Permit CITY OF TIGARD MECHANICAL PERMIT
111 • •� COMMUNITY DEVELOPMENT Permit#: MEC2014-00623
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2014
Parcel: 2S 102AC00700
Jurisdiction: TIGARD
Site address: 12550 SW MAIN ST 120
Project: All Tech Subdivision: BURNHAM TRACT Lot: 1
Project Description: Install new insulated ductwork to the existing RTU. Install new t-bar grilles and(2)restroom exhaust fans. Install
new gas piping for the new meter by NW Natural.
Contractor: MILLENNIUM HVAC INC Owner: DOLAN &CO LLC
2723 NE 159TH CIRCLE BY FLORENCE T DOLAN
RIDGEFIELD, WA 98642 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 971-235-3699 PHONE:
FAX: 360-546-0512
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/17/2014 $257.79
Class of Work: ALT Type of Const: Plan Review 11/17/2014 $64.45
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/17/2014 $30.93
Stories:
Project Valuation: $6,800.00
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: 2 Vent Systems: Total $353.17
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 N• _- ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir: questions to 0 C by calling 503.232.1987 or 1.800.332.2344.
Issu=d By: , ( - Permittee Signature: C. doov,
Call 503.639.4175 by 7:00 a.m.for the next available inspecti••ate.
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 ApplicEj IVE11 FOR OFFICE USE ONLY
City of Tigard Received // /7 /4/ � .4 I'cuhl�1 N.-WeeAy - )�23
13125 SW Hall Blvd.,Tigard,OR 97
1 7 2014 Plan Review
Phone: 503.718.2439 Fax: 503.598. Date/By: Other Permit:
T 1(�A R I i Inspection Line: 503.639.4175 Date Ready/By: luris IZI See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: Supplemental Information
TYPP1/ DIVISION COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit tees*arc 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:$$6,800.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ l-and 2-family dwelling ®CommerciaUindustrial ❑Accessory building For special information use checklist
El 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:12550 SW Main Street Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:#120 Project name:AU Tech 1 T.I. 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: 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
Install new insulated ductwork to the existing roof top unit. fireplace 23.32
Install new t-bar grilles and 2 restroom exhaust fans. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Install new gas piping for the new meter by NW Natural Wood fireplacelinsert 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 ❑ CONTACT PERSON Other: 23.32
Business name:Millennium HVAC,Inc.
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Jerry Bertelson Furnace,etc.
Address:2723 NE 159th Circle Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Ridgefield,WA 98642 Water heater
Phone:(971)235-3699 Fax::(360)546-0512 Fireplace
Range
E-mail:mhvac@iinet.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Same info as above. Other:
MECHANICAL PERMIT FEES*
Address: Subtotal ,2 57, 77
City/State/ZIP: Minimum permit fee($90.00) ---
Plan review(25%of permit fee) 444 VS-
Phone:( ) Fax:( ) State surcharge(12%of permit fee) 3a.7 S
CCB lic.:154708 TOTAL PERMIT FEE eb 5-3•/7
This permit application expires if a permit is not obtain within 180
days after it has been accepted as complete.
Authorized signature: l�C� • Fee methodology set by Tri-County Building Industry Service Board
Print name:Jerry Bertelson Date: 11-14-14
1:\Building\Permits\ .EC_PennitApp_040113.doc 440-4617T(I1/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12550 SW MAIN ST 120, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00623
Chip Barnett
Violation Summary:
Inspector Contractor