Permit 4 ,
CITY OF TIG MECHANICAL PERMIT
: COMMUNITY DEVELOPMENT Permit #: MEC2009 -00204
T I G AR TO 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/12/2009
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 110
Subdivision: Lot: 0
Project: Sterling Communications
Project Description: Install 20' of 1" gas line from new meter to 80kw stand -by generator.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee 05/12/2009 $72.50
#300 12% State Surcharge 05/12/2009 $8.70
PHONE:
Contractor:
AGAPE GASWORKS LLC
8940 SE CLINTON ST
PORTLAND, OR 97266
PHONE: 503 - 570 -9722
FAX: 503- 775 -1007
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue 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 $81.20
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 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
Utili tification Cen - . T les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You m. f •btain .‘,•py of e . es
Is ed By: � 4� ` i �` � � 1 Permittee Signature: `� A '=
Call 503.639.4175 by 7:00 a.m. for an inspection that busin .
This permit card shall be kept In a conspicuous place on the job site until coin • - Ion of the project.
. Approved plans are required on the job site at the time of each inspection.
1 echaeical Permit Application FOR OFFICE USE ONLY
City of Tigard Received DDate/By: O �o' 11.11 Permit No.: ; e ` q
_ ` y ?...,,,, 0 „9,,,,
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
•IPI ' C . Phone: 503.639.4171 Fax: 503.598.1960 D ate /B y: Other Permit:
TI G A R D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
ID New construction Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ kin
1 - 2 dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ y g ,rCommercial/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
Job site address: # Air conditioning or heat pump
/ L /9 % U�" S w S e Q (.4 Q 1 O 1 K( s , } � / / n (requires site plan showing placement) 14.00
City /State /ZIP: — Pot" 4 ( � d� �� ` 9,9- Furnace 100,000 BTU (ducts/vents) 14.00
( Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 5 i �1 Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
KV 0 # TS Is el-e_ '(ern Ga$ wve..,1 r Flue vent for water heater or gas
�t1 Q 1� A ` cl VN A . I e � f r Log l ice 10.00
fl T 'O y G ' h 0 Log lighter (gas) 10.00 •
n I" B la G K "P t Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ,K TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
Name: 5 ..E. r i t v4 Cowl ON ( GO A I Q r1 Environmental exhaust and ventilation
Address: , 49 y S- VS L o i ut n 1 Q '� K w `, # H a
Range hood/other kitchen
t 1 `' equipment ment 10.00
City /State /ZIP: -p, ``��
lQ -. q> a a Clothes dryer exhaust 10.00
�� ( I Single -duct exhaust (bathrooms,
Phone: ( ) 90G,_ at!o Fax: (S ) ciac i6s3 toilet compartments, utility rooms) 6.80
a APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: i it, GaS jt' I c t �/ s LLG _ Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
�, 1 O S Cl',. i St Furnace, etc.
Address: '•1 T Q
Gas heat pump
City/State/ZIP :p-j-L 3 • , q7 d4 6 Wall/suspended/unit heater
Phone: (111 ) , aa Fax:: (SQ3 )114S' qi , l Water heater
Fireplace
•
E -mail: y, i ( (.lCs(p Z 4Y1nQ % I • Co YY` Range
J NTRACTOR Barbecue
Business name: R�D G AS coo c Ks LL _ Clothes dryer (gas)
y \ OtherY1erG-}D` - 1
Address: S s t C, i`, n TOY' 6 4-- MECHANICAL PERMIT FEES*
City/State/ZIP: > Subtotal
�}� Q I
Phone: (Ch ) S1 91 a Fax• (Scf3) v4 s, cf/ ( Minimum permit fee ($72.50) 7A • 5v
Plan review (25% of permit fee) .,5•-
CCB lic.: 1" 1/ y fli ( .2121 / //( State surcharge (12% of permit fee) 4- 7D
TOTAL PERMIT FEE Ti . AD
'
Authorized signatur ' This permit application expires if a permit is not obtained within 180 ir
days after it has been accepted as complete.
Print name:'T . VWs€ L 4 Lye rt. � Date: S - I a. - Q al • Fee methodology set by Tri -County Building Industry Service Board
\
1:Building \Permit PermitApp.doc 01/19/07 440-4617T (I1 /01/COM/WEB)
Mechanical Permit Application City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000:00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including '
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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