Permit `a_'`- CITY OF TIGARD MECHANICAL PERMIT
�' COMMUNITY DEVELOPMENT Permit#: MEC2015-00724
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439
Date Issued: 10/27/2015
Parcel: 2S102CB03200
Jurisdiction- TIGARD
Site address: 9975 SW FREWING ST 220
Project: United Medical Group Subdivision: FREWING'S ORCHARD TRACTS Lot: 21
Project Description. Installation of interior gas furnace,roof mounted a/c and associated ductwork
Contractor: WILLAMETTE HEATING&AIR CONDITIONING INC Owner: MASSIH LLC
4760 SW HAMILTON BY PIERROUZ YASAVOLIAN
PORTLAND, OR 97221 8 BECKET ST
LAKE OSWEGO, OR 97035
PHONE 503-284-3740 PHONE
FAX 503-284-2821
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/27/2015 $316 80
Class of Work: ALT Type of Const: Plan Review 10/27/2015 $79 20
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/27/2015 $38 02
Stories: 2 Info Process/Archiving-Lg$2 00(over 10/27/2015 $2 00
11x17)
Project Valuation: $8,900 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 $436 02
Hoods Comm Incinerators
Woodstoves Gas Fireplaces Required Items and Reports(Conditions)
Clothes Dryers Other Mech Units
Gas Outlets Other Desc
Duct Work
Fire/Smoke Dampers
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy • the rules
or dir questions to -NC by calling 503 232 1987 or 1 800 332 2344
I sued By: _/ _,Z4,01 / Permittee Signature /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•Mechanical Permit ApplicyytiQI1°V :p ;FOROFFICE USE ONLY . .:' '1,
it E � ��. Received �/
City of Tigard Date/By // A7 /J Ada/ Permit No i f cep 724/
• 13125 SW Hall Blvd,Tigard,OR 97223 "
! Plan Review _
Phone 503 639 4171 Fax 503.598 ,q ry Other Permit
'`' Inspection Line 503 639 4175 U�� I 2015
Date/By P�Q/rj t'A'J�
T,1 G A R D p Date Ready/By _Tuns RI See Page 2 for
. Internet www tigard-or gov
Notified/Method Supplemental Information Ug ll A IGA r
TYPE itV y
6 INVNSl0N COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction NAddition/alteration/replacement performed Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
CATEGORY OF CONSTRUCTION Value.$ 760 du
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building
El Multi-family El Master builder ❑Other: For specra!information use checklist
Description I Qty _ Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
m Air conditioning or heat pump
Job site address: 1,6,-....,.1.1.-f,- (requires site plan showing placement) I 14 00
City/State/ZIP: ' a��B 1' t Furnace 100,000 BTU(ducts/vents) ) 14 00
Jv Furnace 100,000+BTU(ducts/vents) 17 90
Suite/bldg./apt.no.: 0q90 Project name: l_i_N 1 i£D �t7)► f}L Gas heat pump 14 00
Cross street/directions to job site: t p/2.Ot-t_Q Duct work 1 14 00
Hydronic hot water system 14 00
Residential boiler(radiator or
hydronic) 14 00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc 10 00
Flue/vent for any of above 10.00
Subdivision: I Lot no.: Other: 10 00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10 00
9 ,
L Gas fireplace 10.00
041 ,[_,[-(I 4e--/c (.0...._ / Flue vent for water heater or gas
DCAE,Jr r %i fireplace 10 00
Log lighter(gas) 10 00
Wood/pellet stove 10.00
Wood fireplace/insert 10 00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10 00
--. Other. 10 00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10 00
City/State/ZIP: Clothes dryer exhaust 10 00
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 6 80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10 00
Other 10 00
Business name: Fuel piping
Contact name: $5.40 for first four;$1.00 for each additional
Address:
Furnace,etc
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( ) I Fax: :( )
Water heater
Fireplace
E-mail:
Range
CONTRACTOR Barbecue
Business name: �� r c# A,e Cw _v Clothes dryer(gas)
�_ 1 ._ r a tJ Other.
Address1�2`„0 9 � j • . MECHANICAL PERMIT FEES*
City/State/ZIP: CY ) 9 Subtotal
'v` Minimum permit fee($72 50)
Phone:( �� � Fax:( ) Plan review(25%of permit fee)
CCB lic.:� State surcharge(8%of permit fee)
- S TOTAL PERMIT FEE
p.
Authorized signature:
r This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 4:-.) 0 _ Date: /' `A • Fee methodology set by Tn-County Building Industry Service Board
I\Bwldmg\Permits/MEC-PermitApp doc 04/06/06 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee: -
$1.00 to $2,000.00 Minimum fee$72.50
$2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30
for each additional$100.00 or fraction
thereof,to and including$5,000.00.
$5,001.00 to$10,000.00 $141.50 for the first$5,000.00 and
$1.80 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and
$1.35 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first$1 00,000.00 and
$1.10 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1\Building\Permits\MEC-PermitApp doc 12/30/05 2