Permit n CITY OF TIGARD a /`/"i MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2013-00104
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2013
Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST 100
Project: Pacific Paint&Supply Subdivision: BURNHAM TRACT Lot: 1
Project Description: (1)gas line to separate building for two meters. 2/10/14,reprinted to add suite address.
Contractor: MASTERFLAME GAS&HEARTH Owner: DOLAN&CO LLC
PO BOX 820130 BY FLORENCE T DOLAN
VANCOUVER,WA 98675 4523 NE DAVIS ST
PORTLAND,OR 97213
PHONE: 360-600-6388 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/19/2013 $99.76
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 02/19/2013 $11.97
Occupancy Grp: Occupancy Load: Plan Review 02/19/2013 $24.94
Stories:
Project Valuation: $1,500.00
Fuel Air Handlers
Fuel Types: 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 $136.67
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: ( 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.
71 o CITY OF TIGARD MECHANICAL PERMIT
` s COMMUNITY DEVELOPMENT Permit #: MEC2013 00104
I- [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/19/2013
I
Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST
Project: Pacific Paint & Supply Subdivision: BURNHAM TRACT Lot: 1
Project Description: (1) gas line to separate building for two meters
Contractor: MASTERFLAME GAS & HEARTH Owner: DOLAN & CO LLC
PO BOX 820130 BY FLORENCE T DOLAN
VANCOUVER, WA 98675 4523 NE DAVIS ST
PORTLAND, OR 97213 ,
PHONE: 360- 600 -6388 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/19/2013 $99.76
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/19/2013 $11.97
Occupancy Grp: Occupancy Load: Plan Review 02/19/2013 $24.94
Stories:
Project Valuation: $1,500.00
Fuel Air Handlers
Fuel Types: 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 $136.67
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 OU, C by callin. 503.232.1987 or 1.800.332.2344. / /
Issued By: Al f L „ k L I l / ` J � Permittee Signature: �� /
L -II 503.639.4175 by 7:00 a.m. for the next available inspe ion dat• / /
This permit card shall be kept in a conspicuous place on the job site u • il completion of the p • ject.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
RECEIVE) Received
City of Tigard Date/By: .), i 3 Permit No.: m 0 1 j -
514 a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit
Inspection Line: 503.639.4175 FEB 1 9 2013 Date/fly: Po�U/ 3 6 3/
T I G A R D Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: T T 6 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 ddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ /jam OO
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
❑ I- and 2- family dwelling tErc ommercial/industrial ❑ Accessory building For special information use check list.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: /; J O f Ili Ma/ ✓/ _CV (requires site plan showing placement) 46.75
J Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: t '( et d el 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: pa1A JCL � P aL L/ J 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
AV
/� S �� / /_� Gas fireplace/insert 33.39
)495 / e � ie u� (rr y Flue vent for water heater or gas
/I_ r JC P If r f / v fireplace 23.32
1 T/ om' Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
0 PROPERTY OWNER I TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: F4G/ A l tin Pi. G� y 7 Ire Ca d Environmental exhaust and ventilation:
a o?.570 SC,tJ / /fi I 'vJ Range hood/other kitchen
Address: equipment 33.39
City/State /ZIP: Q v d Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
3 3 ) � 3
Phone: (5 - 73 Fax: ( ) toilet compartments, utility rooms) 23.32
r5 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
/ Other: 23.32
Business name: 7 ` 7 k - 4
4 s,,, e 6j 5 . e 4 N
(Y/ / �� Fuel piping:
Contact name: 7 a p.t e' ,4,./ gl at $14.15 for first four; $4.03 for each additional_
Address: t P o i o x 'A) / 30 Furnace, etc.
/ .
' �^ Gas heat pump
City /State /ZIP: U PI e O u V e, 4 ✓# 6.,2 Wall /suspended/unit heater
Phone: (366) (3 — _K Q Fax: : ( ) Water heater
E -mail: U Fireplace
Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
/As- f G'a 1 -cAm.e - 4 f qr Other:
Address: / 7 r /0 /t/r 30 7 / " f� MECHANICAL PERMIT FEES"
City /State /ZIP: et( // •IJ 9Y(0 7S Subtotal
Phone: ( ) � 7O— $8Q Fax: ( ) (0 Minimum permit fee ($90.00)
((JJ Plan review (25% of permit fee)
CCB tic.: / j Q 1 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: �a�.K,.e r � -.0 Date: , M • Fee methodology set by Tn County Building Industry Service Board
I:\ BuildingWermits \MEC- PermiiApp.doc 03/07/12 , , 0-4617T ' 1 /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
$1 00,000.00.
$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\Pertnits\MEC- PermitApp.doc 03/07/12 2