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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2012 -00158 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/27/2012 Parcel: 1 S134AD06200 Jurisdiction: Tigard Site address: 10565 SW NIMBUS AVE 100 Project: TSE Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: A Project Description: Duct work. Contractor: HVAC INC Owner: HANSON, RONALD D 5188 SE INTERNATIONAL WAY ROBINSON, CONSTANCE A MILWAUKIE, OR 97222 ROBINSON, CHESTER TRUST ET AL 203604 EAST FINLEY RD KENNEWICK, WA 99331 PHONE: 503- 462 -4822 PHONE: FAX: 503 -462 -6555 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 03/27/2012 $78.27 Class of Work: ALT Type of Const: Plan Review 03/27/2012 $19.57 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/27/2012 $9.39 Stories: 1 Info Process /Archiving - Lg $2.00 (over 03/27/2012 $2.00 Project Valuation: $750.00 11x17) Fuel Air Handlers Fuel Types: 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 $109.23 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: 1 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 les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. ou obtain a copy of the rules or direct questions to OUNC by calling 503.237 1987 1.800.332.2344. Issued By: / ■.. '' ee. Signature: ,` jt .�- v Call 4fillr by 7:00 a.m. for the next available inspection .ate. This permit card shall be kept in a conspicuous place on the job site until comp :tio of the project. Approved plans are required on the job site at the time of each inspe .n. Mechanical Permit Application 0 roll orrlcr I SE ONLY City Tigard Received Permit N tY of Ti an g ""�_�� (�� Date/By: ri • � /%� __ g � � 13125 SW Hall Blvd., Tigard, OR 970 Plan Review 11 Phone: 503.639.4171 Fax: 503.598. 10\ Plate/By: g . ` t' Permit: Inspection Line: 503.639.4175 � / ©� T I G �\ Ii D `� � � , 1h ' Date Ready /:y: Jas: ® See Page 2 for Internet: www.tigard -or.gov '�� "I ` i i'� tk't ik l ' t ` ^ Notified/Method: E Supplemental Information di OV 9�� TYPE OF WORE". � `` � COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction jg Addition/alteratid�Teplacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ — 1 ,- -:, -- o RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwellingCommercial/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 Job site address: V c ( 1 � �� N)' V\ ' to 4 �\� 13 I d S Air conditioning or heat pump l , v 1 11 (requires site plan showing placement) 14.00 City/ State/ZIP: 'I C A7 (7 c\ -0.23 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: 1 O Project name: I ?.., 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 DESCRIPTION OF WORK Water heater 10.00 firGas eplace .i/ Rk( '\ A9' ■ �� Flue ventfor water for or gas 10.00 fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00 Other: 10.00 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 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 // ( v so ✓ J Other. 10.00 Business name: t1 v ( Fuel piping Contact name a iA $5.40 for first four; $1.00 for each additional Address: , I S C 1V/‘ \--.' l \A) V` Furnace, etc. Gas heat pump City/State/ZIP: M \\ W v \�.N ' Y) ;' )/ Wall/suspended/unit heater 11 Phone: ( 4 � � % Fax: : (5 a3) "1 \41--).- 6--,------- Water heater Fireplace E-mail: . p Ay OVO v\VQ ,t " ^p `,0 +'iw\ Range CONTRACTOR Barbecue Business name: IA \I 1 0 ( _ y ' Clothes dryer (gas) O� ek Other: Address: MECHANICAL PERMIT FEES* City/ State/ZIP: V Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) ) S - Plan review (25% of permit fee) CCB tic.: 3 b Vt'l State surcharge (12% of permit fee) ' TOTAL PERMIT FEE /0 1, }5 Authorized signature: CAn 11 This permit application expires if a permit is not obtained within 180 Vt days after it has been accepted as complete. Print name: I \. 1 � Date: "3 -)-.) I • Fee methodology set by Tri -County Building Industry Service Board I:t Building /Permits\MEC- PermitApp.doc of '•'r; 440- 4617r(I 1/02CO /WEB)