Permit CITY OF TIGARD MECHANICAL PERMIT
1114 II
a • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00113
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/07/2012
Parcel: 1S136DCO2504
Jurisdiction: Tigard
Site address: 7275 SW DARTMOUTH ST
Project: Shell Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: Install (2) 5 -ton gas packs, (1) 3 -ton pack. Complete duct systems for the 5 -ton units, vent (1) restroom, rooftop
exhaust in suite 120. Install (2) gas lines and extend (1) gas line.
Contractor: WILLAMETTE HVAC Owner: AMERICAN INDUSTRIES INC
3075 SW 234TH AVE. #206 1750 NW FRONT AVE STE #106
HILLSBORO, OR 97123 PORTLAND, OR 97209
PHONE: 503 - 628 -6841 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/01/2012 $815.07
Class of Work: ALT Type of Const: VB Plan Review 03/01/2012 $203.77
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/01/2012 $97.81
Stories: 1 Info Process /Archiving - Lg $2.00 (over 03/01/2012 $8.00
11x17)
Project Valuation: $28,400.00 Info Process /Archiving - Sm $0.50 (up to 03/01/2012 $6.50
11x17)
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: 2 Vent Systems: Total $1,131.15
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 2 •
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty •des and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not st- - d within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules .dopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may o• ain a copy of the rules
or dire : .estions to c NC • calling 503.232.1987 or 1.800.332.2344.
Issue. By: : / ` / /t� i .c Permittee Signature: } 0
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 T FOR OFFICE USE ONLY
of Tigard � �F l g
Date/By: — / /409" Permit No.: t J _ % /t .
° 13125 SW Hall Blvd., Tigard, OR 97 243` � L LLJJ Plan Re a 2 ✓ ✓✓
C Phone: 503.718.2439 Fax: 503.598.1960 ✓ f ,T her Permit:
MAR L O IL
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Date/By:
T I G A R D Ins Line: 503 Date Ready/ : Juris: I El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 3 & /L ' �, ,. , Supplemental information
CITY OFTIGARD wave >v 7
TYPE o %SING DIVISION M ERCIAL E* 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: $ $28,400.00
CATEGORY 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 I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 7275 SW Dartmouth St (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: tigard or 97223
Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: 60/4„ Heat pump
(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
/� / l? p
D ��� �� 7 �nl/1n� /i�.9t!'f5� r / y �OD 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
Gas fireplace
install two 5 -ton gas packs, one 3 -ton gas pack. Complete duct systems for the vent 33.39
for Flue vent for water heater or gas
two 5 -ton units. vent one restroom. install exhaust in suite 120. Install two fireplace 23.32
Log lighter (gas) 23.32
new gas lines and extend one existing. 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
Business name: same as below Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Fumace, 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, LLC Clothes dryer (gas)
Other:
Address: 3075 SW 234 Ave Suite 206 MECHANICAL PERMIT FEES*
City /State/ZIP: Hillsboro OR 97123 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 259.3200 Fax: (503) 848.2597
Plan review (25% of permit fee)
CCB lic.: 56951 State surcharge (12% of permit fee) Jr
_ TOTAL PERMIT FEE 1 / /✓/. ''
This permit application expires if a permit is not obtainedwithin 180
Authorized signature: . days after it has been accepted as complete.
Print name: Michael M
alstrom Date: 2/7/12 • Fee methodology set by Tri- County Building Industry Service Board
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