Permit CITY OF TIGARD MECHANICAL PERMIT
11111 n
' COMMUNITY DEVELOPMENT Permit#: MEC2015-00441
T f GARD 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 venting.
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 07/07/2015 $449.31
Class of Work: ALT Type of Const: Plan Review 07/07/2015 $112.33
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 07/07/2015 $53.92
Stories:
Project Valuation: $13,990.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Co m pressors
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 $615.56
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009 . - .in a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. farl
Issued By: • �� Permittee Signature: Pi
Call 503.639., 5 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application I O1! OH t It I I sl O\I
City of Tigard D n Eiew 7� � , PmitNo.: 0 i5 13125 SW Hall Blvd.,Tigard,OR 9722 Phone: 503.718.2439 Fax: 50 V D ty �Wit. , ,
1 1,; Ic 1, Inspection Line: 503.639.4175 Date Ready/By: ". See Page 2 for
1
Internet: www.tigard-or.gov I x,015 Notified/Method: Supplemental Information
,10t
TYPE;G 1`�vRs o4 COMMERCIAL FEE' SCHEDULE-USE CHECKUSr
G Mechanical permit fees'are based on the value of the work
❑New construction [[>�Additio�placement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 13, 9°i0
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
.1011 SITE INFORMATION AND LOCATION Heating/cooling:
_ Air conditioning 46.75
Job site address: I d••� ()b S\1, S(1,61 lS re fr9 P,I1 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:"-. rtA, 0 R 117)-a-3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: p,(; ;( On, . rf/-/7% P. pact 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: 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
TJ u,c-f:ky -, V e l-n 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
❑ 0 TENANT Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Atticicrawlspace fans 23.32
❑ APPLICANT ®"CONTACT PERSON Other: 23.32
Fuel piping:
Business name: 0 fe an 0-eovi`n 7 * ^F C`' $14.15 for first four,$4.03 for each additional_
Contact name: ( 1 t'/\+ 1,.gt',ry\e f Furnace,etc.
Gas heat pump
Address: f cI)D.Cf S t ii ti S+1,,, 4.1t Wall/suspended/unit heater
City/State/ZIP: T--,el.Vc J -A 0k_ 970 6 - Water heater
Phone:(Se:, ) IC(_l t5 71 Fax::(SC 1 6,I-G.c.s-6 Fireplace
Range
E-mail: /l{- ._0 0 C \�LF`i'I.1• owl
Barbecue
CONTRACTOR Clothes dryer(gas)
It 9 Other:
Business name:
(mil E4.€4./7 't 4 MECHANICAL PERMIT FEES*
Address: I 1 3cC Stti' Ii 9 -I-I., 4k,'c Subtotal Il60-11
City/State/ZIP: T�q v0.i._.`, c e 7 c6 ,1 Minimum permit fee($90.00) -----
Plan review(25%of permit fee) I'S,.o3
Phone:(S✓tl) 6 7(_ 9-6 9 K Fax:(5 ) li i I -SS S 6 State surcharge(12%of permit fee) 55.a.!
CCB lic.: X7)4 TOTAL PERMIT FEE 610, $a
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: - - _-cti%' • Fee methodology set by Tri-County Building Industry Service Board
Print name:`"p S� f 5-r Date: 0 7/0 T/
I:l Building\Permits1MEC_PermitApp_0401 I3.doc 440-4617r(1 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
MEC2015-00441
George Heimos
hall@bnkconstruction.com
Violation Summary:
Inspector Contractor