Permit n CITY OF TIGARD MECHANICAL PERMIT
•
• 2 ' COMMUNITY DEVELOPMENT Permit #: MEC2012 -00205
T 1 G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/25/2012
Parcel: 1 S126CC00200
Jurisdiction: Tigard
Site address: 10065 SW CASCADE AVE
Project: Toys -R -Us Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Remove and replace (5) rooftop units.
Contractor: BEND HEATING & SHEET METAL INC Owner: LAMAR ADVERTISING OF EUGENE
PO BOX 5727 PO BOX 66338
61540 AMERICAN LN BATON ROUGE, LA 70896
BEND, OR 97702 -9403
PHONE: 541 - 382 -1231 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/25/2012 $726.17
Class of Work: ALT Type of Const: Plan Review 04 /25/2012 $181.54
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 04 /25/2012 $87.14
Stories: Info Process /Archiving - Sm $0.50 (up to 04/25/2012 $15.00
11x17)
Project Valuation: $24,900.00
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 $1,009.85
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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, 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 . ion - • -r. • •se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or •' ect questions to OU by ca in. .232.1987 or 1.800.332.2344.
1 - ued By: ,441! � Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available in lion e.
This permit card shall be kept in a conspicuous place on the job site ntil pletion • the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Appli ' t ti ED FOB? OFFICE USE ONLY
City of Tigard
t' C' Received
Date/By: T �y
l/ '� � Permit No.: 6 ,f�0 / � `X — v v 1
, �
° 13125 SW Hall Blvd., Tigard, O"
•
Plan Revi
C Phone: 503.718.2439 Fax: 503.598.19ib(� 2 5 2012. Date/By: �e- Other Permit: ME
T I G A R D Inspection Line: 503.639 A�" !r Date Ready /By: Juris: El See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE
u�I C' Sn �� 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, andp fit.
Value: $ a/" 9 ,
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
El 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 -Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heatinp,/coolinR:
Air conditioning
Job site address: /0065 5 (f eg (zk ivd (requires site plan showing placement) 46.75
,/i 0 g 8 7 223 Furnace 100,000 BTU (ducts/vents) 54.9
�'
City /State /ZIP: i ` Furnace 100,000+ BTU (ducts/vents) (ducts/ves /vents) 54.91 1
Suite/bldg. /apt. no.: Project name: tid Heat pump
��� a � _ °� �' (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
H �� Gas fireplace /insert 33.39
eirY� �� / / / i ;d 0 , ' t�� e�a� eh / e7 5 Flue vent for water heater or gas
fireplace 23.32
a /'// a / J Log lighter (gas) 23.32
n Wood/pellet stove 33.39
Wood fireplace /insert 23.32
g PROPERTY OWNER ❑ TENANT
Chimney/liner/flue/vent 23.32
Other: 23.32
��
Name: 9N . ,9_„,- Environmental exhaust and ventilation:
Address: r yppf ,��e /��� > / Range hood/other kitchen
equipment 33.39
City/State /ZIP: 7 , , ;,/ ( 34' 1 y 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: //�� (� Other: 23.32
ll�J //CT9 /r/ /�41 ' / meel�i edez1 / Fuel piping:
Contact name: fgS ,997 a
/4,f- eel( $14.15 for first four; $4.03 for each additional
Address: 6150 i9A t�he. Furnace, etc.
,.l � Gas heat pump
d& City /State/ZIP: Ad O I 9 2 - Wall /suspended/unit heater
Phone: (5qO 7f, /�?/ Fax: : (9t /) — �`/ Water heater
E -mail:
v ‘M2, Fireplace
Range
CONTRACTOR Barbecue
Business name: I3l°nJl & „,,, / ,. /) , Other: a ,� { mil,., / / Clothes dryer (gas)
� / /,r / ,net,
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB tic.: 000653 State surcharge (12% of permit fee)
�/ TOTAL PERMIT FEE
Authorized signature: ,f/ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: J /I /< Date:�f4�j / • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building\ Permits \ vrEC•PermitApp.doc 03/07/12 440-4617T(11/02/COM/WEB)
1 o ° Building Division
Over- The - Counter (OTC) Mechanical Permit
TIGARD
Check List
Project Description: a,(EC -3 (C &�..--
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: f C Occupancy Group: lk Type of Construction:
*Type of Use: Oregon Specialty Code: 7_6
Number of Stories: 1
FUEL FURNACES
Type: Furnace < 100K BTU __ Furnaces >= 100K BTU
Gas Pressure: Roof Top Unit (RTU) Tons 1 v
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler (BTUs) Vent Fans Gas Line
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work Gas Fireplace
Fire /Smoke Dampers Other Mechanical Units — Describe:
Total Project Valuation: $ 2 -4 1 c FEES DUE
$ 726. 17 Mechanical Permit Fee
$ ( . _ Plan Review
$ ��7 14 12% State Surcharge
$ Info Proc /Arch, Lg (over 11x17 $2.00)
$r'5•— Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Misc. Admin Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff: /DO 9 K.
Date /Time: $ 1 0- FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
1: \Building\Forms \OTC - MEC.docx 01/13/2011