Permit CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00135
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/07/2009
Parcel: 2S101CB00500
Jurisdiction:
Site address: 12670 SW HALL BLVD BLDG 1
Subdivision: Lot: 0
Project: APEX INDUSTRIES
Project Description: TI
Owner: FEES
TCTPI LLC Description Date Amount
25977 SW CANYON CREEK RD #J Permit Fee 04/07/2009 $478.55
WILSONVILLE, OR 97070 Plan Review 04/07/2009 $119.64
PHONE: 12% State Surcharge 04/07/2009 $57.43
Contractor:
VANCOUVER ROOFING & SHEET METAL CO
P.O. BOX 8951
VANCOUVER, WA 98668
PHONE: 360 - 901 -7673
FAX: 360- 213 -0606
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: F -1 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 2
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 $655.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Related duct
Duct Work: 1 work and
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 -0100. You may obtain a copy of the rules
Issued By: 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 Application CE1 V ED FOR b,FICE USE ONLY
• City of Tigard y `a Pe r mit N o.:
q 131 Plan R eceived SW Hall Blvd., Tigard, OR 97223 MAR 3 0 2009 R : J • Q � ,�� (1�1 111 • ' a Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
I m Other Permit:
DateB .
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: kij .. Fl See Page 2 for
Internet: www.tigard- or.gov Nof : d ethod: 7 7 c , ( Supplemental Information
BUILDING DIVISIO +.-
4 _
TYPE OF WORK �—'' 1 MMERCIAL `I * SCHEDULE – USE CHECKLIST
❑ New construction , ddition/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: $ .',„.?Jo 9c,
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwellinommercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
• ` „�'� ?C) J . ��, Al e / Air conditioning or heat pump
Job site address:
�, � �� GO. (requires site plan showing placement) 14.00
City/State /ZIP: 776,6e-,0 OR_ 9'7.7.23 Furnace 100,000 BTU(ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: 14CF)( Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
/� Hydronic hot water system 14.00
`J e Oe;_ 9910 e/T y Residential boiler (radiator or
(St %) mac. (1 / C' /0/ 6 00/4.51 ot, fir. 70 4/, . (-,, S! C/° 4- h ironic) 14.00
Unit heaters (fuel -type, not electric),
/ 4) e 41 0 1c .L7I -ec ' &6 -9f) in -wall, in -duct, suspended, etc. 14.00
77�, Flue /vent for any of above 6.80
Subdivision: I Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances -
• - DESCRIPTION OF WORK Water heater 10.00
� Gas fireplace 10.00
l �� 7”. 0606:10 'ace 0 Flue vent for water heater or gas
fire N jf;Q� Of CK/J7 /A/6 t. 1/ /O &e:1 J' _ Lo: lace 10.00
%
_ Q 004 Lo• li•hter(•as 10.00
�igoCr Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
Name: , /7eX Z/V f reie Environmental exhaust and ventilation
` /� Range hood /other kitchen
Address: V/ 9 _Jr , //Y A Kke , equipment 10.00
City/State /ZIP: t // t /0 O` %� 9 .� Clothes dryer exhaust 10.00
r /� • Single -duct exhaust (bathrooms,
Phone: (SS ) s3 _8 Fax: (.2S) i 35 _ ig6 S-, toilet compartments, utility rooms) 6.80
—? .APPLICANT j CONTACT PERSON Attic /crawlspace fans 10.00
Business name: V y_44
d // Other: 10.00
lJ /Ili / Fuel piping
Contact name: 64 , prore 7/ - $5.40 for first four; $1.00 for each additional
v✓
Furnace, etc.
Address: / X - . 7 6'FT Gas heat o um
City/State /ZIP: t 1 J .1 (- , j d gP-66/ Wall/suspended/unit heater
Phone: (2/0 90/._. 9( t ) Fax: (460) �/ o6a6 Water heater
�(' / J 1 Fire1lace
E -mail: " (.� e c 640 / t s V i /yJ • f c,vv Range
�./ CONTRACTOR Barbecue
Business name: V'eJ` Clothes dryer (gas)
Other:
Address: d / 2 x left – r — MECHANICAL PERMIT FEES* .
City/State /ZIP: (/,O4(. (Alto 9/66/ Subtotal
Minimum permit fee ($72.50)
Phone: (3'iO) col._ 9 6 3 Fax: 3(o ) o _ f 3 06 a 6 Plan review (25% of permit fee)
CCB lie.: (a 3 0 , e State surcharge (12% of permit fee)
J ,�` TOTAL PERMIT FEE
Authorized silo . n T. — / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: � P LJ /� �� Date: * Fee methodology set by Tri- County Building Industry Service Board
C\BuildingWermits\MEC- PermitApp.doc 01/19/07 440-4617T (I 1 /02/COM/WEB)