Permit p CITY OF TIGARD MECHANICAL PERMIT
= COMMUNITY DEVELOPMENT Permit #: MEC2012 00629
T t A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/04/2012
;
Parcel: 2S 112ACO2400
Jurisdiction: Tigard
Site address: 14555 SW 72ND AVE
Project: Chow Subdivision: FANNO CREEK ACRE TRACTS Lot: 48
Project Description: Add new meter to split tennant spaces with some gas piping. 12/19/12, reprinted to revisescope Qf work: Add gas
supply lines to (2) buildings addressed as14555 & 14655 SW 72nd Ave.
Contractor: AIR RITE CONTROL INC Owner: CHOW, TOM
1623 SE 6TH AVENUE 14725 SW 72ND AVE
PORTLAND, OR 97214 TIGARD, OR 97224
PHONE: 503 - 238 -0388 PHONE: 503 - 781 -1518
FAX: 503 - a3`f - (i7tf 7
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 12/04/2012 $161.16
Class of Work: ALT Type of Const: Plan Review 12/04/2012 $40.29
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/04/2012 $19.34
Stories: Info Process /Archiving - Sm $0.50 (up to 12/04/2012 $1.00
11x17)
Project Valuation: $3,500.00
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 $221.79
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 • uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N. 'cation Center. ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dire• questions to OUNC b . - • 5 or 1.800.332.2344.
Issued By: ��'�j / Permittee Si ature:
l
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.
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CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC2012 00629
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/04/2012
Parcel: 2S 112ACO2400
Jurisdiction: Tigard
Site address: 14555 SW 72ND AVE
Project: Chow Subdivision: FANNO CREEK ACRE TRACTS Lot: 48
Project Description: Add new meter to split tennant spaces with some gas piping
Contractor: AIR RITE CONTROL INC Owner: CHOW, TOM
1623 SE 6TH AVENUE 14725 SW 72ND AVE
PORTLAND, OR 97214 TIGARD, OR 97224
PHONE: 503 - 238 -0388 PHONE: 503 - 781 -1518
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/04/2012 $161.16
Class of Work: ALT Type of Const: Plan Review 12/04/2012 $40.29
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/04/2012 $19.34
Stories: Info Process /Archiving - Sm $0.50 (up to 12/04/2012 $1.00
11x17)
Project Valuation: $3,500.00
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 $221.79
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.
4 Issued By: '- - . Permittee Signature: L Will
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 Applicati Of^ EIVED F OR OFFICE USE ONLY
EI . L � Received ` / r
City of Tigard Date/By: (al `f � � Permit Nc iC) O ' (Q
° 13125 SW Hall Blvd., Tigard, OR 97223 O L C 0 4 2012 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639 CITY oF e S RD Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov
BUILDING II ILDING DNISI i/hod: T Supplemental Information
SI ON N otfiedMet 1
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ErAddition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 7, t S O Q .
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use check list.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 11,..67. S-\, --ID rcA 'Ave (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: --X ; ^ ' ` 0 c QC OrN ' -T Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: r: Stn` \ , Duct work 23.32
Hydronic hot water system 23.32
GtC1M'V._ -5 S(-, vkti cr,>cSL NN.9._ tseNr•mf,1N \ k" ("NCO I V S`'f■ Residential boiler (radiator or
hydronic) 23.32
C'Syr)t - 7 ■.,S•X C■zs` ` ,1. n`NItts> c \-..r te a , (a./..0' - 1 S \ ` Unit heaters (fuel -type, not electric),
1'; 60\^'r cVN } �`1 J US� \ ` - gyp - (- ` � - 7 - 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
ag Q .$ Gas fireplace /insert 33.39
Ack` '(1.Q\. 1; JO (' -Irt7 -5 \ \ c ��.rv(\t,.(4' Flue vent for water heater or gas
11 fireplace 23.32
5 \ p5 w XTX S `"' P ' 42 ' p -¶1' L� ■ \') \ In • Log lighter (gas) 23.32
�-J Ls I a4tS ii nIL S(24 J If2-ANg -• 0 J Yu. f — Fix - � - rL S Wood/pellet stove 33.39
V Wood fireplace /insert 23.32
a PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: - Nrr, CNI(1�1 Environmental exhaust and ventilation:
Address: re i Range hood/other kitchen
�1 a S S� t3 iV.st._ equipment 33.39
City /State /ZIP: -`' \ 1 l f'c J! Af\ Cr) a a q Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503) -1$ . 1'S 1`� Fax: ( ) toilet compartments, utility rooms) 23.32
®. APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: 1X- 2 \\. li4, 1 1, G
Fuel piping:
P
Contact name: y 0.,e,6. 1 Ste( $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: \ a? , z .,__ ( 4 1' \∎ ,a� Gas heat pump
City /State /ZIP: oNck \ 1 � f (� G � �, Wall/suspended/unit heater
Phone: (553) a3c , � '- y c V Fax: : ( 5 ,, 3 LI . co (A 0\ Water heater
_' ,� •� '� \ ,� (� ` Fireplace
E -mail: 1 ,� \- ``
\0 \ 1 `� • 10 �1 `H + ct 1 . Ce`M Range
CONTRA OR Barbecue
Business name: C Q; k P Ce1 n k 1 ` 1 hC
Clothes dryer (gas)
Address: \Is, D-3 "JE L9{ �,>`Q MECHANICAL PERMIT FEES*
City /State /ZIP: R ` \ 0 tut C\--) \ Li Subtotal ,
1 Minimum permit fee ($90.00)
Phone: (9 )3 ) 9,3% . Fax: (503) a3 u ' u yq Plan review (25% of permit fee)
CCB lic.: k-0 23 (a / -'-bA ( State surcharge (12% of permit feej
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: z i
days after it has been accepted as complete.
Print name: itt/-4 i Date: fj a I N I ' 0 0 • Fee methodology set by Tri- County Building Industry Service Board
i
1: \Building\Permits\MtEC•Pe itApp.doc 0347/1- 440- 4617T(I1 /02/COWWEB)
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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