Permit C ITY OF TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00425
s Z ° �JI i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/25/2006
PARCEL: 2S 102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 90 ZONING: C - G
SUBDIVISION: TIGARD MARKETPLACE LOT: JURISDICTION: TIG
Project Description: HVAC mechanical. Project Value: $11,500
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PACIFIC CORP /ELLIOTT ASSOCIATES Description Date Amount
200 SW PINE ST, SUITE 200
PORTLAND, OR 97204 [MECH] Permit Fee 9/25/200E $251.75
[MECPLN] Plan Rev 91251200E $62.94
[TAX] 8% State Surcha 9/25/200E $20.14
Phone: 503- 224 -6791 Total $334.83
Contractor:
WILLAMETTE HVAC SERVICE
PO BOX 23334
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PM 503- 628 -6841
FAX 503- 848 -2597
Reg #: LIC 56951
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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 tain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: /* •* (1474/
Call 503 - 639 -4175 by 7:00 a.m. for inspections th t 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.
13500 ct.<<-c-ri
Mechanical Permit Annli t'sn; , FOR (H TIC 1('l.: (�SI� ONLY
L
City of Tigard ' 1 i 7 l } p Received , l Permit No.: fl 10 . Q4 ,,,
° 13125 SW Hall Blvd., Tigard, OR 972 �\ Plan , i
' . Phone: 503.639.4171 Fax: 503. 8. 1960 2 Datein IAN o Other Pe ' . ,, - / Ol�31 ��
TI G n It I� Inspection Line: 503.639.4175/ (orAU G 2 2006 Date Rem' C � ( 1 , 1 io s. ® . Page 2 for
Internet: www.tigard- or.gov Notified/Method b' ao `, , Yf Supplemental Information
t1„; ti ;I l Olt ii ∎-) .tii ., IIM i s n,
TYP T9fT�i T --• r7n q(' CORER L FEE* SCHEDULE - USE CHECKLIST
Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
0 New construction p
• performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ // 5700 . --S
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1 - and 2 family dwelling PrCommercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. ( Ea. I Total
• JOB SITE INFORMATION AND LOCATION L Heating/cooling
Job site address: / 3 SO® S'C.A.) 1 ! / v
G � , 14114/ Air conditioning or h gtp ump
(r ' (requires site plan showing lacement ) 14.00
City / State/ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
f Furnace 100,000+ BTU ( duds/vents) 17.90
Suite/bldg./apt. no.. Project name ! `t Gas heat pump 14.00 g,,
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
311 hydronic) 14.00
Unit heaters (fuel -type, not electric),
/� j in -wall, in -duct, suspended, etc. 10.00
Subdivision:
\ 0
I Lot no.: Flue/vent for any of above 10.00
. Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
�j Gas fireplace 10.00
�tC c.J ��1� C n„-A e,vro� Flue vent for water heater or gas
f c2c., r..� wa c......-. / y N fireplace 10.00
11'1 A s l Log lighter (gas) 10.00
c719 Wood/pellet stove 10.00
1j 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
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City / State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: > ! / G /-,1/4 C Clothes dryer (gas)
q Other:
Address: ) ''O )3o A 1 3 3 7 'r MECHANICAL PERMIT FEES*
City / State/ZIP: as C2./' q /t.z 81 Subtotal
( ) b $ - li to ( 5 , 3 'Ng �sy' Minimum permit fee ($72.50)
Phone: /� I F a x Plan review (25% of permit fee)
CCB lie.: . 5-6 q s State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized Signature: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
' I Print name: 7' S I Date: • Fee methodology set by Tri- County Building Industry Service Board
I:U luildingWemitsVMEC- PennitApp.doc 04/06/06 440 - 4617T(I1 /02/COM/WEB)
, a _• � i� ` ,
Mechanical Permit Application - City of Tigard
Page 2 - S upplemental 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 ' •`
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
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Note: All new commercial buildings require 2 sets of plans.
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