Permit 11 CITY OF TIGARD 0- MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00234
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/31/2012
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15955 SW 72ND AVE
Project: Guitarish Music/Advantage Point Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Add RTU gaspack, gas lines, duct work and exhaust fan. 2/13/12, reprinted to correct address and project name.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: PACIFIC REALTY ASSOCIATES
PO BOX 241 ATTN: N PIVEN
DUNDEE, OR 97115 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503- 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/31/2012 $474.71
` Class of Work: ALT Type of Const: IIIB 12% State Surcharge - Mechanical 05/31/2012 $56.97
` Occupancy Grp: B Occupancy Load: Plan Review 05/31/2012 $118.68
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 05/31/2012 $14.00
11x17)
Project Valuation: $15,000.00
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: Vent Systems: Total $664.36
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific tinn Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct q s to ∎ UNC by calling 503.232.1987 or 1.800.332.2344.
Issued B , z 4 Permittee Signatur % -(-
::.
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.
CITY OF TIGARD MECHANICAL PERMIT
$ COMMUNITY DEVELOPMENT Permit #: MEC2012 -00234
• TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/31/2012
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: Advantage Point Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Add RTU gaspack, gas lines, duct work and exhaust fan.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: PACIFIC REALTY ASSOCIATES
PO BOX 241 ATTN: N PIVEN
DUNDEE, OR 97115 15350 SE SEQUOIA PKWY #300
'` PORTLAND, OR 97224
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/31/2012 $474.71
Class of Work: ALT Type Const: IIIB 12% State Surcharge - Mechanical . 05/31/2012 $56.97
Occupancy Grp: B Occupancy Load: Plan Review. 05/31/2012 $118.68
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 05/31/2012 $14.00
11x17)
Project Valuation: $15,000.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $664.36
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 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
• applica. . All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
iss :me, or if wo • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules dopted by. the Oregon
lity Notification Ce er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You ay o in .a copy of the rules
•.r direct questions to O ' C , • 503.232.1987 or 1.800.332.2344. .
-sued By: k , II Permittee Signature: .
k
•
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.
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Mechanical Permit Apnlicatioih, 10R OIFf•ICI; USE ONLY
E
City of Tigard x� %�l.j Received
E D Date/By: ii , 1 v Ai Permit No.: _ � (a.. 6t3
° 13125 SW Hall Blvd., Fax: 503.98.1960 OR 97223 ' t r , � O / V
F 5 Plan Review Other Permit: 2. •
Phone: 503.718.2439
MAY i 1 Date/By: /J/d
T I G A It D Inspection Line: 503.639.4175 ZD �2 Date ReadyB •: Juris: ®' See Page Zfor , •
Internet: www.tigard - or.gov CITY OF T1 Notified/Method: .5 ./' /, a/ /r_ Supplemental Information
BU11.nrn1C DIVISION �A R O N '
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
' El 'Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ f • $' "7
CA GORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SiSTEMS 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 Heatinpfcooling:
Air conditioning - '
Job site address: (5-9 / v✓ 76147(1,40,„ (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) . 46.75
City/State/ZIP: /7 / j" /
�Furnace Fuace 100,000+ BTU,(ducts /vents) 54.91
Suite/bldg. /apt. no.: , Project name: l' Heat pump .
(requires site plan showing placement) 61.06.
Cross street/directions to job site: /41,1,441\ -( !�/ A� Pr Duct work • 23.32
� � 1 � / YAP ' 1 i + I _ 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: 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
/� /� A 72( - be 4 -n /, Gas fireplace/insert 33.39
/ /lJ( G( // /�/�j rl✓ Flue vent for water heater or gas
.e)' fireplace 23.32
L Log lighter (gas) 23.32
dye( r - - .11--
.�T Wood/pellet stove 33.39
13 t° X 't.ci �S� FA IA- Wood fireplace /insert 23.32
PROP RTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
��( /// Other: 23.32
Name: AC tat Environmental exhaust and ventilation:
' v
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
Business name: Ok/14(/ Oth er: 23.32 Fuel piping:
Contact name: 6 7 4 //I i- l A4 �/ ° 4' "
$14.15 for first four; $4.03 for each additional
Address: 6�N Furnace, etc.
Gas heat pump •
• City/State /ZIP: Wall /suspended/unit heater
Phone: ((b ) / c7 /'7 , , Fax: : ( ) Water heater • ,
/y Fireplace
E -mail: /'fid? /. fi i ke/ .�
t1 Range
`/ v ® a CONTRACTOR Barbecue
• Business'name: � A (...........-• Clothes dryer (gas)
Address:
j Lf Other:
MECHANICAL PERMIT FEES*
City /State /ZI '� '
`� , V / 1 Y ^ d ig # 9 7) 5 Subtotal
v
Phone: (I'0? `"� �( ) ���j� , � ( / C Fax: ( ) Minimum permit fee ($90.00)
// Plan review (25% of permit fee)
�CCB lic.: / � l�`� \k� State surcharge (12% of permit fee) ,p
6 TOTAL PERMIT FEE 17 fp(p� 3 �P
Authorized signature: This permit application expires if a permit is not obtained within 180
days after,it has been accepted as complete.
Print name: L 1...L M //--) 7A„. ate: 5 / r� • Fee methodology set by Tri -County Building Industry Service Board
Mudding C- PennitApp.doc 09/09/10 44 17T(11/0 OM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
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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 $10 i.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 bui require 2 sets of plans. .
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1: Building \Pennits\MEC- PermitApp.doc 09/09/10 d ; �2.
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