Permit y CITY OF TIGARD MECHANICAL PERMIT
' s COMMUNITY DEVELOPMENT Permit#: MEC2015-00275
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/12/2015
Parcel: 1 S136DB02601
Jurisdiction: Tigard
Site address: 11509 SW PACIFIC HWY
Project: Dead God's Tattoo Subdivision: 2000-025 PARTITION PLAT Lot: 2
Project Description: Replacing existing duct work.
Contractor: KINCAID CUSTOM SURFACE INC Owner: HWY 99 LLC
3023 NE ROCKY BUTTE RD 11606 SW PACIFIC HWY, STE 200
PORTLAND,OR 97220 TIGARD,OR 97223
PHONE: 503-781-6937 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/12/2015 $90.55
Class of Work: ALT Type of Const: Plan Review 05/12/2015 $22.64
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 05/12/2015 $10.87
Stories:
Project Valuation: $1,200.00
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 $124.06
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1 :::. •. _•
Issued By: / Permittee Signature:
Call 503.. 5 by 7:00 a.m.for the next available inspec :n date.
This permit card shall be kept in a conspicuous place on the job site unti/ompletion of the project.
Approved plans are required on the job site at the time of e,ch inspection.
Mechanical Permit Application FOR 01 1 R F I F 0\1 1
City of Tigard CEIVED Received
Date/By: 977- Permit No.:
13125 SW Hall Blvd.,Tigard OR 9g Plan Review
• Phone: 503.718.2439 Fax: 503.598.11] 12 2015 Date/By: Other Permit: / ._, IT-eV it
i I,O Inspection Line: 503.639.4175 IYIQY Date Ready/By: tuns: ® See Page 2 for
Internet: www.tigard-or.gov ClN OF TIGARD Notified/Method: ie Supplemental Information
TYPE t>� �G D1VlStON COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees°are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑New construction N Addition/alteration/replacement
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other. Value:$ )a Q Q.(3
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling N Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 1)50 q/ s-1r-� p�(Fir / ' Air conditioning 46.75
City/State/ZIP: T/&4 eo / OR 9 7D23 Furnace 100,000 BTU(ducts/vents) 46.75
Suite/bldg./apt.no.: Project name: Furnace 100,000+BTU(ducts/vents) 54.91
Cross street/directions to job site: Heat pump 61.06
'I�Is+ aft 99 N / PAC IFIC -FR(I ACE. Daictwork 23.32
Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
Subdivision: I Lot no.: in-wall,in-duct,suspended,etc. 46.75
Tax map/parcel no.: Flue/vent for any of above 23.32
DESCRIPTION OF WORK Other. 23.32
Replace existing flex ductwork with sheet metal ductwork Other fuel appliances:
Water heater 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
❑ PROPERTY OWNER 1 ,TENANT Log lighter(gas) 23.32
Wood/pellet stove 33.39
Name: 50.S EPH .5'COI MS-IPSO
Address: 115-09 s o 1'gC%cl L Hp),
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
City/State/ZIP: 1'f6 jD ` OR 91c9D3 Other: _ 2332 _
Phone:(971 ) (10 0 �^OO.0 9 Fax:( ) Environmental exhaust and ventilation: _
N APPLICANT N CONTACT PERSON Range hood/other kitchen
equipment 33.39
Business name: j IX DEM O)J (3/q(T LL C./ Clothes dryer exhaust 33.39
Contact name: i(s`C pi.../ S kI2t S--rAo Single-duct exhaust(bathrooms,
Address: (1606 .51(4 P tFI C. h11r,1y toilet compartments,utility moms) 23.32
City/State/ZIP: TIGARD, OR g7aa3 Attic%rawLspace fans 23.32
Other. _ 23.32
Phone:(971 ) WO •
00_94 Fax::( ) Fuel piping:m g
•
E-mail: ' KO AMJ v
AD 0 GM A)L- Co M S14.15 for first four,54.03 for each additional
CONTRACTOR Furnace,etc.
Business name: KI N C Pl10 C V S7Q M S Q RFAc E Gas heat pump
Address: 0 a 3 ME ROCK`I a v7IE RD Wall/suspended/unit heater
City/State/ZIP: poira_A1.1D, OR. 97,4aO Water heater
Phone:(971 ) - 63 - ;6.33 Fax:( ) Fireplace
/4.5 9%i' Range
CCB lic.: 7
Barbecue
Authorized signature: /A / Clothes dryer(gas)
Print name: 7oSef' sg,/'.7OO I Dater//a /tS I Other:
/// MECHANICAL PERMIT FEES;
I\Building\P«mits\MEC_Pe mitApp_040113 doe 440-46171(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
11509 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00275
Chip Barnett
Violation Summary:
Inspector Contractor