Permit CITY OF TIGARD MECHANICAL PERMIT
111. 2 °° COMMUNITY DEVELOPMENT Permit#: MEC2015 00394
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2015
Parcel: 2S101AB03000
Jurisdiction: TIGARD
Site address: 7150 SW DARTMOUTH ST
Project: Pediatric Associates Northwest Subdivision: 2012-009 PARTITION PLAT Lot: 2
Project Description: Interior HVAC,connecting to existing RTU's.
Contractor: MCKINSTRY COMPANY LLC Owner: DF DEVELOPMENT LLC
16790 NE MASON ST., STE. 100 23077 SW NEWLAND RD
PORTLAND, OR 97230 WILSONVILLE, OR 97070
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/25/2015 $1,677.45
Class of Work: ALT Type of Const: VB Plan Review 06/25/2015 $419.36
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 06/25/2015 $201.29
Stories: 1 Info Process/Archiving-Lg$2.00(over 06/25/2015 $8.00
11x17)
Project Valuation: $62,546.00
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: 6 Vent Systems: Total $2,306.10
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: registers and
Duct Work: 4 grills
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ou may ',stain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.• . 952-001-0090.
Issued By: Permittee i• ature:
Call 503.639.•175 by 7:00 a.m.for the next available inspect •n date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
130P 20 G-oo u31 .
Mechanical Permit Application ( FOR OFFICE USE ONLY
i j� Received (P /8 /S
III City of Tigard �a�,�i 1 U Date/By: Penn"o.: flS-66 394/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review •
a Phone: 503.718.2439 Fax: 503.598.1960 DateBy: / Z r Other Permit:
T I G A R D Inspection Line: 503.639.4175 JUN 18 2015 Date Ready t y: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 67)b Supplemental Information
I.
TYPE, . 'ERCIAL. FEE* SCHEDULE-.USE CIJ.ECK isT
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ ( 2i 51 .
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use check list.
❑Multi-family ❑Master builder ❑Other: Description Qty. _ Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:7150 SW Dartmouth Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard/Oregon/97223 Furnace 100,000+BTU(ducts/vents) , 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Tigard Pediatrics Duct work 23.32
Cross street/directions to job site:SW Dartmouth&SW 72nd 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
H ,,,,
New construction- VAC system install r 'T 1 fireplace 23.32
Log lighter(gas) 23.32 _
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
❑ PROPERTY OWNER ❑ TENANT
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
0 APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:McKinstry Company
$14.15 for first four;$4.03 for each additional
Contact name:Adam Mueller Furnace,etc.
Address: 16790 NE Mason Street Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland/Oregon/97230 Water heater
Phone:(503)307-9151 Fax::(503)331-6906 Fireplace
Range
E-mail:adammu^a,mckinstry.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:McKinstry Company Other:
MECHANICAL PERMIT FEES*
Address:16790 NE Mason Street Subtotal
City/State/ZIP:Portland/Oregon/97230 Minimum permit fee($90.00) -go,1
Plan review(25%of permit fee) tun.011 _
Phone:(503)307-9151 Fax:(503)331-6906 State surcharge(12%of permit fee) 201,)j
CCB lie.:172811 TOTAL PERMIT FEE 2I794727
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:Adam Mueller Date:6/11/15
I\Building\Petmits\MEC_PermitApp_040113.doe 440-4617T(11/02/COM/WEB)