Permit CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: MEC2012 -00255
T I G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2012
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 140
Project: Shell Subdivision: 2004 -015 PARTITION PLAT Lot: 2
Project Description: Omsta;; mew 7.5 ton RTU with duct system, vent two and connect gas (line for new RTU.
Contractor: WILLAMETTE HVAC Owner: SN PROPERTIES PARTNERSHIP
3075 SW 234TH AVE. #206 1121 SW SALMON ST
HILLSBORO, OR 97123 PORTLAND, OR 97205
PHONE: 503 - 628 -6841 PHONE:
FAX: 503 -848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/16/2012 $489.95
Class of Work: ALT Type of Const: Plan Review 05/16/2012 $122.49
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/16/2012 $58.79
Stories: Info Process /Archiving - Lg $2.00 (over 05/16/2012 $4.00
11x17)
Project Valuation: $15,600.00 Info Process /Archiving - Sm $0.50 (up to 05/16/2012 $5.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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: 2 Vent Systems: Total $680.73
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 • •- suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility • cation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain - copy of the rules
or dir- questions to OUNC b c mg 50 32.1987 or 1.800.332.2344.
Issu d By: _ � � a Perm ittee Signature: hitt—a 7 c.) - 21 /
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 FOR OFFICE USE ONLY
City of Tigard RECEIVED Recived J� Cn��� �
De e eive / Permit No.: e (N •�
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
I .! Phone: 503.718.2439 Fax: 503.598.1960 6 Other Permit:
T I G A R D Inspection Line: 503.639 MAY 2012 Date/By:
Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov
CITY N Supplemental Information
O� DIVISION
TYPE OF V1�(�lK`'" 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: $ $15,600.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS 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:
/7 w/ Air conditioning
^
Job site address: D. 3 0 / f K (requires site plan showing placement) 46.75
_ p Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: c:_? �. Furnace 100,000+ BTU (ducts/vents) 54.91
1 e /bldg. /apt. no f (./
-� Proj na me: House-of Bread F L L Heat pump
(requires site plan showing placement) 61.06
ro ss 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
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Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert
new 7.5 ton RTU and complete duct system. Vent two restrooms. Connect replacr water 33.39
e t
Flue vent for heater or gas
gas line to new RTU. fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ 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
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) _ 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: same as below
Fuel piping:
Contact name: S14.15 for first four; $4.03 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: Willamette HVAC LLC Clothes dryer (gas)
Other:
Address: 3075 SW 234 Ave Suite 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro, OR 97123 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 259.3200 Fax: (503) 848.2597
Plan review (25% of permit fee)
CCB lic.: 56951 State surcharge (12% of permit fee) 7¢,
/ i TOTAL PERMIT FEE r lp
/ / This permit application expires if a permit is not obtained within 180
Authorized signature: //" / days after it has been accepted as complete.
Print name: Michael Malstrom Date: 5/16/12 • Fee methodology set by Tri- County Building Industry Service Board
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