Permit CITY OF TIGARD MECHANICAL PERMIT
° • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00607
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/21/2012
Parcel: 2S 101 AA08200
Jurisdiction: Tigard
Site address: 12455 SW 68TH AVE
Project: McGee Wealth Management Subdivision: WEST PORTLAND HEIGHTS Lot: 5 -8 & 35
Project Description: Replace rooftop HVAC unit
Contractor: TEMP CONTROL MECHANICAL SERVICE Owner: MCGEE WEALTH MANAGEMENT
4800 N CHANNEL AVE 12455 SW 68TH PKWY
PO BOX 11065 TIGARD, OR 97223
PORTLAND, OR 97211
PHONE: 503 - 285 -6139 PHONE: 503 - 597 -2222
FAX: 503 - 735 -3690
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/21/2012 $344.90
Class of Work: ALT Type of Const: VB Plan Review 11/21/2012 $86.23
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 11/21/2012 $41.39
Stories: Info Process /Archiving Sm $0.50 (up to 11/21/2012 $9.50
11x17)
Project Valuation: $9,900.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $482.02
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. 872..1987 or 1.800.332.2344.
Issued By: a- 0323
�' Permittee Signature: 771
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 Aeplicatl FOR OFFICE: USE: ONLY Received
City of Tigard �� Date /By: a P ermitNo. qw, ono
11,1 • 13125 SW Hall Blvd., Tigard, OR 97223 , . Plan Revi • C ' v
Phone: 503.718.2439 Fax: 503.598.1960 1''1)‘/ 2:1 2012 Date /By: '1.0,11
Ti G n It Il Inspection Line: 503.639 Date Read 'Ty: INE 63 See Page 2 for
Internet: www.tigard - or.gov CITY OFTIGARD Notified /Method: Supplemental Information
BUILDING DIVISION
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: $ $9,900.00
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: 12455 SW 68 Ave (requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: I Project name: 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
Replace rooftop HVAC unit Gas fireplace/insert 33.39
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: McGee Wealth Management Environmental exhaust and ventilation:
Address: 12455 SW 68 Ave Range hood/other kitchen
equipment 33.39
City/State /ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Phone: 503 597 -2222 Fax: Single -duct exhaust (bathrooms,
( ) ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Temp Control Mechanical Service Corp. Other: 23.32
Fuel piping:
Contact name: Mike Kellar $14.15 for first four; $4.03 for each additional
Address: 4750 N. Channel Ave. Furnace, etc.
Gas heat pump
City /State/ZIP: Portland, OR 97217 Wall/suspended/unit heater
Phone: (503) 358 -5234 I Fax: : ( ) Water heater
Fireplace
E -mail: michael.kellar@tcms.lincservice.com Range
CONTRACTOR Barbecue
Business name: Temp Control Mechanical Service Corp. Clothes dryer (gas)
Other:
Address: 4750 N Channel Ave MECHANICAL PERMIT FEES*
City/State /ZIP: Portland, OR 97217 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 285 -6139 I Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 103165 State surcharge (12% of permit fee) G
TOTAL PERMIT FEE Li-&2 .D
This permit application expires If a permit is not obtained within 180
Authorized Signature: d after it has been accepted as complete.
Print name: Michael Kellar I Date: 11/21/2012 * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permits \MEC- PermitApp.doc 03/07/12 440-4617T(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.
I:\ Building \Permits \MEC- PermitApp.doc 03/07/12 2
•
Commercial Application Checklist
City of Tigard
e ' 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2439, Fax: 503.598.1 960
.i_ I c ;' n Internet address: www.tigard - or.gov
PROJECT INFORMATION
Project name: /11( 6.ee 0 ( k,--A keOlif C «y, i,r;, Date: /1
Address: a y SS s' W G 1 fh Ave I City: Ty4,.. State: I ZIP: 9 7a07_
Scope of work: 2e / /a-( e r0O- r'/o/" f/UAC G
Reference no.: Map and tax -lot no.:
Contact person name: /c,/i t Avk r Company: jcnp iv/r/
Phone: frG3) -/'' - a6 o/ Fax:
•
Cellular phone: S03 3S - 5,13 E -mail: /" CLiael, to //.- co k' n c Set cr . C6 7)
• The purpose of this checklist is to help define a complete submittal package for the scope of work. Plan
review will not take place until a complete package is submitted.
• This checklist can be used for all commercial construction projects, including new construction, additions,
alterations and tenant improvements.
• For complex projects, applicants should use the "location" space to note the item's location and page
number from the plans or the specification book.
• It is not necessary to duplicate submittal information, even if it is asked for in multiple sections.
• In the checklist, "Required" means that the applicant must provide this information for plan review.
• In the checklist, "P" means —
• if checked by the applicant — the information is provided for the plan review.
• if checked by the plans reviewer — this information is required for the plan review.
• In the checklist, "NA" means that the information does not apply.
• Choose only those sections of the checklist that apply to your scope of work. Section 1.0, "General Project
Data," must be included with each .ro'ect submitted.
PRE PROCESS
An applicant may request a pre- submittal meeting with representatives of the jurisdiction in which the project
will be built. The meeting may take place during the conceptual, schematic, or in- progress phase, or when the
applicant has completed plans.
INDEX OF CHECKLIST SECTIONS
1.0 General project data Page 2 7.0 Mechanical data (Types I and II
2.0 Civil data Page 2 kitchen -hood permits) Page 6
3.0 Architectural data Page 3 8.0 Plumbing data Page 7
4.0 Structural data Page 4 9.0 Electrical data Page 8
5.0 Mechanical data (new construction, tenant 10.0 Fire - suppression data Page 9
improvement, gas - piping permits) Page 5 11.0 Fire - detection and fire -alarm data Page 9
6.0 Mechanical data (additional or replacement 12.0 Re -roof installation data Page 10
rooftop - equipment installation permits) Page 6 13.0 Jurisdictional requirements Page 10
This checklist is for building department jurisdictions in Clackamas, Multnomah, and Washington counties.
440 -2734 (8/0 I/WEB/COM)
1:\ Building \ Forms \COM- Checklist.doc 11/21/12
SECTION 1.0 — GENERAL PROJECT DATA
Construction documents Location (sheet number or spec section)
1.1 ® Required No. of sets of plans: New: 1 TI: 2
1.2 ® Required Cover sheet title block
1.3 ® Required Cover sheet vicinity map
1.4 ® Required Cover sheet plan index
1.5 ❑ P ❑ NA Code summary
1.6 ❑ P ❑ NA Deferred submittal summary
1.7 ❑ P ❑ NA Professional stamp and signature
1.8 ❑ P ❑ NA Fire and life- safety plan
1.9 ❑ P ❑ NA Landscape plan
1.10 ❑ P ❑ NA Landscape specifications
Supporting documents Notes
1.20 ❑ P ❑ NA Land -use or planning actions
1.21 ❑ P ❑ NA Required fire -flow calculations
1.22 ❑ P ❑ NA Fire - hydrant flow -test report
1.23 ❑ P ❑ NA Fire department or fire district building survey report
1.24 El P ❑ NA Material safety data sheets (MSDS)
SECTION 2.0 — CIVIL DATA
Construction documents Location (sheet number or spec section)
2.1 ® Required Site plan
2.2 ® Required Site utility plan
2.3 ® Required Grading plan
2.4 ® Required Erosion - control plan
2.5 ❑ P ❑ NA Utility -vault location and details
Supporting documents Notes
2.20 ❑ P ❑ NA Geotechnical /soil engineer report
2.21 ❑ P ❑ NA Storm -water calculations
2.22 ❑ P ❑ NA Site retaining -wall structural calculations
2.23 ❑ P ❑ NA "Assurance of Compliance" with environmental rules ....
440 -2734 (8/01 /WEB /COM) Tri- County Commercial Application Checklist 2
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
1: \Bui lding \Fonns \COM- Checklist.doc
SECTION 6.11 — !\'IECI- I.ANICAI. DATA (Additional or replacement rooftop installation permits)
Construction documents Location (sheet number or spec section)
6.1 ® Required Roof plan
6.2 ❑ P ❑ NA Roof framing plan
6.3 ❑ P ❑ NA Fuel gas piping plan
6.4 ❑ P ❑ NA Roof access details
Supporting documents Notes
6.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
6.21 ❑ P ❑ NA Equipment manufacturers' catalog "cut sheets"
or specifications
6.22 ❑ P ❑ NA Fuel gas piping sizing calculations
6.23 ❑ P ❑ NA Energy code compliance forms
SECTION 7.0 — i\'IECI-IAN!CAL DATA (Type 1 and Type II kitchen hood permits)
Construction documents Location (sheet number or spec section)
7.1 ® Required Site plan
7.2 ® Required Floor plan(s)
7.3 ® Required Kitchen equipment plan
7.4 ® Required Kitchen equipment and hood elevations
7.5 ❑ P ❑ NA Roof plan
7.6 ❑ P ❑ NA Cross sections through hoods, ducts and shafts
7.7 ❑ P ❑ NA Fire -rated construction details
7.8 ❑ P ❑ NA Fire suppression details
Supporting documents Notes
7.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
7.21 ® Required Make -up air calculations
7.22 ❑ P ❑ NA Equipment manufacturers' catalog "cut sheets"
or specifications
7.23 ❑ P ❑ NA Hood /grease extractor listing documentation
7.24 ❑ P ❑ NA Hood /grease duct sizing calculations
7.25 ❑ P ❑ NA Fire suppression information
440 -2734 (8/01 /WEB /COM) Tri- County Commercial Application Checklist 6
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
1: \Building \Forms \COM- Checkl ist.doc