Permit CITY OF TIGARD MECHANICAL PERMIT
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11 • - COMMUNITY DEVELOPMENT Permit #: MEC2012 -00141
Date Issued: 03/15/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S 112DC00100
Jurisdiction: Tigard
Site address: 15605 SW 72ND AVE
Project: Consumer Cellular Subdivlsion: PACIFIC TIGARD INDUSTRIAL Lot: 1 -2
Project Description: Installation of (1) ductless split system for elevator mechanical room.
Contractor: ARJAE SHEET METAL CO, INC. Owner: PACTRUST
5510 SE MCLOUGHLIN BLVD. 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97202 PORTLAND, OR 97224
PHONE: 503 - 231 -7717 PHONE: 503 - 624 -6300
FAX: 503- 230 -4888
FEES
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Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/15/2012 $151.95
-Class of Work: ALT - Type of Const: Plan Review- 03/15/2012 $37.99
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/15/2012 $18.23
Stories: Info Process /Archiving - Lg $2.00 (over 03/15/2012 $2.00
11x17)
Project Valuation: $3,200.00 Info Process /Archiving - Sm $0.50 (up to 03/15/2012 $2.50
11x17)
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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 $212.67
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, St .te of Ojj Spe - Co. . and all other
applicable law. All work will be done in accordance with approved plans. This permit will ex• e if I or is of sta ed hi 180 days of
issuance, or i • • , is suspended for more the 180 days. ATTENTION: Oregon law requires yo , to f. o e rules = doptlf •y the Oregon
Utility Noti . . tion Cen - . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 1090. I , u may ob • in opy of the rules
or direct • estions to OUN. b - ! - 03.232.1987 or 1.800.332.2344. ' ,
/► i ._
Issued = ���/ Ji // PermitteeSignature: / L yv
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 Ti and RECEIVED Received ®� g Date /By: J Permit No.: /L* 4/ '
n 13125 S W Hall Blvd., Tigard, OR 97223
' C Phone: 503.718.2439 Fax: 503.598.1960 Plan Revle
MAR 15 2012 Date /By: , i1 or Other Permit:
TIGARD Ins Line: 503.639.4175 Date R e a . : Juris
Internet: www.tigard - or.gov Notified /Method: Supplemental Information
CITY OF TIGARD
TYPE OF WO�� ILDlAlG DIVISION 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: $ 3200.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - 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: 15605 SW 72 ave (requires site plan showing placement) 46.75
City/State/ZIP: Portland or Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: consumer cellular fullfil 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
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
Install (1) ductless split for the elevator mechanical room Gas fireplace /insert 33.39
Flue vent for water heater or gas
fireplace 23.32
• Lo • li • hter • as 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
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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: ARJAE SHEET METAL Other: 23.32
Fuel piping:
Contact name: HEATH BURMEISTER $14.15 for first four; $4.03 for each a dditional_
Address: 8545 SE MCLOUGHLIN BLVD Furnace, etc.
Gas heat pump
City/State /ZIP: MILWAUKIE Wall/suspended/unit heater
Phone: ( ) 231 -7717 Fax: : ( ) 230 -4888 Water heater
Fireplace
E -mail: HEATH @ARJAE.COM Range
CONTRACTOR Barbecue
Business name: ARJAE SHEET METAL
Clothes dryer (gas)
Other:
Address: 8545 SE MCLOUGHLIN BLVD MECHANICAL PERMIT FEES*
City /State /ZIP: MILWAUKIE OR Subtotal / 57 .9S
Phone: ( ) 231 -7717 1-4888 Minimum permit fee ($90.00) y.
Plan review (25% of pennit fee) 7.
CCB tic.: 60835 State surcharge (12% of permit fee) j g'_a3
r TOTAL PERMIT FEE '4/ • 0
This permit application expires if a permit is not obtained
Authorized si :nature: ' / ' vow. days after it has been accepted as comp e wit .
MI L� t! Date: 3 - — (0 • Fee methodology set by Tn -County Building Industry Se ice Board
I: \Building \Perini'\ EC- PermiiApp.doc 03'07'12 4404617T(I1,02/COM /WEB) Q?! a' � 7