Permit CITY OF TIGARD MECHANICAL PERMIT
I I
COMMUNITY DEVELOPMENT Permit #: MEC2013 00766
T [GA RO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/18/2013
Parcel: 25101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 410
Project: NWCUA Subdivision: VARNS ACRES Lot: 9
Project Description: Relocate grilles, add (1) exhaust fan
Contractor: AMERICAN HEATING INC Owner: GK TRIANGLE CORPORATE PARK III L
1339 SE GIDEON ST BY THOMSON REUTERS INC
PORTLAND, OR 97202 ATTN: MEGAN DOWLING
PO BOX 130174
CARLSBAD, CA 92013
PHONE: 503 - 239 -4600 PHONE:
FAX: 503- 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/18/2013 $212.83
Class of Work: ALT Type of Const: Plan Review 12/18/2013 $53.21
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/18/2013 $25.54
Stories:
Project Valuation: $5,200.00
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: 1 Vent Systems: Total $291.58
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: relocate
Duct Work: grilles
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 ' , • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility i !cation Cen - . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or di ct questions to OUN• by • • •.232.1987 or 1.800.332.2344.
Iss d By: j Permittee Signature: 4/4674(7—(CL–
Call
503.639.4175 by 7:00 a.m. for the next available inspec ' 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 Annlica • FOR OFFICE USE ONLY
Cif oTi and Received / Permit No.:
h' g El �I E Date/By: /z / /f! JL //�_U/ 746
13125 SW Hall Blvd., Tigard, OR 9 2
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Other Penult: P a'br3 �� fr 3
Inspection Line: 503.639.4175 DEC 18 2013 Date
T I G A R D Date Ready/By: ReadyBy: Iuris: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE OF1filitaet'it7Jim+ri 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: $ $5,200.00
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. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 13221 SW 68 Parkway Furnace 100,000 BTU (ducts/vents) 46.75
City/State /ZIP: Tigard OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 61.06
Suite/bldg. /apt. no.: 410 Project name: NWCUA Duct work 23.32
Cross street/directions to job site: 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
Flue /vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
relocate grilles fireplace 23.32
one new exhaust fan Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: ( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: American Heating Inc Fuel piping: $1
514.15 for first four; $4.03 for each additional
Contact name: Brad Manchester Furnace, etc.
Address: 5035 SE 24 Ave Gas heat pump
WalUsuspended/unit heater
City/State /ZIP: Portland OR 97202 Water heater
Phone: (503) 239 -4600 Fax: : (503) 239 -7038 Fireplace
Range
E -mail: Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: American Heating Inc Other:
MECHANICAL PERMIT FEES*
Address: 5035 SE 24 Ave Subtotal „.37._/:;,2", • -;
City/State /ZIP: Portland OR 97202 Minimum permit fee ($90.00) -----
Plan review (25% of permit fee) 53. d/
Phone: (503) 239-4600 Fax: (503) 239 -7038
State surcharge (12% of permit fee) 3, s. 5q
CCB lie.: 33135 TOTAL PERMIT FEE o29 /. 5y
This permit application expires if a permit is not obtained within 180
G days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name: Brad Manchester Date: 12/18/2013
I:\Buil ding \Permits\MEC_PermitApp_040113.doc 440 -46I7r (11 /02/COM/WEB)