Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2012 -00270
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
Parcel: 25101 DD00200
Jurisdiction: Tigard
Site address: 7051 SW SANDBURG ST 200
Project: Plastic Metals Technology Subdivision: 1998 -147 PARTITION PLAT Lot: 2
Project Description: Paint booth
Contractor: SPRAY BOOTHS NW INTERNET SALES LLC Owner: SUMMIT PROPERTIES INC
PO BOX 1395 5550 SW MACADAM AVE, SUITE 205
TUALATIN, OR 97062 PORTLAND, OR 97239
PHONE: 503 - 778 -0212 PHONE:
FAX: 503 -427 -0159
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/04/2012 $474.71
Class of Work: ALT Type of Const: VB Plan Review 06/04/2012 $118.68
Occupancy Grp: F -1 Occupancy Load: 12% State Surcharge - Mechanical 06/04/2012 $56.97
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 06/04/2012 $6.00
11x17)
Project Valuation: $15,000.00
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 $656.36
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Spray Booth
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 Notification 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 questions to UNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /t 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.
1
Mechanical Permit Application REC, - FO R (1141(1.; t i s I O N I.\
City of Tigard '+ Y 5.03 lot ,1 Permit No.:I fri ) -' 0
I II I 13125 SW Hall Blvd., Tigard, OR 97223 �`^
Phone: 503.718.2439 Fax: 503.598.1960 MAY 2 3 2 Plan Re • 01 t Date/By: C ' •i 4 ( ( Other Permit:
T I G A li I) Inspection Line: 503.639.4175 C Date Ready : y: 3uris: fa See Page 2 for
Internet: www.tigard -or.gov CITY OF TTG q y � 11 Notified 2. Supplemental Information
BUILDING DIV ISIO N -
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction E" Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhand profit.
Value: Sic
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMEN'IrI SYSTEMS FEES*
❑ 1 - and 2- family dwelling We ommercial/industrial ❑ Accessory building For spedal Information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 7o S( s.t/`•' , . \ C ,l;,al,A0 �� sr . (requires site plan showing placement) 46.75
�rar� Furnace 100,000 BTU (ducts/vents) 46.75
City/ State/ZIP: IC y rf1.D 0 '1 1223 Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: qp. me t iits Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
7 Sq0 D iod , . 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.: 2.S( O( ]»00 Z00 Other fuel appliances: _
DESCRIPTION OF WORK Water heater 23.32
p Gas fireplace/insert 33.39 ,
i I1NZtii' 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/liner /flue/vent 23.32
Other: 23.32
Name: . 1 L M LAS erit .. Q PJI) 4 ,O4 QS1 Environmental exhaust and ventilation:
Address: /051 C _ , � D )Q � Si. [` Range hood/other kitchen
.iw _ equipment 33.39
City/State/ZIP: I � tsp o q 722.3 Clothes dryer exhaust 33.39
Phone: (CA3) (v$ q -. o7 ' Fax: ( )
Single-duct compartments, rt exhaust (bathrooms, utility rooms)
toilet compartments, utility rooms) 23.32
($ APPLICANT 13 CONTACT PERSON Attic /crawlspace fans 23.32
usiness name: ,� -S�f G M e S
Other: 23.32
G" Fuel piping:
Contact name: QA71/4l b fut.0 G ci S7 $1415 for first tour, $403 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater
..$
Phone: ( ) Fax : : ( ) Water heater
Fireplace
E -mail:
3 Range
��
CONTRACTOR Barbecue
Business name: SPac 34" � 'N t) [/J162Al0 SII L Lt!'.
D V Clothes dryer (gas)
Other:
Address: i 0 �Qy ;Tr MECHANICAL PERMIT FEES*
City/ State/ZIP: p 'TURLR
-- r) OI_ 9 70 �o Z Subtotal
Phone: ( 5)3) 178 -...02...17, Fax: (5 `f27 --0 ( Minimum permit fee ($90.00)
T Plan review (25% of permit fee)
CCB lic.: i g 4 5 7 t j (', 113 State surcharge (12% of permit fee)
� TOTAL PERMIT FEE
K•.,,,,„ This permit application expires If a permit is not obtained within 180
Authorized signature: �� days after it has been accepted as complete.
Print name: KCer.r71- • T ' 2d u s4 I Date: , di * Fee methodology set by Tri- County Building Industry Service Board
\ I: Building \Permits \ MEC- Pen 7nitApp.doc 03/0711{ 440- 461TTT(I1 /OTJCOM/WEB)
CITY OF TIGARD FEE AND PAYMENT HISTORY
. y _ 13125 SW Hall Blvd., Tigard OR 97223
• 503.639.4171
T1GARD
MEC2012 -00270 - 7051 SW SANDBURG ST 200, TIGARD, OR 97223
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due
Permit Fee 230 -0000 -43102 $474.71 $474.71 $474.71
Plan Review 230 -0000 -43111 $118.68 $118.68 $118.68
12% State Surcharge - Mechanical 100 -0000 -24001 $56.97 $56.97 $56.97
Info Process /Archiving - Sm $0.50 (up to 230 -0000 -43135 $6.00 $6.00 $6.00
11x17)
Totals for Fees $656.36 $656.36 $0.00 $656.36
Receipt # Payment Method Check # Payor: Receipt Date Receipt Amount
Total Payments: $0.00
Balance Due: $656