Permit CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00404
T t G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/01/2012
Parcel: 2S 101 AA00101
Jurisdiction: Tigard
Site address: 12000 SW 66TH AVE
Project: Landmark Ford Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: (1) push/pull furnace on existing paint booth
'9REPRINT 8/1/12 Add Duct Work in ASI**
Contractor: WILLAMETTE HVAC LLC Owner: CORLISS, JAMES L & CORA K
3075 SW 234TH AVE. #206 LEASE TO: FORD LEASING
HILLSBORO, OR 97123 DEVELOPMENT COMPANY
PO BOX 23970
TIGARD, OR 97281
PHONE: 503 - 259 -3200 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/01/2012 $249.36
Class of Work: ALT Type of Const: Plan Review 08/01/2012 $62.34
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 08/01/2012 $29.92
Stories: Info Process /Archiving - Sm $0.50 (up to 08/01/2012 $0.50
11x17)
Project Valuation: $6,500.00
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: 1 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 $342.12
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
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 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 OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: i\1 APP CAI-10A
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
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00404
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/01/2012
TIGARD . 9 Parcel: 25101AA00101
Jurisdiction: Tigard
Site address: 12000 SW 66TH AVE
Project: Landmark Ford Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: (1) push /pull furnace on existing paint booth
Contractor: WILLAMETTE HVAC LLC Owner: CORLISS, JAMES L & CORA K
3075 SW 234TH AVE. #206 LEASE TO: FORD LEASING
HILLSBORO, OR 97123 DEVELOPMENT COMPANY
PO BOX 23970
TIGARD, OR 97281
PHONE: 503 - 259 -3200 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/01/2012 $249.36
Class of Work: ALT Type of Const: Plan Review .08/01/2012 $62.34
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 08/01/2012 $29.92
Stories: Info Process /Archiving - Sm $0.50 (up to 08/01/2012 $0.50
Project Valuation: $6,500.00 11x17)
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: 1 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 $342.12
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. 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 -rted 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. Y-ou may o. ain a copy of the rules
or direct questions to OU C by calling 503.232.1987 or 1.800.332.2344.
Issued 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.
1
•
Mechanical Permit Application D FOR OFFICE USE ONLY
City of Tigard Received
Date/By: $ ( I Permit No�,��(a,,.. t / A
7 ° 13125 SW Hall Blvd., Tigard, OR 97223
AUG 01 2012 Plan Review ��' �' /�� �
Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 DateDate/By: fi r]
T I G A R D Inspection Line: 503.639.4175 OFG aotl D a t e R eadyBy: 171 See Page 2 for
Internet: www.tigard- or.gov li 11111/ Noti f ied/Method: Supplemental Information
BUILO1NOOIVISIO'► BM
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: $ $6,500.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- 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: 12000 Southwest 66th Avenue (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: Tigard OR Fumace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: landmark ford 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
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
furnace on existing paint booth Gas fireplace/insert f wat 33.39
push/pull g P 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 ❑ 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: $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) ❑0000❑❑❑❑❑❑ °0000❑❑ ❑111111 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
Phone: (503) 259.3200 Fax: (503) 848.2597 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 56951 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized si ature: /� This permit application expires if a permit is not obtained within 180
f� / 1 v(� (� / � da after it has been accepted as complete.
Print name: Michael malstrom Dat . • Fee methodology set by Tri- County Building Industry Service Board
I:\Building \ Permits \MEC- PermitApp.doc 03/07/12 4404617T(1I /02/COM/WEB)
III e ° Building Division
Over- The - Counter (OTC) Mechanical Permit
T l c n li Check List
Project Description: G 4 e-tt .J(Z'. -C, MCC, a0I ° 4Dtii9c
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: Oregon Specialty Code:
Number of Stories:
FUEL FURNACES
Type: Furnace < 100K BTU Furnaces >= 100K BTU
Gas Pressure: Roof Top Unit (RTU) Tons
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler (BTUs) Vent Fans Gas Line
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work l Gas Fireplace
Fire /Smoke Dampers Other Mechanical Units — Describe:
Total Project Valuation: $ 6j ` ,� FEES DUE
$ , 36, Mechanical Permit Fee
$ Malerk Plan Review
$ Z - 12% State Surcharge
$ Info Proc /Arch, Lg (over 11x17 $2.00)
$ . Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Misc. Admin Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff:
Date /Time: $ jk2- TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I:\Building\Forms \OTC - MEC.docx 01/13/2011