Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2014-00445
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/25/2014
Parcel: 1S134BC00200
Jurisdiction: Tigard
Site address: 12180 SW SCHOLLS FERRY RD
Project: Pharmaca Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Modification of ducts and fans to convert former restaurant to retail pharmacy
Contractor: OREGON HEATING&AIR CONDITIONING Owner: ATLAS GREENWAY LLC
19300 SW 118TH AVE 333 NW NINTH AVE, STE 1009
TUALATIN, OR 97062 PORTLAND, OR 97209
PHONE: 503-691-9699 PHONE
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/19/2014 $622.03
Class of Work: ALT Type of Const: Plan Review 08/19/2014 $155.51
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/19/2014 $74.64
Stories:
Project Valuation: $20,795.00
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 $852 18
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct quns to UNC by calling 503.232.1987 or 1.800.332.2344.
i✓ OPC414_4_,Ldi Issued B :` Permittee Signature: 4.; , /.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RECEIVED
Mechanical Permit Application um(O1 I I( i I .I (1\1.1
City of Tigard AUG 1 9 2014 Date/By: J® � PermitNo.: gd.„0/ ,�p�ft��
• 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
• I Phone: 503.718.2439 Fax: 503. 9j0 Date/By: Other Permit: du p/ /1.7---e0/F/
Inspection Line: 503.639.4175 kl 1 I OH I I�lf�l�V Date Ready/By: Juns VI See Page 2 for
I WARD g g
Internet: www.ti azd-or. ov BUILDING DIVISION' Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees"are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other: mechanical materials,equipment,labor,overhead and profit.
Value:$ 2 5
CA ORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/Symms --
EES"
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family Master builder ❑Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
D ti r L�k/��� i �� / Air conditioning ( ) 46.75
Job site address: �/ Furnace 1 conditioning
BTU(ducts/vents) 46.75
City/State/ZIP: /) r Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: " 64040;11f
Duct work 23.32 ‘
Cross street/directions to job site: Hydronic hot water system 23.32 Q
/ !// S Residential boiler(radiator or
hydronic) 23.32 Q
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
r Flue vent for water heater or gas
g)IyID,
� / fireplace 23.32 b
PA17(a � Log lighter(gas) 23.32
Wood/pellet stove 33.39 ,,```
Wood fireplace/insert 23.32 /1
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) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
APPLICANT CONTACT PERSON Other: 23.32
Business n me: Q ,�� Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:/`A"�j Furnace,etc.
Address: / /+ Gas heat pump
[,I//, C Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:(50 r/ ho, Fax: :( ) Fireplace
�1 Range
E-mail: C/',v —/& 01/2,40).10, Ae474) % 1..45N•--% Barbecue
COONT OR
Clothes dryer(gas)
Business name: al-Ad v Other:
n ��/ MECHANICAL PERMIT FEES"
Address: //J/ ` �j Subtotal 101 & t ,
City/State/ZIP: v %�j /ten ✓ / 7//2 Minimum permit fee($90.00) —
v ` L Plan review(25%of permit fee) /55".5/
Phone:(5j f3) J i��} Fax:( ) State surcharge(12%of permit fee) "7/.(p'/
CC")lic.: "//7)—lI „�f TOTAL PERMIT FEE ?SA.!?
/ 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: /' Kr Yf1, k Date: 40
I:\BuildingTenniuMC_PennitApp_040113 OM/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.
1:\Building\Permits MEC_PermitApp_040113.doc 2