Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2012 -00224
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 • Date Issued: 05/08/2012
Parcel: 2S 101 AB01606
Jurisdiction: Tigard
Site address: 7357 SW BEVELAND RD 200
Project: Beveland Wellness Center Subdivision: HERMOSO PARK Lot: 17
Project Description: Relocate ducts and grilles.
Contractor: THOMAS C CLARKE CONSTRUCTION Owner: CLARKE, THOMAS C & SUSAN L
7357 SW BEVELAND ST 12439 SW 22ND AVE
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
PHONE: 503 - 597 -7017 PHONE:
FAX: 503 - 597 -7018
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/08/2012 $145.81
Class of Work: ALT Type of Const: Plan Review 05/08/2012 $36.45
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/08/2012 $17.50
Stories: • -
Project Valuation: $3,000.00
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 $199.76
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
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. •ecialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work '- n.t started within 180 days of
issuance, or if work is suspended for more the 180 ATTENTION: Oregon law requires you to • - e rules adopted by the Oregon
Utility Notifi . '• - - r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - i; • I. Yo may obtain a copy of the rules
or direct q - stions to OU . 503.232.1987 or 1.800.332.2344.
I i f
ssued By ` 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 Application voiz olr•icl.: usl..ONLY
City of Tigard Date/By: 5 2 r LY��-
y g / �'/ Permit � � G I� / �/_
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
e Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TI A K D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
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: mechanical materials, equipment, labor, overhead, and profit.
Value: $jam Gal-
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
❑ 1- and 2- family dwelling , ommercial/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: 7 7 SLR 'g�Vr 1, h '- Sit / I r' 31D (requires site plan showing placement) 46.75
p, ,Z2 Furnace 100,000 BTU (ducts/vents) 46.75
City/State /ZIP:
C- Z� G'R l -S Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: vo vsS 1uv 1 4 C R EA_3't5 4eat pu
Require site plan showing placement) 61.06
Cross street/directions to job site: ' 7 `AD ( 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
^ Gas fireplace/insert 33.39
T rz 11 A't' `' 1 1 Q 2U'(t1M ftvtT Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney/lfiner /flue /vent 23.32
Other: 23.32
Name: V-111 1 S S I () 1 ✓, Get 'q 4S FLJLmv2p, - clUvvl Environmental exhaust and ventilation:
Address: 1 ..1-)''S----7 SLti.I �TzI �M % 5 - 2d) Range hood/other kitchen
equipment 33.39
City/State /ZIP: (,0124) OIL_ Z 7-3 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (S) " - 7q3 -26,z I Fax: ( ) toilet compartments, utility rooms) 23.32
„APPLICANT -CI-CONTACT PERSON Attic/crawlspace fans 23.32
Business name: 5i-31 �� C i L 1E �1 VI �t Other: 23.32 _
�� \ I Fuel piping:
Contact name: r 1 rAAA G/VLlc ____ $14.15 for first four; $4.03 for each additional
Address: C 1'2 - C1 Sla ' � ri( IA/10 ST s I I h . /to Furnace, etc.
Gas heat pump
City /State /ZIP: �1( c2 , CI 12-7 3 Wall /suspended/unit heater •
Phone: S 70 — ze, I Fax: : (95) S/ 7o /P-1 Water heater
- - / Fireplace
�'w \ V�1
E -mail: �® _S C' C Jac / C&4V Range
CONTRACTOR Barbecue
Business name: r • , l (^i (Ajax Co'vlc _ Clothes dryer (gas)
/ Other:
Address: %
-72,c•—? '� u � .*�+'i o , ? V �. 1 , / io MECHANICAL PERMIT FEES"
City/State /ZIP: "1���0 r^ / « ,C Subtotal /�j
c7C� 1 p O Minimum permit fee ($90.00) �—
Phone:
O 9) ( i z , z I Fax: S7 7 / Plan review (25% of permit fee) 36.q s
CCB lic.: 1 G� j /\
. State surcharge (12% of permit fee) (7. 60 „ TOTAL PERMIT FEE 19 9,7 4”
Authorized slgna Ir • / / / This permit application expires if a permit is not obtained within 180
c � \ / L ei days after it has been accepted as complete.
mplete.
Print name: �( Cla�1�l =✓ 1 Date��J� • Fee methodology set by Tri County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 03/07/12 qk / 0-361 T(11 /02/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.
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