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Permit y II CITY OF TIGARD MECHANICAL PERMIT ° F 1 COMM DEVELOPMENT Pe rmit #: MEC201300266 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2013 Parcel: 25101 DA00104 Jurisdiction: TIGARD Site address: 13333 SW 68TH PKWY, STE# 210 Project: Xerox Subdivision: VARNS ACRES Lot: 9 Project Description: Install VAV box and modify ductwork Contractor: HVAC INC Owner: TRIANGLE POINTE LLC 5188 SE INTERNATIONAL WAY 901 NE GLISAN ST, #100 MILWAUKIE, OR 97222 PORTLAND, OR 97232 PHONE: 503 - 462 -4822 PHONE: FAX: 503 - 462 -6555 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 05/21/2013 $254.98 Class of Work: ALT Type of Const: Plan Review 05/21/2013 $63.75 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/21/2013 $30.60 Stories: Project Valuation: $6,700.00 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 $349.33 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 Notific • enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -00 % You may obtain a copy of the rules or direct estions to OUNC b calling 503.232.1987 or 1.800.332.2344. �� Issued y: 7 f� Permittee Signat e: ,7 / Iii'!/ /, 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. 05/15/2013 09:19 5034626555 HVAC INC PAGE 02/04 Mechanical Perm Apphc atloRE "E t a i o: 01•1•1( h: t !N f. u\ 1.1 City of Tigard Date/n L �I Parmit Nn•: I ( a • --6-0-14 1 3125 SW I4a11 Blvd_. Tigard. 97223 MAY 1 2013 I _ Other Permit: Phone; 503.718.2439 Fax; 503.598.1960 inspection Line: 503.639.4175 r smtc RcadytIty see Page 2 for ^';" Internet: www.tigard- or.gov ern OFTIG Notified/Method. supplemental information BUILDING DIVISION • ': 'w ' . .. - - , %,It 1'J>IJ16 • _ Mechanical permit fen* are based on the value of the work ❑ New construction A Addition /alterntion/roplacement performed. indicate The value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other. mechanical materials, equipment, labor, overhead, and profit. Value $ , II/ —' ❑ 1- and 2- falnily dwelling . ,Commercial/industrial ❑ AcceSSo y building . For specidl in,flimratfui use c/reckfisr. ❑ Multi - family ❑ Master builder 0 Other — Description Qty. Ea. Total Mahng ng "Stiff 1P(la` R`1V�; t X11130 Yt )1il'lioiwt:: _ A conditioning site address: 133 33 SLJ to D A.A tL •' ins Fite , Ian showini .Incemcnt 46.75 Furnace 100,000 BTU dueoa/vcnts IM 46.75 City /State/ZiP: . . ..I ',FA 1.1,_ C)171 1-- Furnace 100.000+ 13T1J (ducts/venle) 54.91 Suite/bldg.apL no.: Feet name. id� L I r HCtd if ��,� 1 .. 'res die len a , laccmcat 61.06 •� �� Duct work 23.32 ■ Cross street/dire ions to job site: •! H drone hot waters stem 2332 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric). in -wall, in -duct, suspended, etc. 46.75 Subdivision; I Lot no.; Flue/vent for any of above 23.32 Other; 23.32 Tax map /parcel nn.: Other fuel a ■ 1 fiances: . E S wato*, or: WOtt ' .. • • Water heater 2332 I 1 m Gas fire.1aoc /insert 33.39 V l+r� , . r Flue vent for water heater or gas fireplace 23.32 Log lighter ( 23.32 ' _ Wood /•crlctstove 33.39 Wood fireplace /insert 23.32 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 d exhaust 3339 Single -duct exhaust (bat Phone: ( ) Fax: ( ) toilet compartments. utility rooms) 23.32 . .. �i�. y A tt G '� '.1ii11�'ErtiE"7L1'fl'C . a COiV1E'JfcC"N` 1<�'•1t8�01'V. _ i craws ■• cc fang 2332 Business name: `' r �1 23.32 v�� `/ Fuel .i Contact name: d 3 $14.15 for first four; $4.03 fir each additional Furnace, etc. // a� ' Oita heat ern, City/State/Z1P: ( `1 A *f 1 . / Cfl W all /sus ended /tmil heater 1111 Phone: ( 3 ■. . . 1 0 t r " Fax :: ( 1,,...s-s-- s-s-- — Water heater Fi -.lace OM E -mml: ` l a ON ot 1 V X v ( v ( 4On Range ... : �p 13arbccue �� Business name: 34 `) r ) L., /�,i.„,, Ciothcs dryer (gas) � Other v e ' Address: . _ .. 10�EAT1'&O9 "..: , _ . , ... .., City /State/ZIP: Subtotal Egg Minimum permit fee ($90.00) Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lie.: -.._ : ._ t31 $( A 4 State surcharge (12% of permit fee) • r s • � M Tcirr If PERMIT FEE q ,5 Authorized sl nature: T1rip permit application e:plrea If a permit mit i n s not ahtn:tieil w thin 1811 0 Rai days after it has been accepted as campicer. r print name: _ D 1, - TIE, ` , - Date: 5 _ ` Fee methodology set by Tri- County Building Industry Service Bard I:\Daddir5 \fmroileiMF.0 -Perml p.doc 0 , 440 -4617T(11 /O2/COM/WF13) 05/15/2013 09:19 5034626555 HVAC INC PAGE 01/04 TWENTIETH : , -. ;'. ,• 1986 li' ;/ �•�� 1.-. 1006 °� ANNNEiSARY OR CCI3# 50897 WA L &I# HVACI*125J6 CA 863290 HVAC FAx # (503) 462 -6555 DATE: 5/15/2013 FROM; JODY DEPEW To: PERMIT DEPT COMPANY: CITY OF TIGARD SUBJECT: MECH/ELECT PERMITS NEEDED FOR XEROX © TRIANGLE POINT FAx #: (503) 598 -1960 No. OF PAGES: 4 (INCLUDING THIS SHEET) DAN SAID TO CHARGE FOR PLAN REVIEW AND THEY WILL DO IT IN FIELD. WE i HAVE ATTACHMENT DETAILS ON DRAWINGS, WHICH WE WILL HAVE ONSITE WITH PERMIT. LET ME KNOW FEE AMOUNT AND I WILL FAX OVER PAYMENT AUTHORIZATION FORM. JODYD@HVACINCORP.COM THANK YOU, JODY DEPEW HVAC, INC. I IF ALL PAGES ARE NOT RECEIVED, PLEASE CALL US AT (503) 462 -4822 5188 SE INTERNATIONAL WAY, MILWAUWIE, OR 97222-4802