Permit CITY OF TIGARD MECHANICAL PERMIT
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!i COMMUNITY DEVELOPMENT Permit#: MEC2012 -00199
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/24/2012
Parcel: 2S101AB00100
Jurisdiction: TIGARD
Site address: 12005 SW 70TH AVE
Project: Acupuncture Clinic Subdivision: Lot:
Project Description: Installation of Type II hood exhaust.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: RED ROCK BUSINESS ASSOCIATES LLC
PO BOX 241 23077 SW NEWLAND RD
DUNDEE, OR 97115 WILSONVILLE, OR 97070
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/24/2012 $84.41
Class of Work: ALT Type of Const: Plan Review 04 /24/2012 $21.10
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 04 /24/2012 $10.13
Stories:
Project Valuation: $1,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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 $115.64
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas O utlets: Other Desc: -
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Sp Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is • • 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 N. • • : enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You � :y 0. ain a copy of the rules
or dir: que tions toe NC b : • If • : • 03.232.1987 or 1.800.332.2344. /
Iss ed By: / iP a -. c / Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Mechanical Permit Apulicatic ' '•: -, l )R ol� Flcl: usl.: c),N 1.Y
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City of Tigard I'° Received 5/ a 4 �� ( Permit rlge4o a -a� //9
° 13125 SW Hall Blvd., Tigard,OR 97223 APR 2 4 2012 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: CnherPermit: - 6/40€941
I' I C. n R D Inspection Line: 503.639.4175 y � / r . 1 � p Date Ready/By: Jung. la See Page 2 for
Internet: www.tigard- or.gov CITY I �+ Y �� %tl ° Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are b. • • : • . • :. - . the work
❑ New construction Addition /alteration/replacement performed. Indicate , • . ue (rounded to the nearest tl . . 1
❑ Demolition Other: mechanical material., e• i.ment, labor, overhead, and .ro it.
CATEGORY OF CONSTRUCTION ®'�
RESIDENTIAL t ••3l 11 0101 k•Y01 DI3
❑ 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
Job site address: ZOO 5- 7 —` 1 J � (requires site plan showing placement) 46.75
• T Furnace 100,000 BTU (ducts/vents) 46.75
City /State/ZIP: i - / / 7 - Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Pr .Ject name: I / , � , 1�� Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: �( Duct work 23.32
, Pd y �' v.� _ l O � /�ZI !/ -/-1"? Hydronic hot
boiler 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: I 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
7/
Ii J a -e � Gas fireplace/insert g 33,39
/ �1 Flue vent for water heater or as
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
) Fax: Single -duct exhaust (bathrooms,
Phone: (
( ) toilet compartments, utility rooms) 23.32
APPLICANT y CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Other: 23.32
0/&/*/1tj ' { . _) /�I Fuel piping:
1i / �7) ✓" 77t/Vl.; VLF 1 4.15 for
Contact name: $14.15 first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Lt Wall /suspended/unit heater
Phone: (�3) Sit/ C, CJl � Fax: : ( ) Water heater
�
-p Fireplace
E -mail: AA / L / / e/tl�l . �' Range
L
- CONTRACTOR Barbecue
Business name: /
FC, Clothes dryer (gas)
v �
Other:
Address: 1}1/ , J MECHANICAL PERMIT FEES*
City/State /ZIP: `�%0 y � ? C - O / 7 / / � Subtotal �y. q Phone: ( ) Fax: ( ) C Minimum permit fee ($90.00)
Plan review (25% of permit fee) 9,1. to
CCB lic.: / �` State surcharge (12% of permit fee) /0.1 3
I TOTAL PERMIT FEE /75. (o
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: / ` Date: • Fee methodology set by Tri County Building Industry Service Board
I:\Building\PermitsVMEC- PermitApp.doc 09/09/10 410-4617T(11/0 COM/WEB)
Mechanical Permit Application - City of Tigard
Page . 2 - Supplemental Information '
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and • , •
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof. •
Note: All new commercial buildings require 2 sets of plans.
•
IABuildingWermits MEC- PermitApp.doc 09/09/10 2