Permit CITY OF TIGARD MECHANICAL PERMIT
t! . COMMUNITY DEVELOPMENT Permit #: MEC2013 -00297
Date Issued: 06/05/2013
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 1 S136AD04000
Jurisdiction: Tigard
Site address: 11527 SW PACIFIC HWY
Project: Labor Works Subdivision: VILLA RIDGE Lot: 7
Project Description: Move a return away from new restroom
Contractor: WILLAMETTE HVAC LLC Owner: PACIFIC TERRACE COMMERCIAL LLC
3075 SW 234TH AVE. #206 BY SMITH, EDITA M
HILLSBORO, OR 97123 833 NW 170TH DR
BEAVERTON, OR 97006
PHONE: 503 - 259 -3200 PHONE
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/05/2013 $69.06
Class of Work: ALT Type of Const: Plan Review 06/05/2013 $17 27
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 06/05/2013 $8 29
Stories:
Project Valuation: $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 $94.62
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 Notificati enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You ma obtain a copy of the rules
or direct que ions to UNC by c ling 503.232.1987 or 1.800 332.2344.
Issued By: - Permittee Signature: k
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 Application ' FOR OFFICE USE ONLY •
City of Tigard Received ��y� 3 Permit No .
.96 DOa9
° 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review , / Other Permi
M Phone: 503.718.2439 Fax: 503.598 1960 JUN 04 2 313 o AM
T I G A R D Inspection Line. 503.639.4175 Date Ready /By Jurts HI See Page 2 for
Internet: www.ttgard- or.gov Cl OFTIGARD Notified/Method:6 y i3 ri Supplemental Information
s i i x I, I I II , 'i • _ : Mi Wei I�/ tl .j29 -- ■
TYPE OF M'O � a " ' • 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. o,
Value $ $500.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQLJIPM ENT / SYSTEMS FEES
❑ I - and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
Heating/cooling: � +
JOB SITE' INFORMATION AND LOCATION t•
Air conditioning
Job site address: 11527 SW pacific H W Y (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: Tigard OR 97224
Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Labor works 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 C
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
Gas fireplace/insert vent ale 33.39
Move a return away from new restroom
Flue vent for w ater heater or gas
• fireplace 23.32
Log lighter (gas) 23 32
Wood /pellet stove 33 39
Wood fireplace/insert 23 32
❑ PROPERTY OWNER , . ° I ' • • ❑ 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
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) 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: 514.15 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
Phone: (503) 259.3200 Fax: (503) 848.2597 Minimum permit fee ($90.00)
Plan review (25% of permit fee) • i
CCB lie.: 56951 State surcharge (12% of permit fee) ,
TOTAL PERMIT FEE I , •
n This permit application expires if a permit is not obtained within 180h+ . ' v
Authorized signature :. rrr ' � days after it has been accepted as complete.
Print name: michael malstrom Date: 6/4/13 • Fee methodology set by Tn- County Building Industry Service Board r .. .
I \Building\Permns\MEC- PermitAppdoe 03/07/12 440.461 Tr (II /02/COM/WEB)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11527 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
06/06/2013 00:00
MEC2013-00297
FAIL
Not Ready for Inspection OSSC 110.5 and ORSC R109.3
No duct installed at fan box at bathroom
Violation Summary:
Inspector Contractor