Permit CITY OF TIGARD MECHANICAL PERMIT
II ° COMMUNITY DEVELOPMENT Permit: MEC2009 -00346
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/21/2009
Parcel: 1 S 136CA01601
Jurisdiction: Tigard
Site address: 11665 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Keybank
Project Description: Limited mechanical TI.
Owner: FEES
HALL, DONALD W & GRACE L & Description Date Amount
HALL, JOHN G ET AL, BY FIRST AMERICAN permit Fee 08/21/2009 $326.00
REAL ESTATE TA, 8435 N STEMMONS Plan Review 07/15/2009 $81.50
PHONE: 12% State Surcharge - Mechanical 08/21/2009 $39.12
Contractor:
GREY WOLF HVAC INC.
7306 NE 37TH AVE
VANCOUVER, WA 98665
PHONE: 360 - 588 -3207
FAX: 360- 326 -8506
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm: 1
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 $446.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Condenser
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 -0100. You ma obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. r
/ r`
Issued By Cl.J��� � l Q Ad0 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.
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Mechanical Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard Received 1, Permit No.: i , 'ik . • -
fh
13125 SW Hal9Blvd., Tigard, 97223 JUL 1 5 2009 C ` t3 • � �1J F2OO co 3
Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: L '
T I G A R D Inspection Line: 503.639 CITY OF TIGARD Date Ready /By: rum: El See Page 2 for
Internet: www.tigard or.gov Notified/Method 14 • � �.Q� .--ti Supplemental Information
BUILDING DIVISIO LM, 1 l
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: mical materials equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION r - -
Value: $ �C1
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
Job site address: 1 1 Co G. S SW pa c i-P i G H W Air conditioning or heat pump lll.dP
Y • (requires site plan showing placement) 14.00
City /State/ZIP: T( C∎rd j 0 VP.. C O 2.2.3 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Key eh : - Tiplard . 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
Flue/vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Urn 1 1 I to nu of 1 r}'1 provrfn>✓rt Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I X TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: Ve'y t Environmental exhaust and ventilation
Address: 2.025 Of�'CI. I 0 3-1-. `'1 t; h F lop y Range hood /other kitchen
equipment 10.00
City/State /ZIP: C It ve l an d r OH 44 1, S Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms, L
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 v'�
❑ APPLICANT 01 CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: ja cob S Fuel r in
P g
Contact name: Cnrl Sc.hro..r $5.40 for first four; $1.00 for each additiona
Address: 250 E. aroad SF. &)i f e 1 i o Gas heat p t pump
City/State /ZIP: COI tkrr] b U $ , 014 L'321 Wall/suspended/unit heater
Phone: (UN ) 437 . 4300 Fax:: ((Q) LI)'f3l• 4304 Water heater
Fireplace
E -mail: Chris. &,hr an k @Jacobs • CO r�n Range
CONTRACTOR Barbecue
Business name: '1 ell o1 ` v ' At, Clothes dryer (gas)
y Q 4..-(k) Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: ` � State surcharge (12% of permit fee)
TOTAL PERMIT FEE 3wZ 6%.0,2.1 � � Thi p er m it application expires if a permit is not obtained within 180
0A446 Authorized signature: da after it has been accepted as complete.
Print name: {� �j -- Date: 114,(09 • Fee methodology set by Tri -County Building Industry Service Board
1:\ Building \.Permits \MEC- PermitApp.doc 01/19/07 440-4617T (I 1/02/COM/WEB)