Permit CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: MEC2014-00549
T f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2014
Parcel: 1 S 126DC04700
Jurisdiction: Tigard
Site address: 9575 SW LOCUST ST
Project: Phoenix Inn Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Gas line to backup generator.
Contractor: PLUMBING CONCEPTS INC Owner: PIH TIGARD LLC
PO BOX 1068 111 CONGRESS AVE#2600
CLACKAMAS, OR 97015 AUSTIN,TX 78701
PHONE: 503-658-5232 PHONE:
FAX: 503-658-5232
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/07/2014 $108.97
Class of Work: ALT Type of Const: Plan Review 10/07/2014 $27.24
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/07/2014 $13.08
Stories: Info Process/Archiving-Sm$0.50(up to 10/07/2014 $0.50
11x17)
Project Valuation: $1,800.00
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 $149.79
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow t - rules adopted by the Oregon
Utility No• . on Cen : . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You maw ain a copy of the rules
or dire, questions to OU b •n 503.232.1987 7 or1.800.332.2344.
Iss ed By: • ����∎,e4 Permittee Signature:
—"GANCall 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Dateed
• 13125 SW Hall Blvd.,Tigard,0' ��� Plan Review
w �.r
Phone: 503.718.2439 Fax: 503. ..r. l E i`� Date/By: Other Permit: / '''/I,
Inspection Line: 503.639.4175 •y �G . ' �-•
T I G A R D p T r1 Date Ready/By: Juris % See Page 2 for
Internet: www.tigard-or.gov Of 1 1 2` Notified/Method: �_/ Supplemental Information
1, COMMERCIAL FEE*_SCHEDULE — USE CHECKLIST
TYPE OF `
P
+� ! s� Mechanical permit fees*are based on the value of the work rf❑New construction ❑Addition/a1l � �acement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGOR OF CONSTRUCTION Value:$ 1�6S
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ommercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: G S 7S 6.1.„) L4-)CL.(5 f S Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: . Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: ��(TCt�rk Z`�j//t/ 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
Other: 23.32
Subdivision: Lot no.:
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
6Aj 6i„-E, 7(`, 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 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
Fuel piping:
Business name: C —e /0.1J
$14.15 for first four;$4.03 for each additional
Contact name: j c-j J--p� �1�,-,L 6f D Furnace,etc.
Address: ✓ ^!� Gas heat pump
Wall/suspended/unit heater _
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace •
Range .
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other: ( e-c Business name: 00 `S0 1` /Q V,c_ _ MECHANICAL PERMIT FEES*
Address: 0 X (p` Subtotal
C Minimum permit fee($90.00)
City/State/ZIP:G �� ( (� Plan review(25%of permit fee)
Phone:( /3) 6.515 l Z Fax:( ) State surcharge(12%of permit fee) t�74
CCB lic.: 17tS"87 TOTAL PERMIT FEE 7/
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatu • Fee methodology set by Tri-County Building Industry Service Board
Print name: $& 2_, Date: l D( J I cf
I:\Building\Permits\MEC_PermitApp_040113.doc 440-46171(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_040I I 3.doc 2
RECFI E
OCT 7 2014
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CITY OF TIGARD
REVIEWED FOR COMPLIANCE
Approved: [
CO 2:1,1
OTC: [ I
Permit#:
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Address: (?5-75-6-,0 1-10e_44 ST5-7`' 6Te*--
Suite#: I
B Date: (� 1
OFFICE COPY