Permit CITY OF TIGARD MECHANICAL PERMIT
r Y
a COMMUNITY DEVELOPMENT Permit#: MEC2014-00626
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2014
T t
G A[�L7 9 Parcel: 1 S135BD00300
Jurisdiction: TIGARD
Site address: 9735 SW SHADY LN 307
Project: Dr.Weinberg Subdivision: ASHBROOK FARM Lot: 5
Project Description: Installing(1)80 CFM exhaust fan in breakroom.
Contractor: WILLAMETTE HVAC LLC Owner: MCFADDEN,ARTHUR L
3075 SW 234TH AVE.#206 BY SKLARZ, ERIC
HILLSBORO,OR 97123 621 SW MORRISON ST, STE 800
PORTLAND, OR 97205
PHONE: 503-259-3200 PHONE:
FAX: 503-848-2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/18/2014 $72.13
Class of Work: ALT Type of Const: Plan Review 11/18/2014 $18.03
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/18/2014 $8.66
Stories:
Project Valuation: $600.00
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 $98.82
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Exhaust fan
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 ay obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.33�f944,
1J4/t
Issued By: • Permittee Signature:
Call 503 • 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.
a Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard
Date/By: ii � �r Permit No.: . -'
1 3125 SW Hall Blvd.,Tigard,OR 97 F.�( ` '"''
pri
L vLIV�+�1 Plan Review Other Permit: •
Phone: 503.718.2439 Fax: 503.598.1 Date/By: r /i— p •
T 1 G A R D inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
Nov 18 Z014
TYPE OF WO'.14, ■ COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
• - Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alte.. • 1- >i t1C1oN performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: 1UJllf�'171 mechanical materials,equipment,labor,overhead,and profit.
Value:$$600.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/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
Job site address:9735 SW Shady Ln (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:307 Project name:Dr.Weinberg Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Install one 80 CFM exhaust fan inside new break room Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32 _
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: _
Business name:same as below
Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Address: Furnace,etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( )
Fax::( ) Water heater
Fireplace
E-mail:
Range ,
CONTRACTOR Barbecue
Business name:Willamette HVAC,LLC Clothes dryer(gas)
Other:
Address:3075 SW 234th Ave Suite 206 MECHANICAL PERMIT FEES*
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Minimum permit fee($90.00)
Phone:(503)259.3200 Fax:(503)848.2597 Plan review(25%of permit fee)
CCB lie.:56951 State surcharge(12%of permit fee)
TOTAL PERMIT FEE eb lj�, �o
Authorized signature: This permit application expires if a permit is not obtain wit in 180
I'B �� (/`Y days after it has been accepted as complete.
Print name:michael malstrom Date: 11/11/14 * Fee methodology set by Tri-County Building Industry Service Board
I:\Building\Permits\MEC-PermiiApp.doc 03/07/12 440-46171(11/02/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
9735 SW SHADY LN 307, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00626
George Heimos
Violation Summary:
Inspector Contractor