Permit CITY OF TIGARD MECHANICAL PERMIT
11 4 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00403
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2012
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12280 SW SCHOLLS FERRY RD
Project: Little Caesars Subdivision: WINDSOR PLACE Lot: 32
Project Description: Type II hood, exhaust fan, MUA fan and gas piping
Contractor: OREGON HEATING & AIR CONDITIONING Owner: FW OR- GREENWAY TOWN CENTER LLC
PO BOX 241 PO BOX 790830
DUNDEE, OR 97115 SAN ANTONIO, TX 78279
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 -691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/02/2012 $395.97
Class of Work: ALT Type of Const: VB Plan Review 08/02/2012 $98.99
Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Mechanical 08/02/2012 $47.52
Stories: 1 Info Process /Archiving - Lg $2.00 (over 08/02/2012 $2.00
11x17)
Project Valuation: $11,820.00 Info Process /Archiving - Sm $0.50 (up to 08/02/2012 $11.50
11x17)
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Fumaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Fumaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 1 Vent Systems: Total $555.98
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 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: Permlttee 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 p r r cilil I Olz OFFIcl.: 1Jst: ()NI.,
City of Tigard bate/By: ••• 't No.
III
C ° 13125 SW Hall Blvd., Tigard, OR 97223 AUG 01 2012
Phone: 503.718.2439 Fax: 503.598.1960 • an evlew� ` 0 0IM
Date/By: ether Permit:
T I G A R D Inspection Line: 503.639.4175 f . Date Read : y : ® See Page 2 for
� j Internet: www.tigard or.gov I ` ¢G R41 Notifie Supplemental Information
BUILOtWWG DING' .
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, er
labor, vh d and rofit
Value: $�
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPME / STEMS FEES•
13 1 - and 2- family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
� ))J Air conditioning
Job site address: / 40 y� GG�! 3� � f c � A b C 4 (requires site plan showing placement) 46.75
/_� � ► /J Furnace 100,000 BTU ( ducts/vents) 46.75
City/State /ZIP: I/
i / - ►� / I Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: /] Project name: /- j//te COP Heat pump
(/ (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
I )l i l p (r 3 1_ Hydronic hot water system 23.32
r i/� 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
b/e0o/ 7.- Gas f fr/ins 33.39
Flue vent ant foor wateto r heater or gas
lX /'® 0- /� / fA fireplace 23.32
r v Log lighter (gas) 23.32
4 { �/ Wood/pellet stove 33.39
6 C / v Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ 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
Fa Single -duct exhaust (bathrooms,
Phone:
( ( ) toilet compartments, utility rooms) 23.32
APPLICANT CONTACT PERSON Attic/crawlspacefans 23.32
Other: 23.32
Business name: oi / Fuel piping:
Contact name: G C / , "/ /" $14.15 for first four; $4.03 for each additional
Address: �` [ /_ � ' f 1 'V Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: (< ) >S _! /b I Fax:: ( ) Water heater
/ �) /{ / /,, n, Fireplace
E -mail:
G( ' L l.�f [/ / t ai 't ; ' �`�' Range
CONTRACTOR Barbecue
O / / A6 Clothes dryer (gas)
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Business name: 1"b1V
Other.
Address: �� MECHANICAL PERMTT FEES*
City/State /Z g.e•-e---, r O J >d45- Subtotal
Phone: (ye9 6 / ?b Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: / '7 ./ 'ui State surcharge (12 %ofpermit fee)
TOTAL PERMIT FEE
Authorized si ature: This p ermit application expires if a permit is not obtained within 180
�' days after it has been accepted as complete.
Print name: 6 / L "f`/I�t I Date: / `ate B) I • Fee methodology set by Tri County Building Industry Service Board
I:\ Building \Pernits\MEC- PermitApp.doc 03/07/12 7T (II /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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