Permit CITY OF TIGARD MECHANICAL PERMIT
r • COMMUNITY DEVELOPMENT Permit#: MEC2014-00392
Date Issued: 07/28/2014
TIGARD 13125 SW Hall Blvd .Tigard OR 97223 503.718.2439 Parcel: 2S113A800700
Jurisdiction: Tigard
Site address: 16255 SW UPPER BOONES FERRY RD
Project: The Circuit Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: (4)vent fans. 7/30114.reprinted to add(4)radiant heaters.with associated gas piping&(2)ductless heat pumps
Contractor: HUSKY HEATING &COOLING LLC Owner: COLEMAN BOULDERING LLC
211E 5TH ST ATTN: ANDY COLEMAN
NEWBERG, OR 97132 16255 SW UPPER BOONES FERRY RD
TIGARD, OR 97224
PHONE 503-936-7980 PHONE
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/28/2014 $115.11
Class of Work: ALT Type of Const: VB Plan Review 07/28/2014 $28 78
Occupancy Grp: A-3 Occupancy Load: 12%State Surcharge-Mechanical 07/28/2014 $13 81
Stories: 1
Permit Fee 07130/2014 $562 80
Project Valuation: $23.000 00 Plan Review 07/30/2014 $140.70
12%State Surcharge- Mechanical 07/30/2014 $67 54
Info Process/Archiving-Sm$0.50(up to 07/30/2014 $5.00
Fuel Air Handlers 11x17)
Fuel Types. Natural Gas Units< 10000 elm
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: 2
Heat Puirip.
Appliances
Vent Fans. 4 Vent Systems: Total $933.74
Hoods. Comm Incinerators: —
Required Items and Reports(Conditions)
Woodstoves• Gas Fireplaces'
Clothes Dryers: Other Mech Units.
Gas Outlets. 4 Other Desc. radiant
Duct Work: heaters
Fire/Smoke Dampers'
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance. or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.19 t9B3& 344.
Issued By: L. Permittee Signature:
Call 503. .4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applica FOR OFFICE USE ONLY
City of Tigard ECEIvE R PertNo.:
II 13125 SW Hal Blvd.,Ti ard,OR 9 � — � ` 9!
Phone: 503.718.2439 Fax: 503.598.1960 ,I. DateBy: �
g Plan Revi
Inspection Line: 503.639.4175 JUL 3 0 F Date Rea I��►����`—1,��uris
TIGARD g g Notified/Method: Supplemental Information Page 2 for
Internet: www.ti ard-or. ov �}^{}'����I u �uq��
TYPE O1"1 8 • 1771 tfIX11 ►IVI COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: echanical materials equipment.labor.overhead,and profit.
Gt r/ Ilfl.Gt L Value:$ s�� 66 O
CATEGORY OF CONSTRUCTION RESIDENTIA EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ACommercial/industrial D Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. La. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address 1t ZS< SW Z gnr ,_,r, penairzyt 24:,
Furnace 100,000 BTU(ducts/vents) - 46.75
City/State/ZIP: '`I V z,r> Ota— Furnace 100,000+BTU(ducts/vents) _ 54.91
Suite/bldg./apt.no.: Project name: UYLG.J tT Heat pump 61.06 Z.
C- Duct work 23.32
Cross street/directions to job site: U/�1 Hydronic hot water system _ 23.32
i Residential boiler(radiator or
/0 dill
_ 23.32
/9; Unit heaters(fuel-type,not electric),
/` L/ in-wall,in-duct,suspended,etc. 46.75- al 70 l Flue/vent for any of above y 23.32 y
Subdivision: Lot no.: Other: 1 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
ltt.r51-art-L Pet-[°N1 171= 0 ) 1- 7{0.•-,c-- \'tei4r'G - j hs 1--tD-ç-r- fireplace 23.32
Log lighter(gas) 23.32
(.M) L.o CA"r1 e..-►S , t1.-- 4-"T- Wood/pel let stove 33.39
A L L A N-T t t,0..J OF (2) Luc n 4 NGPc'r Po&APS - Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY 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) eit, 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: - 23.32
Business name: Fuel piping:
��� �'rt s' `� GF�Ots�� $14.15 for first four;$4.03 for each additional
Contact name: Izvt- Furnace,eta
Gas heat pump
Address: 2A1 E sin. ,E Wall/suspended/unit heater '9 _
City/State/ZIP: N,eL,u Qom,, tom. 91137_ Water heater
Phone:(507)936-79E-0 Fax::( ) Fireplace
Range
E-mail:es U 'i ArTl N6�1- t_ -t -Cie v't Barbecue
CONTRACTOR Clothes dryer(gas)
� 4 Other.
�/`-
Business name: MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.
Authorized s'.. a ure * Fee methodology set by Tri-County Building Industry Service Board
fPrint name: �� ' Date: 7— .5( - I
r\BuiId.ng,PertnitsMFC emitApp 040113 doc 440-4617r(1I/07JCOSNWEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: 1 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.
I:1Building\Pennits\MEC_PermitApp_0401 I3.doc 2
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
N .= . " Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: _ DATE ¶ ( IVE DEPT: DING DIVISION j
JUL 3 0 2014
FROM: I 6 CITY OFT ! ' RD
COMPANY: 1\J ,_e,�,
BUILDI ' IIVISION
PHONE: 5-6 3 - 9 4, 7 9g0 B
RE: / ‘.3-5- c-•.) m (e...20/4/- 3 2
(Site Address) -ermit Number)
( -
(Project name or subdivision name and lot number)'
ATTACHED ARE THE FOLLOWI l` TEM`
Copies: 1 Description: - I , i pies 'Description:
Additional set(s) of plans. Revisions:
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. /1 0 Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: C L fliu J .
FORQFFI�E USE ONLY
Routed to ' • „- ec .cian: Date: "7 Corr//r e( Initials:
Fees Du Ipill11 es ❑ No Fee Description: Amount Due:
$
$ 726- 41
$
$
Special
Ins 11 - _�
+s.?�t Permit .- ;4-Na/ — • No ■ Done
A. .licant Notifie ' Initials
i
1:1Build ng\Forms\TransmivalLetter-Revisions.doc 05/25/2012
CITY OF TIGARD MECHANICAL PERMIT
B COMMUNITY DEVELOPMENT Permit#: MEC2014 00392
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/28/2014
Parcel: 2S113AB00700
Jurisdiction: Tigard
Site address: 16255 SW UPPER BOONES FERRY RD
Project: The Circuit Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: TI and change of occupancy. 3/13/2014: REPRINT permit for correction of owner information.
Contractor: HUSKY HEATING&COOLING LLC Owner: COLEMAN BOULDERING LLC
211 E 5TH ST ATTN:ANDY COLEMAN
NEWBERG, OR 97132 16255 SW UPPER BOONES FERRY RD
TIGARD, OR 97224
PHONE: 503-936-7980 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/28/2014 $115.11
Class of Work: ALT Type of Const: Plan Review 07/28/2014 $28.78
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 07/28/2014 $13.81
Stories:
Project Valuation: $2,000.00
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: 4 Vent Systems: Total $157.70
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units.
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire :.-s ions . : NC by calling 503.232.1987 or 1.800.332.2344.
Is=ued By: I .,,/
I Permittee Signature: �
L_J
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit App ' FOR OFFICE 11SE ONLY
City of Tigard � CEIVED Received .� �� i Permit No.: / t �y �J/a--
Vir Date/By:
13125 SW Hall Blvd.,Tigard, R 97223
2 Plan Review
Phone: 503.718.2439 Fax: 503.5980 2 2014 Date/By: Other Permit:
T I G A R n Inspection Line: 503.639.4175 Date Ready/By:
Read B y orris
See Page for
Internet: www.tigard-or.gov CT1 ° IGARD Notified/Method: S upplemental Information
ormation
TYP ORK
9�' COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction El Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ 2/ OdG O°
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. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
A Air conditioning 46.75
Job site address: Z SS S w Lk p Fo A 5 u. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: a c. E 1?ZZ11 Furnace 100,000+BTU(ducts/vents) _ 54.91
t� ■ { Heat pump 61.06
Suite/bldg./apt.no.: Project name: ---11(g. 0112A,i T Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
`A Q I Residential boiler(radiator or
Sw v\OQu Yoo ^15 �t p(nrf��+M hydronic) 23.32
l 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
i h 5 1( {b tn(Av.- rl`—/O` trop net YP_AA`S fireplace 23.32
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: jar 6 IP�t.,., —Co��,,,,,,"t BctJoie,-r LLC Range hood/other kitchen
equipment 33.39
Address: ( 6,02'7SSW Np.tr 'geanrS Clothes dryer exhaust 33.39
City/State/ZIP: 'Ai .( l( 0 g Q 0 22. Single-duct exhaust(bathrooms,
I l toilet compartments,utility rooms) 23.32
Phone:(503 )2_y 6_S-((( Fax:(6-03)t /-I - (5 3 L Attic/crawlspace fans 23.32
pi APPLICANT Eil CONTACT PERSON Other: 23.32
Business name:
/.e e Fuel piping:
ten a_rr` G a /d rt Lt ci Lt- $14.15 for first four;$4.03 for each additional
Contact name: y C6 le -J Furnace,etc.
Address: /6z5-5— /!w V\ 'g00 np 5 y Al Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: ) .r0L. 1 a 7 ZZy Water heater
Phone:(503)ZC f�-J5((, Fax: :(5-67 IN —( S 3 ti Fireplace
E-mail: Range
A hj 1 Aa .4 re,-,k.r y F$1. Cov Barbecue
CONTRAC EIR Clothes dryer(gas)
r Other:
Business name: ' H ct>k 11,4 h� -i- c,,„/t ti LIZ: r�
Y i MECHANICAL PERMIT FEES*
Address: I_)•E 544, �-�.. _ Subtotal //6r 1/`
City/State/ZIP: N r-j.. 8 ( 7 ( Minimum permit fee($90.00) 7�—
Phone: 1 l Fax:( ) Plan review(25%of permit fee) .A-b-rT�
S C 3_15 6 - 1 2 State surcharge(12%of permit fee)4 /3• V
CCB lic.: ' ' '- ^ ' ^ 1 9 r7 Q g$ 6(Co(/(O TOTAL PERMIT FEE ri -7,?0,
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: �r • Fee methodology set by Tri-County Building Industry Service Board
Print name: 11,7„.,79L4.4/ S/ f. Date: 7—.z — y
I:\Building\Permits\MEC_PermitApp_040113.doc 7 440-46I7T(11/02/COM/WEB)
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.
l:\Building\Permits\MEC_PermitApp_040113.doc 2