Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00184
T E G A.R. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/11/2013
Parcel: 2S 112 DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: Bikram Yoga Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Install new 5 ton RTU and duct work. Modification of existing RTU and duct work and venting.
Contractor: WILLAMETTE HVAC LLC Owner: PACIFIC REALTY ASSOCIATES
3075 SW 234TH AVE. #206 ATTN: N PIVEN
HILLSBORO, OR 97123 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 259 -3200 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/11/2013 $754.11
Class of Work: ALT Type of Const: VB Plan Review 04/11/2013 $188.53
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 04/11/2013 $90.49
Stories: 1 Info Process /Archiving - Lg $2.00 (over 04/11/2013 $4.00
11x17)
Project Valuation: $26,000.00 Info Process /Archiving - Sm $0.50 (up to 04/11/2013 $3.50
11x17)
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 Fumaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 5 Vent Systems: Total $1,040.63
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
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 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.
Mechanical Permit ApplicR CElVED
�' 1l Rived � f C L/ A � 3 �(Q
City of Tigard Deceate /B 1 7
Permit No }-
N • 13125 SW Hall Blvd., Tigard, OR 972AP 0 3 Z013
I ■ . Phone: 503.718.2439 Fax: 503.598.1960 Date By: � , f/ ( 5 Other Permit: 4, took,3 a,,4,,.2.
TIGARD
Inspection Line: 503.639 CITY Of TIGARD Date R: OW: y: ,� )) � Cr ' Juris ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Y� 1 U /3 CI Supplemental Information
43UILDING DIVISION o(,_,e_
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: $ $26,000.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 15957 SW 72nd Ave (requires site plan showing placement) 46.75
Furnace 100,000 BTU (duets/vents) 46.75
City /State /ZIP: Tigard OR 97224 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Bikram yoga Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.3
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
Install 5 ton RTI: and duct sytem. Re -work and add new duct work for existing RTl1 Gas fireplace /insert 33.39
Flue vent for water heater or gas
to service the rest of the space. Vent restrooms, showers, and dryers. Restrooms fireplace 23.32
Log lighter (gas) 23.32
and showers will be vented with a single roof top fan. Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER l ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood /other kitchen
equipment 33.39
City /State /ZIP: 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: same as below Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: Willamette HVAC, LLC
Clothes dryer (gas)
Other:
Address: 3075 SW 234 "' Ave Suite 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro, OR 97123 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 259.3200 Fax: (503) 848.2597 Plan review (25% of permit fee)
CCB lie.: 56951 (((I I State surcharge (12% of permit fee)
i TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: I / days after it has been accepted as complete.
Print name: michael malstrom Date: 4/1/13 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits1MEC- PermitApp. doe 03/07/12 440 -46I7T (1 I /02/COM/WEB)