Permit CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2014-00251
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/29/2014
Parcel: 2S113AD01800
Jurisdiction: Tigard
Site address: 16700 SW 72ND AVE B16
Project: Collection Connection Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS 5-1
Project Description: Install(2)RTU's,(1)restroom exhaust fans,duct modifications&gas extension.
Contractor: OREGON HEATING&AIR CONDITIONING Owner: PACIFIC REALTY ASSOCIATES
19300 SW 118TH AVE ATTN: N PIVEN
TUALATIN, OR 97062 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-691-9699 PHONE:
FAX: 503-691-8556
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 05/29/2014 $601.71
Class of Work: ALT Type of Const: IIIB Plan Review 05/29/2014 $150.43
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 05/29/2014 $72.21
Stories: Info Process/Archiving-Sm$0.50(up to 05/29/2014 $12.50
11x17)
Project Valuation: $20,000.00
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: 2 Vent Systems: Total $836.85
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 2
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the ules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You r ay -btain a copy of the rules
or direct questions to •• C b calling 503.232.1987 or 1.800.332.2344.
Issued By: ` ,11 Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR()I I It I: 1 SF: 0\I.1
City of Tigard Received 5 as fil Permit No.:Mfe ry 1 5/
• 13125 SW Hall Blvd.,Tigard,OR 97223 l,. Opt
//�� Plan Revte p
i Phone: 503.718.2439 Fax: 503.598.196 Date/By: .r y 42`7 r�Other Permit:Aid„9,0/4_0(x)-7/
Inspection Line: 503.639.4175 Juris: ® Page H.; %R D p g V/Fil Date Ready :y: ge 2 for
Internet: www.tigard-or.gov iI Notified/Method: gi Supplemental Information
TYPE OF WO �M'�A/nY 22 , v.l 4 ` CO R FEE* SCHEDULE — USE CHECKLIST r.
i U� i Mechanical permit fees*are based on the value of the work
❑New construction Addition/alterct,�� AR[.j performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other:
['Kok mechanical materials,equipment,labor,overhead,and profit.
Value:$
CAT GORY OF CONSTRUCTION RESIDENTIAL EQUIPME /S 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:
�( /1j Air conditioning 46.75
Job site address: /41 7.7 ��/1 !(J
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: e-tcl a� Furnace 100,000+BTU(ducts/vents) 54.91
g te /Project A�y A� r Heat pump k _ 61.06
Suite/bldg./apt.t.no.: �� name:L/,-_ �� i r e� t^, Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
ØvØtø Reside ntial boiler(radiator or
►1 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
C2) /f.jJ
Flue rep vent for water heater or gas
��.,�{ fireplace 23.32
/ Log lighter(gas) 23.32
.4)7',A7"tA 01 Ala Wood/pellet stove 33.39
d/.1. , Wood fireplace/insert 23.32
ply Chimney/liner/flue/vent 23.32
PERTY OWNER I ❑ 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
WAPPLICANT CONTACT PERSON Other: 23.32
Business name: /9/.44e> Fuel piping:
�/66�/ll�-`` $14.15 for first four;$4.03 for each additional
Contact name: (-7„,,,- ,/ /� P, Furnace,etc.
Address: ` Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:(Y13)8/1,1 747,2_ Fax::( ) Fireplace
Range
E-mail: &/ Zi'C, icre: y.,Lee/1 ✓ t L'a`m Barbecue
CONTRA R
Clothes dryer(gas)
Business name: 0A— -c,„..- Other:
MECHANICAL PERMIT FEES*
Address: l', ? -n,- of,11/ Subtotal
��� L
City/State/ZIP: 11 /7V 92h c Minimum permit fee($90.00)
Phone: G p, Fax: Plan review(25%of permit fee)
(�) U''I / ! ( ) State surcharge(12%of permit fee)
CCB lic.: 1 7).1 7,1,0p TOTAL PERMIT FEE _
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:
• Fee methodology set by Tri-County Building Industry Service Board
Print name: e�(t Or Litt t- %"<., I Date: 2!
I:\Building\Permits\MEC_PermitApp_040113.doc 17r(1 /02/COM/WEB)
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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