Permit CITY OF T I G A R D MECHANICAL PERMIT
,,o0l,i DEVELOPMENT SERVICES PERMIT #: MEC2005 -00082
41-
Ail 13125 S Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/18/2005
PARCEL: 2S102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 15 SHERWIN - WILLIAMS ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: HVAC Valuation $18,500.
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: 1 VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: 2 VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 437,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: U 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: 2
GAS OUTLETS:
Owner: FEES
13500 PACIFIC CORP BY CAP ADVISORS Description Date Amount
38345 TEN MILE RD STE 170 [MECPLN] Plan Rev 3/2/2005 $146.71
FARMINGTON HILLS, MI 48335 [MECPLN] Plan Rev 3/2/2005 $86.56
•
[TAX] 8% State Surchar€ 3/18/200f $27.70
Phone: [MECH] Permit Fee 3/2/2005 $60.15
[MECH] Permit Fee 3/18/200E $286.10
Contractor: Refund - [MECPLN] Plal 3/11/200° - $146.71
OREGON HEATING + A/C INC Total $460.51
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 538 - 2953
Reg #: LIC 125815
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to O NC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: 41/ Permittee Signature:� - 0 7
Call 503- 639 -4175 by 7:00 a.m. for inspections 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 • 3 • t QIL ± vp FOR OFFICE USE ONLY
City o£Tiga'd ` Received iv PermitNo� C� +� �i ' � D 6
13125 SW Hall Blvd., Tigard, OR 97223 y
Phone: 503.639.4171 Fax: 503.598.196 02 / I Plan Review ? /G S
2005 I I Date/By: Other Permit:
Inspection Line: 503.639.4175 o. e 2 for
Internet: www.ci.tigard.or.us
_... Date Ready/By: Juris: ® See Page
g ClT N / 5 Supplemental In .rmation
111 Y OF TIG�� v, /I:7li��%>> ' JWI ' ;
ISION COMMEKCIALFEE *,,..CIIEDULE L USE_ CHECKLIST '
A New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition El Other: mechanical materials, equipment, labo verhead, and profit.
- CATEGORY OF CONSTRUCTION Value: $ ��
RESIDENTIAL EQUIPMENT,/ SkSTEMS'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 or heat pump
Job site address:
I3 . 5 - 0 U 9.0 (L( U it - H o b q I (requires site plan showing placement) 14.00
City/State/ZIP: � c Furnace 100,000 BTU ( ducts/vents) 14.00
Suite/bldg. /apt. no.: 6 `�d Project name: I (� 1f Furnace 100,000+ BTU (ducts/vents) 17.90
w�� l Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
•I•I•IHi Hydronic hot water system 14.00
or. zarie ,IT."" Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: l Lot no.: Flue/vent for any of above 10.00
• Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
I / / �(�
DESCRIPTION OF WORK ,, Water heater 10.00
9 `1 tiv(
I'" — ? g_' S I U}+ /W( v Gas fireplace 10.00
/ I Flue vent for wa heater or gas
3 04 LW - S S fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY 'OWNER . 1 ❑ 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
Other: 10.00
Business name: Fuel p t to
� l g
Contact name: aity C �J j -, 0 /6 "J $5.40 for first four; $1.00 for each additional
Address: 1 V / Furnace etc. •
Gas heat pump
City/ State/ZIP: Wall/suspended /unit heater
Phone: ( ) I Fax :: ( ) Water heater
Fireplace
E -mail: Range
C tA -f C lothes e
Business name: '((LL Clothes dryer (gas)
L
■ Other:
Address: po MECHANICAL PERMIT FEES*
City/ State/ZIP: O - ( '71( S Subtotal
Phone: (51j,) 0 24,9 F
( ) ✓ ' /,� 7 L Minimum permit fee ($72.50)
Plan review (25% of permit fee) _
CCB lic.: / Z 456/ 5 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: Q'2L„/71 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ( 4_ L / I Date: /.L/ I • Fee methodology set by Tri- County Building Industry Service Board
is Building \Permits'.MEC- PemdtApp.doc 12/03 440.4617T(I1rovCOM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or I S 0
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and 1
$1.10 for each additional $100.00 or 2,5
fraction thereof. C f (o
Ve ()Al- 3
Note: All new commercial buildings require 2 sets of plans.
S'
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i:\Building\Permits\MEC- PermitApp.doc 12/03 2
i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00082
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/18/2005
Phone: (503) 639 -4171 .. p11 A ,�P1ln I"h
Inspection Requests (24 Hrs.): (503) 639 -4175 _�'!!� ° 'I .. ,
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
5/10/2005 7:16AM 19
SITE ADDRESS: CLASS OF WORK:
13500 SW PACIFIC HWY 15 SHERWIN- e$
SUBDIVISION: TIGARD MARKETPLACE` # ' TYPE OF USE:
PROJECT NAME: SHERWIN- WILLIAMS PAINT STORE
DESCRIPTION: HVAC Valuation $18,500.
OWNER: PHONE #:
13500 PACIFIC CORP BY CAP ADVISORS,
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 538 -2953
Inspection Request Scheduled For: Date: 5/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 00650301 503.538 -2953 N '
Corrections/Comments/Instructions:
t/'" ( 04e ...... k Eat_
I
p P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL , ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 51 V6 Phone #: (503) 718
L