit fee) �
�
014'd-'//t-'1/1 TRMT ��
" `
Authorized signature: This permit application expires OTAL if a per isi I not obtained FEE w(ithin 18'(41/1 / days after it has been accepted as complete.
Print name: Michael Malstrom Date: 4/6/09 * Fee methodology set by Tn-County Building Industry Service Board
•\ Buildin4APermits\<MEC PermitApp doe 01/19/07 440 -4617T (I 1 /02 /COM/WEB)
Building Division
Over- The - Counter (OTC) Mechanical Permit
• TIGARD Check List
• Description of Project: M TT
GENERAL INFORMATION
• Class of Work:* Floor Furnace: Evap. Coolers:
Type of Use:* ( Unit Heaters: Vent Fans:
Occupancy Group: Vents w/o Appl.: Vent Systems:
Stories: Boilers, Comp, Heat Pump, A /C: Hoods:
Fuel Types: 0 - 3 HP: Domestic Incinerator.
ELC / GAS / NG / OIL / OTHER 3 - 15 HP: Com. /Ind. Incinerator.
Max Input: BTU: 15 - 30 HP: Repair Units:
Fire Dampers: 30 - 50 HP: Wood Stoves:
Gas Pressure: H / M / L >50 HP Clothes Dryer
No. of Units: Air Handling Units: Other Units: Sp
Furnace <100k BTU: 510,000 CFM: Gas Outlets:
Furnace >_100k BTU: >10,000 CFM:
Notes:
7 �
INSPECTIONS FEES DUE
•
• Post /beam mechanical $ ((0:3, i0 Permit Fee
Gas line $ / 9'. 5 State Surcharge
Mechanical rough -in $ 4c 3 Plan Review Fee
Fire damper $ Additional Permit Fee
Duct work $ Additional Plan Review Fee
Smoke detector $ Investigation Fee
Investigation inspection $ Misc. Fee
Misc. inspection $ Hourly Rate Fee
Final inspection $ Hourly Rate State Surcharge
$ ZZ'5, otal Fees Due
OTHER PERMITS REQUIRED
Building Electrical
Plumbing Site Work
•
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
• I:\Building\Forms \OTC - MEC.doc 09/22/06