Permit CITY OF TIGARD MECHANICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit#: MEC2015-00161
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/08/2015
Parcel: 1 S126CC00200
Jurisdiction: Tigard
Site address: 10065 SW CASCADE AVE
Project: Toys"R"Us Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Replacing(2)RTU's.
Contractor: NORTHWEST MECHANICAL GROUP Owner: GIRAFFE PROPERTIES LLC
4243 SE INTERNATIONAL WAY STE BY TOYS"R"US
MILWAUKIE,OR 97222 ONE GEOFFREY WAY
WAYNE, NJ 07470
PHONE: 503-652-4444 PHONE:
FAX: 503-652-4445
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/08/2015 $277.46
Class of Work: ALT Type of Const: VB Plan Review 04/08/2015 $69.37
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 04/08/2015 $33.30
Stories: 1 Info Process/Archiving-Sm$0.50(up to 04/08/2015 $12.50
Project Valuation: $7,500.00 11x17)
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 $392.63
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 2 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 • . .4. 1)._
Issued By: ••rmittee Signature:
i.�. tom
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
Cl of Tigard REies ived
�, i Permit No.:
• 13125 SW Hall lvd.,Tigard,OR 97223 �i1\'�D _I Phone: 503.718.2439 Fax: 503.598.196( Q 1.∎ f ' . ( 1� Other Permit:
Date/By: etiG
Ti G A R D Inspection Line: 503.639.4175 ^015 Date Ready/By: funs ES See Page 2 for
Internet: www.tigard-or.gov OR t 4 (• Notified/Method: 2. Supplemental Information
';,+;cam.< , `: "'II PE OP'YO. C' `' ` a,z ty 1 , li FEE*;.Sb H E ULE CHECKLIST
tiRCIAL:. �-.USE CHE"
1 .. Mechanical permit fees*are as on the value of the work
❑New construction 'Addition/alteratio y t . ment ee i performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: , t echanical materials,equipment,labor,overhe d profit.
E 1 243-7 R Value $
C o, I ONS t11 _ .! ' .
�y��. . . � r�°� ' ■V RiiIDOrllLI.EQgr :MVO**nigs.
❑ I-and 2-family dwelling Al Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
Heating/cooling:
Air conditioning 46.75
Job site address: , pp(pG '1.0 CASC,ADE $UID. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: "7"-1(aRaZi> DfZ. 41 a.2. Furnace 100,000+BTU(ducts/vents) 54.91
117715 ' ii Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: ' _ I.A.5 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
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
A� T ^ /� Flue vent for water heater or gas
�E P W CE �T�-La t IT lt- 1 HVA-C fireplace 23.32
LL.10 175 Log lighter(gas) 1 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
fa<PPLICANT CI CONTACT PERSON Other: 23.32
Fuel piping: _
Business name: W M e � \`►�' rr1Q 1_� S14.15 for first four;$4.03 for each additional
Contact name: ( %4_ tJ vt..\ Furnace,etc.
Address: LiS if 3 ' ' "E w`K`C` {C-I S .a Gas/sus pump
1.."l_ �` 1 V� Wall/suspended/unitheater
City/State/ZIP: M`L4 e °1-1 a Water heater
Phone:(ft)
�2__41,.4 IFFax::(EDS) 1.052 4445 Fireplace
Range
E-mail: C aVItke- PC.` OIAA .LArn Barbecue
CONTRACTOR Clothes dryer(gas)EST Business name: ' /O�`rfl'' (SA L WP" 1 � e Other:
MECHANICAL PERMIT FEES*
Address: � Subtotal
City/State/ZIP: t V 1\1\k, •Minimum permit fee($90.00)
(J Planlreview(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 18''1 O►��2�,.� 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: /1 L` �.�.4 Date:
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1:\BuildingPermits\ EECC_P�ermitApp_040113.doe 440-4617T(11/02/COM/WEB)