Permit CITY OF TIGARD MECHANICAL PERMIT
11 11 1 —
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00603
T1GAR.L7 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2011
Parcel: 2S102CB03200
Jurisdiction: Tigard
Site address: 9975 SW FREWING ST 220
Project: Spec Space Subdivision: FREWING'S ORCHARD TRACTS Lot: 21
Project Description: Installation of mini -split ductless heat pump.
Contractor: ULTIMATE COMFORT Owner: BY PICOCO
5946 SE LLOYD ST MASSIH LLC
MILWAUKIE, OR 97222 4343 VON KARMAN AVE 3RD FL
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NEWPORT BEACH, CA 92660
PHONE: 503 - 786 -0494 PHONE:
FAX: 503 - 821 -7423
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/28/2011 $161.16
Class of Work: ALT Type of Const: Plan Review 12/28/2011 $40.29
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/28/2011 $19.34
Stories:
Project Valuation: $3,474.00
Fuel Air Handlers
Fuel Types: Electricity 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 $220.79
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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, 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 -0090. Yo • ay obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.80, . !
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Issued By: - Permittee Signature: //
Call 51 by 7:00 a.m. for the next available inspectilM.
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
C i ty of Tigard d ®AT� , �t / O ,
R ECE O VE I Date/By: eceive /� / Permit No.. / ! U./ a V (rJ
Ph
'" 13125 SW Hall Blvd., Tigard, OR 9 7223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Q ,r . Q �!(
DEC 2 3 2 011 Date/By: Other Permit /d t , -0e,25--3
T I G A R D Inspection Line: 503.639 Date Ready /By: Juris. ® See Page 2 for
Internet: www.tigard- or.goV
CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
Value: $ 47 (1
CATEGORY OF .CONSTRUCTION RESIDENTIAL,EQUIPME / 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: L ST sul T Z Zt� (requires site plan showing placement) 46.75
r/ C Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP:
7 �. ,C 0 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Z 2,0 Project name: Pa,e. I f I`L P 1c ,, P U`-Z -e,_ Heat pump it plan showing placement) 61.06
Cross street/directions to job site: � eW 1 ` yl ,� S1 I c, f / c Irl tl y 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
mini_ Gas fireplace 33.39
Is4a,II,_, -II nin Q-- in/ ' Sp/ /-t doc Flue vent for water heater or gas
b ea `tom r fireplace 23.32
, I Log l ighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
gr PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Pi e fr oi>L 14',fU-4/4iew Environmental exhaust and ventilation:
Address: 8 13e c key
5 - 4 ,_
Range hood/other kitchen
equipment 33.39
City /State /ZIP: L. i G)s e4 o 0 i- 9 76 35 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503 ) 7C q z, 1,./ Gt Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 _
Business name: Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range _
CONTRACTOR Barbecue
Business name: 0/2,T C t TE1Qpi S,, / - n,4. (00A) u 1.1 n4/?c'_ /, ,, ( _ Clothes dryer (gas)
l i L 1� Other:
Address: 5q 4 b 5: Lieu u A S f MECHANICAL PERMIT FEES*
i t Subtotal /,,/. �0
City /State /ZIP: �✓1; L� n w 1,1, �, (5-12___ � 7 .2._.2._-L- /"'`
7 b O N 4i Fax: (
l 55 ) Lf -7 t
.r� 2 Minimum (25% of permit ($90.00) -�
- 1 3 Plan review (25% of permit fee) �
Phone: (,D)) ` (f, (9-9
CCB lic.: 1 q if se Z 5 7 A 4 4 3 State surcharge (12% of permit fee) O 54°'
✓� I �x/�� pe-�'(n/ TOTAL PERMIT FEE p2o�j• 7f
Authorized signature: 1 e,,A- l/1/\� \ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: fl /e 5-1/1 � Date: t ( z 3 i * Fee methodology set by Tri- County Building Industry Service Board
1:\Building \Permits \MEC- PermitApp.doc 09/09/10 440 -4617T (11/02 /COM/WEB)
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 $100.00 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.
I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 2
,A)
RECEIVED
DEC 2 3 2011
CITY OF TIGARD
BUILDING DIVISION
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