Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2015-00192
T LGARLD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/07/2015
Parcel: 1 S135BC01100
Jurisdiction: Tigard
Site address: 11131 SW GREENBURG RD
Project: Sky High Sports Subdivision: OAKBURG Lot: 27
Project Description: Gas line check due to structural damage in adjoining tenant space.
Contractor: ARROW MECHANICAL Owner: GREENBURG SPACE CENTER LLC
10330 SW TUALATIN RD PO BOX 91305
TUALATIN,OR 97062 PORTLAND, OR 97291
PHONE: 503-692-1565 PHONE:
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/07/2015 $69.06
Class of Work: ALT Type of Const: Plan Review 04/07/2015 $17.27
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 04/07/2015 $8.29
Stories:
Project Valuation: $300.00
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 $94.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct s to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard CEIVED Received ,i , ..
Deasy, Ay / /5"( L....e4.9 Permit No.:Heedn/5:7,1:)/9g
, --4 13125 SW Hall Blvd Tigard,OR F3
1111 Plan Review
Other Permit:
' g Phone: 503.718.2439 Fax: 503.598.1960 ,. Dt/By:
Inspection Line: 503.639.4175 APR ,7 2015 Date Ready/By: )urk: El See Page 2 for
TIGARD
Internet: www.tigard-or.gov Notified/Method. Supplemental information
CITY OF TIGARD _
t0i7:'":".".'''":6`="*PAS.
- - -'- - ""-- - Mechanical permit fees*are based on the value of the work
0 New construction •dditio .1teration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
, Value:$
...,,f:.,.g.„-,..,.,,-,_,,,,,a,,4....-T,,,,,,z,-44-ewirkg..44-Le...,...:;'3..t-fiautkri*,.. *,,,;...,:,t,,sz--if.1.--,.,i'm;:gq. ...q.V.:,,,•.:,4::,..; :;.. -4.:,;=;;;- ,'''4,,..?;,;:.-.1,;:, ....;,,,,,, ,,:.-{ ,..„2,4-..ii,z,,,, ,,,, ,i4T:as...:I.4.APt4
0 l-and 2-family dwelling 1,74 Commercial/industrial 0 Accessory building For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. Total
• "•''''*-•*7-';•,1,*•74.-'4tM::F'W.itfiittA.Wiliaiffralr 1-i;••'.71 "-:;46.0gage.1,390/4
-'-'•""s7-j-',1 Heating/cooling: . '1
_ 46.75
Job site address: i ) 1 1 ) _S„si 6(LE 8/1) (3 f/e 6 1. 4C) , Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 'I`) &.ei::, y, C1 7 Furnace 100,000+BTU(ducts/vents) 54.91
( Heat pump 61.06
Suite/bldg./apt.no.: I Project name: S(00 It H 5 P0,17
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-dud,suspended,etc. 46.75
Flue/vent for any of above 23.32
•
Other: 23.32
Subdivision: I Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
.':'.• ...•' •1. '.:•,.•:.::-•'.. :' :•••.••;• ••:'s•l'•,•, ..••:••.., ,:,•:' ..,,' 0. ' .;1;1 ratigeMaWagetn0$ Gas fireplacermsert 33.39
',!:••. •. , .•••.:,..:.••.,.:,;.•'...::-,•.:- - •-''•• .' ' •' - '''''''"" "'*'7'-"*'...:.4414 ".11"*;)"<-4•Q'z-14'i"'-i•- Flue vent for water heater or gas
6A5 1-)O C ‹ fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/Moen 23.32
Chimney/liner/flue/vent 23.32
23.32
,u,-,i4,-i----,..•,,,o,,, ,,,,,,,,,,.,..z...%.,•,;.,...,..v•:4-#4,,,„4.,?..,„*.A.,„$,-1,1,4:w•-17,14.mr.w.11,mwz..ri Other:
gial.:013*.tWi:,-,:fetc-L,.-.:2-='.-t i'-',.="44;4171410:Ot,-...1.'-i-i-4-1--S-z-s'I'-'?-'•1-z-',;---,-,,- ''',''' '="f-Mefgl'1"..A.k' Environmental exhaust and ventilation:
Name: K tr 4 /6 N4 5 Pak 7 5. Range hood/other kitchen
equipment 33.39
Address: I 1 i 3 1 5•-• Gq..Filq.Z6 le- Clothes dryer exhaust 33.39
City/State/ZIP: 1 )GAM) bt . ‘i 7 Q q Single-duct exhaust(bathrooms,
A toilet compartments,utility rooms) 23.32
Phone:(5D3 ) 9 2 II ..:59 c 7 Fax:( ) AtiickrawIspace fans 23.32
.042-aw,0„-5-40,0, :e*A-74,7Watf,ri.--4*--04-. 41:7-'alterreli*.T'A,m,,x,:iiror.f. Other: 23.32
Fuel 4.4r.,.10.7;:c472ii,,4-1,-544:::-..-.::-..,,a-...,,,,:f.,,,,,-.,,,,:,-.,:',iz:*-isiym-.413",--z:,..o0..,7,-,-*,..,,•::,.. .,.-z,-.4,-;,-,..,...-4--,,,,,--,-,:1?-;,,,,,,-:,4-4,-••-,..--...,- piptux:
Business name: *le 11‘.4 (••■LC.\ilt A 4 t CAA. $14.15 for first four,$4.03 for each additional
Contact name: 5T c, t"t.tn rAD4y Furnace,etc.
Gas heat pump
Address: 1 CI ili S W ert.1 Pt(....A'7%p.) er).
Wall/suspended/unit heater
City/State/ZIP: Tv 6t..A---Nk%f.) tOk, GI --?ok-A Water heater _
Phone:vc( 113) .69P *, /1 Fax::($4) 4<pi . /4::),lit Fireplace
Range
E-mail:
Barbecue
q-iiA;V4Agt%":*ii0;Pirf•Z"-,ii-'41';:'-'17:t4,>4=Aittigikl:Vek*K=5*T-07:14 Clothes dryer(Igas)
Atigil'ee4=";ez4t'i'ia*I*jl',f401,4-- -'41ki.:. °- , -:;-::,:ql:rtg.4 ?:,:,- :,:::= :::::5,: ;::=-':: -felizq.,•., .
Other:
Business name: A.11.404.„) /1,rci .44,4 e,,,04.4.,
',:fgatagg.ti' ."-. i:' !', ,.F:aaj..i:i :''' . ', .:
Address: /C)y yt,;) 5 i4 Tvkl.04,7f,‘,) otc,,,
Subtotal
City/State/ZIP: yri464 411r1 ini 0 k t 9"VG4i; Minimum permit fee($90.00) ...-------
Plan review(25%of permit fee) /'7.,7
Phone:(.93). 404:61t u )/ ...4" Fax:($10) 49/ -I6P79 State surcharge(12%of permit fee) tar
CCB lie.: >47 ei TOTAL PERMIT FEE 9 I.0.2-
- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized sign e: • Fee methodology set by Tr-County Building Industry Service Board
Print name: Date:1<•7,4.4- ,
I\Building11, . EC_PermitApp_040113 doc 44114617T(I 1/02./COWWEB)
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