Permit Ia CITY OF TIGARD MECHANICAL PERMIT
I a COMMUNITY DEVELOPMENT Permit#: MEC2013-00575
TIGARC) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2013
Parcel: 15 1350003301
Jurisdiction: Tigard
Slte address: 11945 SW PACIFIC HWY 216
Project: Tigard Plaza Subdivision: METZGER ACRE TRACTS Lot: 9
Project Description: Relocating gas meter.
Contractor: HEAT RELIEF CO Owner: COMMERCIAL ENTERPRISES LLC
13122 NE DAVID CIR#800 8320 NW HWY 99
PORTLAND, OR 97230 VANCOUVER,WA 98665
PHONE: 503-261-9915 PHONE:
FAX: 503-261-9814
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/10/2013 $78.27
Class of Work: ALT Type of Const: VB Plan Review 10/10/2013 $19.57
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 10/10/2013 $9.39
Stories: 1 Info Process/Archiving-Sm$0.50(up to 10/10/2013 $0.50
11x17)
Project Valuation: $800.00
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: i
Appliances
Vent Fans: Vent Systems: l Total $107.73
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.
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 Application FOR OFFICE USE ONLY
• •• •.•. •• [�c,4iv�ti • •
- City of Tigard • • • • , Date/Bf: •�1 ( , 1 1,.. Permit No.: MrG�t�,U4 S-7 S—
,1,1h ° 13125 SW Hall Blvd.,Tigard,OR 97223 It: ' e E1'�1 Plan R'ie �D Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 i et DateBy:* • •
TI GARD Inspection Line: 503.639.4175 Date Ready Juris: E] See Page 2 for
Internet: www.tigard-or.gov 013 Notified/Method:/(///10//3 ��7
p Supplemental Information
• • • • • •. • /: M G/•
7 K �'' �i/rt r �...+T�i'Pi: OF- `O' �t�,1-.177c9,7 5rrI" r r:'/. 114 it 6� iER '.,'l:'', do ipi 4Iti iiECI�Z.k.`i••
r,_ ' 4r �'T,r ] � • •• performed.lInndicate the value(roundedto the nearest dollar)of all
❑New construction [ Addition/alterati i' t.11 -
❑Demolition ❑Other 1 mechanical materials,equipment,labor,overhead,and profit.
4� _ ; _
F1' 1 •Y SFr _' 4 . � °• a ' • �C� �'
Value $ ' do di
y ;-� �"1 '.� ,� , • +lam'') y -,:. ]�,' °'' .
f74 ,—...- 1 nor _t__d__-_tte ,F • _ t.+. ._�G�:O `iY�' � J4�• a tilt.£
ng Commercial/industrial i A g�rsao��,r 1 t g• • • For special information use checklist.
❑Multi-family Master builder TT/ Description I Qty. I Ea. I Total
' x "+ B ` ' s i'.if;r3s}471s_ . � z1-. s y
Heating/cooling:-.ias.ai _ .cb rr.,, r _ ":^Y )W4...."511^tn • vI+ :6"Iasai° g r w`
Air conditioning
Job site address: 11 q LAC-3 51 ,1 PuG)J- / �` , I . ( _ (requires site plan showing placement) 46.75
City/State/ZIP:TC•1 Qrd _JwOR. q 1_ •mow up Furnace 100,000 BTU(ducts/vents) 46.75
J J Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I co I Project name: 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: I Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
q ' ..1 :7 °' Q4 ' ; �,'-arf t*-;: Water heater 23.32
I' • 0 Cale./ �AS I V\Q.}Q.f - Per n)(9.) J iQ L a./ Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
p ' ,.G i W ray q1 xY . � , _....-2.i.-a 1, -j i�`r�r-- 'rr�,rr '^-a7 Chimney/liner/flue/vent 23.32
Ir..0..c=....` `�aP Other. 23.32
Name: 1 ' ,r ,1Q 7.. Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 3339
City/State/ZIP: Clothes dryer exhaust _ 33.39
Phone:( ) Fax:( ) Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
i-k 4-T1 :II 4 116'1;r s U P..ra `p Q ki y'fit, iJ 15 Attic/crawlspace fans 23.32 _
Other: 23.32 name: Q6.--.4.l P T
-
Fuel piping:
Contact name: . $14.15 for first four;$4.03 for each additional
Address: )3- (, l ea L.Q -+v.• Furnace,etc. _
Gas heat pump
City/State/ZIP: -- ''c eg,.. Wall/suspended/unit heater
Phone:(iix3 at,( G el I I Fax::( c.�2 i q Water heater
/^ Fireplace
E-mail: hr. 0 h?A rel•i Qr • , CO On Range
y + � < " w . . ' „, � ; -
:1 , _ ��Q„ ,a •R. , <4 r , „"4...4...;4 Barbecue
Business name: C I Clothes dryer(gas)
Other.
i 3 aD,•
Address: {[� p,,,'
A �C` 'J rut.,5:w.v..-.:i..§r CHA5n-CA1;:l'EIoki FEES'z,.zn;4f,
City/State/ZrP{�3y y k C.°,12.— -- 0 Subtotal
Phone:(C3...):3),.2(4 q t-S Fax:( 1 t , I`i Minimum permit fee($90.00)
Plan review(25%of permit fee)
-
CCB lic.: 1 ',��LI
i D State surcharge(12%of permit fee)
s____ _ \/, TOTAL PERMIT FEE
-Authorized signature: Ci-�.v This permit application expires if a permit is not obtained within 180
` days after it has been accepted as complete.
Print name: L.' lf CA.C.Q--Vk I Date/6-7,72a)3 ` Fee methodology set by Tri-County Building Industry Service Board
I:\Building\Pamirs\MEC-PnmitApp.doc 09/09/10 440-4617T(II/02/COM/WEB)