Permit CITY OF TIGARD MECHANICAL PERMIT
111 -: N
3 . COMMUNITY DEVELOPMENT Permit#: MEC2015-00229
T t G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/07/2015
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12266 SW SCHOLLS FERRY RD
Project: Pacific Dental Services,LLC Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Mechanical for TI:Duct work and grilles.
Contractor: OREGON HEATING&AIR CONDITIONING Owner: FW OR-GREENWAY TOWN CENTER LLC
19300 SW 118TH AVE ONE INDEPENDENT DRIVE, SUITE 114
TUALATIN,OR 97062 JACKSONVILLE, FL 32202
PHONE: 503-691-9699 PHONE: 503-603-4709
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/06/2015 $487.41
Class of Work: ALT Type of Const: Vg Plan Review 07/06/2015 $121.85
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 07/06/2015 $58.49
Stories: 1
Project Valuation: $15,421.00
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 $667.75
Hoods: Comm Incinerators:
Woodstoves Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Grills and
Duct Work: 1 registers
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct qu- •UNC b calling 503.232.1987 or 1.800.332.2344.
Issued .y: i % Permittee Signature:
i
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mectialiical Permit Application FOR OFFICE USE ON1.1
City of Tigard Received _
`.7 ] 'LVE Date/By: kr �+, 1 -7,--- Permit No.:/1), •�_)I 5—.....( )1?
1111
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie /riC.�]r
II Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ' �� Other Permit:�Lta 1,---.... At 1
I I t.n I I 1 Inspection Line: 503.639.4175 APR 21 2015 Date Ready : ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:il 9.4I4 r Supplemental Information
�r11T�'t.
I t OMMERCIAL FEE* SCHEDULE - USE CHECKLIST
i1, I I 1 r; • • p. / Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alterati• 1 -r acement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ®Other:TI mechanical materials,equipment.labor,overhead,and profit.
Value:$ 15,421
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 I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 12266 SW SCHOLLS FERRY RD Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:TIGARD,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name:TBE(DENTAL OFFICE) 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
Flue vent for water heater or gas
MECHANICAL DISTRIBUTION fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent , 23.32
El PROPERTY OWNER l ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:REGENCY CENTERS Range hood/other kitchen
equipment 33.39
Address:5335 SW MEADOWS,SUITE 295 Clothes dryer exhaust 33.39
City/State/ZIP:LAKE OSWEGO,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)603-4709 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 23.32
Business name:PACIFIC DENTAL SERVICES Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:BRANDON WEBB Furnace,etc.
Address:2044 CALIFORNIA AVE Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:CORONA,CA 92881 Water heater
Phone:(951)582-5758 Fax: :(714)388-3951 Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name:T �t,,, mitt_ MECHANICAL PERMIT FEES*
Address: /9 0 (`► // c "it, Subtotal
City/State/ZIP:_7� ,4�1l ) e� 9 7669' Minimum permit fee($90.00)
�� Plan review(25%of permit fee)
Phone:( )) ?/- 9.61F Fax:( ) State surcharge(12%of permit fee)
?1 A/ TOTAL PERMIT FEE
CCB lic.: C 7
This permit application expires if a permit is not obtained within 180
lywii" days after it has been accepted as complete.
Authorized signature: i,, �• Fee methodology set by Tri County Building Industry Service Board
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Print name:BRAN I •N ' EBB Date:4-20-15
I:\Building�Pennits\MEC_PermitApp_0401 13.doc 440-461 Tr(I 1/02/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
12266 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00229
George Heimos
Violation Summary:
Inspector Contractor