Permit r CITY OF TIGARD MECHANICAL PERMIT s
a -- COMMUNITY DEVELOPMENT Permit #: MEC2012 -00517
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/31/2012
Parcel: 1 S 136DB02502
Jurisdiction: Tigard
•
Site address: 11634 SW PACIFIC HWY
Project: Subway Subdivision: AZOIC TERRACE Lot: 1 •
•
Project Description: Add 3 -ton gas pack to addition
Contractor: CANDEN DEVELOPMENT LLC Owner: KESSLER, JULES
2546 NE 45TH AVE BY KAREN LILLEBO
PORTLAND, OR 97213 6312 SW CAPITOL HWY #443
PORTLAND, OR 97239
PHONE: 503 - 307 -9321 PHONE:
FAX: 503 - 281 -1676 ,
FEES
Specifics: Description Date Amount
-= Type of Use: COM • Permit Fee 10/31/2012 $191.86
Class of Work: ALT Type of Const: VB Plan Review 10/31/2012 $47.97
• Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Mechanical 10/31/2012 $23.02
•
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 10/31/2012 $11.50
• 11x17)
Project Valuation: $4,500.00
Fuel Air Handlers
Fuel Types: 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 $274.35
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 •,,/"- e Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -•: ° . , You . stain a • • of the r -
or direct OUNC calling 503.232.1987 or 1.800.332.2344.
Issue By: I� 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.
�
Mechanical Permit Application ,ItS FOR OFFICE USE OiNLI'
Cit of Tigard i ��n
Received /o • q i� , J j PermitNo.: IF E4 AO ip�' 005!7
q 13125 SW Hall Blvd., Tigard, OR 9 �L1 r LD 4
r I Date/By: 1 l 6 -,'• . Plan Review 1 -r7 n
Phone: 503.718.2439 Fax: 503.59 40 V Date/By: 9 l i Cher Permit: ((�' /' I� �Q /1_
Inspection Line: 503.639
T I G A R D 0 ItA Date Ready Juris: Ei See Page 2 for
Internet: www.tigard - or.gov OCT 0 9 2012 NoiZ ethodi / mss . / , /
;. r /j Supplemental Information
TYPE O !,( 7s COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Additio a r acem >� a r9pEr �N 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.
Value: $ V500, c O
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
❑ 1- and 2- family dwelling f�'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: //6, 3 y j) /s tt P Ma)/ - - / (requires site plan showing placement) 46.75
City /State /ZIP: �� OI Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: 5114/ fhr a n fidrj 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
�,,/ L J- / Gas fireplace/insert 33.39
✓1W/t 3 �0� 6></i pit., p� add/ �l/1} 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
El PROPERTY OWNER TENANT Other:
Chimney/liner/flue/vent 23.32
5Y'e r
Other: 23.32
Name: Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 116 .5W 04.4; P6 �/ equipment 33.39
City /State /ZIP: urd 401"' Clothes dryer exhaust 33.39
Fax: Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: (44.,i Dewely 01 1 ' Other: 23.32
Fuel piping:
Contact name: _brim /1 S14.15 for first four; $4.03 for each additional 0.4 Address: c >,-(/$ A /g gS Furnace, etc.
/V Gas heat pump
City /State /ZIP: Poy2tiaild t I - 77 ?- /3 Wall /suspended/unit heater
Phone: (W) 3 6 9 e 3 ? ( Fax: : (jaJ aty /6 76 Water heater
T / Fireplace
ndl'4 . b
E-mail: cRe/A /A1" 1/ d a fi 54, /den Range
CONTRACTOR Barbecue
Business name: 4/106.4 ' Ur(o�f+7 r. Clothes dryer (gas)
I, Other:
Address: as ( /v . E V,5 MECHANICAL PERMIT FEES*
City /State /ZIP: ?d7 s#( [/ /l- 97 f- /3 Subtotal
Phone: J3) 307 73 al Fax: Z 3 ) ? f `� 2� Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: /6 y6. ? State surcharge (12 % of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Le rill rift b I Date: `p - q - / a- * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Pennits\MEC- PermitApp. oc 03/07/12 440-4617T(I1 /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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