Permit CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC201400479
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2014
Parcel: 2S102CB00302
Jurisdiction: Tigard
Site address: 13185 SW PACIFIC HWY
Project: Metro PC Subdivision: NORTH TIGARDVILLE ADDITION Lot: 33
Project Description: Replacing existing RTU with a new push-pull unit.
Contractor: JACOBS HEATING&AIR CONDITIONING Owner: CJ GLOBAL LLC
4474 SE MILWAUKIE PO BOX 5668
PORTLAND, OR 97202 ALOHA,OR 97006
PHONE: 503-234-7331 PHONE:
FAX: 503-296-5351
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/02/2014 $115.11
Class of Work: ALT Type of Const: VB Plan Review 10/02/2014 $28.78
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 10/02/2014 $13.81
Stories: Info Process/Archiving-Lg$2.00(over 10/02/2014 $12.00
11x17)
Project Valuation: $2,000.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $169.70
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 11111/ Permittee Signature:
OVA,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received GI 7l ��o Permit No.: %1,�'4_Cl f Lt�y
•74 13125 SW Hall Blvd.,Tigard,OR 97 �ty Plan Revie• pit—Ft['v�
Phone: 503.718.2439 Fax: 503.598. ` , ,
Dante/Bey: t,f.t / j J�- I+ Other Permit:
Inspection Line: 503.639.4175 y
T I G A R D Date Ready/By: �+ 3uns: ® See Page 2 for
Internet: www.tigard-oI.gov SEP 2 2014 Notified/Method. 7/��t fiSk>t ?T. Supplemental Information
TYPE OF WOI 4 Y Ja :i'Or} "*- "COOMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction la Addition/altera3tonArspftitement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 2D0Q, 00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ,j 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: 13 i 4 3 ;;„v �.,`1l:ri{,L fl l L f-I W Ay Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: r Furnace 100,000+BTU(ducts/vents) 54.91
T� A8 h (Project n-! 'G rU °�7 22�' Heat pump 61.06
Suite/bldg.apt.no.: name: 1'4ItgO Pc_ Duct work 23.32
Cross street/directions to job site: Svc P AC t rl c N il v/ (1/kA) 4_ Hydronic hot water system 23.32
l/ Residential boiler(radiator or
G\N I 7A%t is 54 R-C 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
REM 0 t,c. E X i<t t/ubi 1 p IAC E l 1 i"u AI�l.0 nNE fireplace 23.32
Log lighter(gas) 23.32
(LESS \A/Q-4 u+ 1 LI("Ai r (1 t2 t t1.,)(Oli S H e w U ) 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 tr CONTACT PERSON Other: 23.32
Fuel piping:
Business name: .i i\Lo k�3 R i;.:1,\t ?/s U ti t� 4'IL Co Nti $14.15 for first four;$4.03 for each additional
Contact name: Llt I I 1,01I 1)&2_ Furnace,etc.
_ Gas heat pump
Address: LiL-f-ILI I 1NilU L' V -
Ai L /� � �3 Wall/suspended/unit heater
City/State/ZIP: port tl-AN b 011660 N 1716 Z Water heater
Phone:( ) Fax::(5O3) Zci 6 _ Si Range
503 Z.3nn� - �33! Range
E-mail: CJMMC T.. 1 Barbecue _
CONTRACTOR Clothes dryer(gas)
Other'
Business name: -IA e v 4-1r,Ai i.kiLs AN b
u � A tn- 0U'�J MECHANICAL PERMIT FEES*
Address: l 7 7/4 SE /14/ L kill lif k l 1 A U e Subtotal
City/State/ZIP: pp 2 f LAL�(O 0146,010 9-7?0 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(S63) Z 3 Li -73 3 1 Fax:(50 3 )29i- S 3 5 / State surcharge(12%of permit fee)
CCB lie.: 1 q Li / 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: Date: 2 o
�1 Z
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