Permit CITY OF TIGARD MECHANICAL PERMIT
—
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00139
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/19/2013
y -... Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10110 SW NIMBUS AVE B6
Project: Impact Medical Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: Add air distribution to new office from existing plenum
Contractor: REITMEIER MECHANICAL Owner: HANSON, RONALD D
19570 SW 90TH CT ROBINSON, CONSTANCE A
TUALATIN, OR 97062 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 603 -0205 PHONE:
FAX: 503- 603 -0150
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/19/2013 $105.90
Class of Work: ALT Type of Const: IIIB Plan Review 03/19/2013 $26.48
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/19/2013 $12.71
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 03/19/2013 $0.50
11x17)
Project Valuation: $1,700.00
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 $145.59
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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
issuan -, or i is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit. Notification Ce er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or d rect questions to OU •y calling 503.232.1987 or 1.800.332.2344.
Issue. =y: I / I / 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 Applicatiorll�T, D FOR OFFICE USE ONLY
City of Tigard �� II��lI.• Date/By •
(3 c Permit Not( Q 3.- op i 341
° 13125 SW Hall Blvd., Tigard, OR 97223 P lan Rcvicw �h
1 _ MAR 122013 � =
Phon 503.718.2439 Fax: 503.598.1960 Datc /By: Other Permit:
Ins ection Line: 503.639.4175 ®S Pa c 2 for
' Ti(, x, lL )'?" P Date Ready /By. g
Internet: www.ugard or.gov CITY (*TIGARD Notified /Method !D / r t t6, Supplemental Information
BUILDING DIVISIO ,. - % - / / .,n-.--,---
TYPE OF WORK COM ; i'RCIAL 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: S / 7a>
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ I - and 2- family dwelling .r 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: l0 `\ 0 . 14•J S (requires site plan showing placement) 46.75
Furnace 100.000 BTU (ducts /vents) 46.75
City /State /ZIP: 0(1,"tiNt a � '� n 'L
t � L G \ ` Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: 17 •-• Co Project name: 12■-(9 Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: St; ) S I I■,h ...•-(). j Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydroniff) 23.32
Unit hiatus (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
//�� Gas fireplace /insert 33.39
Q » rT\ ItST11- .9 Tfl Flue vent for water heater or gas
(3' " f) - Le � i 's t s r(.) fireplace 23.32
Log lighter (gas) 23.32
PLV./J0 ki Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: �l Environmental exhaust and ventilation:
Address: 1 Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspacc fans 23.32
Vi el, 1N1��t.Jt'�Qc��C�V F uel piping: :23.32
Business name: ( el
Contact name: _ n ik,... c , $14.15 for first four; $4.03 for each additional
Address: \ O s‘,...) R cakm- Furnace, etc.
Gas heat pump
City/State/ZIP: ' T p t nit_ c oco-L_ Wall/suspended/unit heater
Phone: (5'-0',) ( r Zoc - Fax: : ( ocjo Water heater
Fireplace
p
E-mail: ., C.-' C' x v (.1 n,� L C.� cg Range
Q CONTRACTOR Barbecue
Business name: cp,,n,..�/ Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee (890.00)
Plan review (25% of permit fee)
CCB lie.: 1 5 3 7 - 7 O State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature:
` days after it has been accepted as complete.
Print name: , -
P �— Date: S/2./3 • Fcc methodology set by Tri -County Building Industry Service Board
I: \Building \Permits \M - PermitApp.doc 03/07/12 440-461 T (II /02 /COM /WEB)