Permit 114 CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: MEC2014-00528
T t G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2014
Parcel: 2S 103DD00400
Jurisdiction: Tigard
Site address: 13727 SW PACIFIC HWY 150
Project: Subway Subdivision: MELROSE Lot: 2
Project Description: Replacing RTU,ductwork,gas piping,smoke detector,and thermostat.
Contractor: ARROW MECHANICAL Owner: WILSON'S TIGARD RETAIL CENTER IN
10330 SW TUALATIN RD PO BOX 347
TUALATIN, OR 97062 BEAVERTON, OR 97004
PHONE: 503-692-1565 PHONE:
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/02/2014 $269.03
Class of Work: ALT Type of Const: VB Plan Review 10/02/2014 $67.26
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 10/02/2014 $32.28
Stories:
Info Process/Archiving-Sm$0.50(up to 10/02/2014 $5.00
11x17)
Project Valuation: $7,190.00
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 $373.57
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct q ons to O by calling 503.232.1987 or 1.800.332.2344.
�
Issued y: 4 / /l Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available insp:, on date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE OrL1'
City of Tigard \Jt)EFIMMEffilli Permit No '
13125 SW Hall Blvd.,Tigard.OR 9722
Phone: 503.718.2439 Fax: 503.598.i Plan Revie MDate/By. l
Other permit
%. ...+ --6N
Inspection Line. 503.639.4175 S LP L 4 2 014
TIC R n
Date Ready/By: Juts: 0 See Page 2 rue
Internet: www.tigard-or.gov ^ 1 e-` Notfied/Method: ip 4/-i /yam_ 7' ._6„ Supplemental InNr M$aa•
TYPE OF\'4'O 1 ,,,T, ` (OM IERCIAL I?I Is" SCIIFI)f?LE. - USG 4'HECK:LIS7'
1 w$, ` Mechanical permit fees*are based on the value of the work
❑New-construction [] Addition/alteratio r laceme performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ Other mechanical materials,equipment,labor,overhead,and profit.
U _ Value S 'j/ t/0/ 4,0
CATEGORY OF CONS 1 RUt 11Oitf :4..: ;•;y RIsSiDENTIAL EQUIPMENT/SYS'I'EiGIfi,F1C'ES'I
❑ 1-and 2-family dwelling XCommercial/industrial ❑Accessory building
For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description _I Qty. ) Ea. J Total
J013 SIT:E.INFORMATION AND,.LOCATION 1 Heatinp,/cooling:
Air conditioning 46.75
Job site address: 13 717 5, PAC-4c re_ }f' Furnace 100,000 BTU(ducts/vents) 46.75
_City/State/ZIP: - 'i,^rC,[S o& 617ii 3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: C,..r) I Project name: Heat pump 61.06
rtr / 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: I Lot no.:
Other: 23.32 1
Other fuel appliances:
Tax map'parcel no. Water heater 23.32
DFSCRIPTION OF wORlk )k Gas firepla.e/insert 33.39
kepiFlue vent for water heater or gas
A c 6 9,00/�TGr um,.7 �6'.i..)$6 Cur.e t fireplace 23.32
PaPtw7 r-OItK &A$Y fa?ORG s"-►aced- ATtrt,7e14C- .44443 I 1�d/peer(gas) 23.32
/ l / Wood/pellet stove 33.39
714th a,0 47 TAT Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
— Other: 23.32
❑ PROPERTY OWNER 1 tm TENANT
— --- .. .--- __ Environmental exhaust and ventilation:
Name: t ,bwo.y/ Range hood/other kitchen
equipment 33.39
Address: t 312? 6,,,,,,,, P,,, ..t,Fj L N.wy _ Clothes dryer exhaust 33.39
City/State/ZIP: Ail 0 eit q`t;Z 3 Single-dud exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(x'03) R... -71 7,1 Fax( ) Attic/crawlspace fans 23.32
., ;*„.APPI.ItANT , ,'' CONI'AC"t' PERSON Other: 23.32
Business name: Fuel piping:
kit*t"- is, 4 I $14.15 for first four,$4.03 for each additional
Contact name: ci F s "lot ar/e avy Furnace,etc.
Address: ( ))3o T A I '7-‘,4 Al r Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: T L't'r' 0A. 43 7 aic2. d Water heater -
Phone:( 'D3) 69 i Z. ,ti 6" Fax::(6•03) 4 1/ 'd /3 71 �g� .
E-mail:
Barbecue
C.'ONTRACfOR Clothes dryer(gar)
Business name: L Akei 0 64.j.R,4i P4
Other: ,
Address: .... . ... ...s . �.„M . :.�-. ,.
�e 3 3e, , T,J�C.�T Subtotal
City/State/ZIP:-7-,,,A bir`r s,1 ix 4706z Minimum permit fee($90.00) —
Phone:(5.3) 9 „a L�.r I Fax(6b3) Cl/. 15 79,
Plan review(25%of permit fee)
i - S @ J �J`� State surcharge(12%of permit fee)
CCB lie.: L"',q 3 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 Tn-County Building Industry Service Board
Print name: Dolan tae 1 .i M. Date: cili 1/j'f
I.\Building\Permits\MEC_PemtitApp_040113.doc 440-46617f(11/02/COM/WEB)
CITY OF TIGARD FEE AND PAYMENT HISTORY
i; • 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TI C;A}D
MEC2014-00528 - 13727 SW PACIFIC HWY 150, TIGARD, OR 97223
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
Permit Fee 230-0000-43102 $269.03 $269.03 $269.03
Plan Review 230-0000-43111 $67.26 $67.26 $67.26
12%State Surcharge-Mechanical 100-0000-24001 $32.28 $32.28 $32.28
Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $5.00 $5.00 $5.00
11x17)
Totals for Fees $373.57 $373.57 $0.00 $373.57
Receipt# Payment Method Check# Pavor_ Receipt Date Receipt Amount
Total Payments: $0.00
Balance Due: $373.57