Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00020
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/28/2016
Parcel: 1 S135BC00202
Jurisdiction: TIGARD
Site address: 10763 SW GREENBURG RD 100
Project: Acadia Healthcare Subdivision: OAKBURG Lot: 27
Project Description: Mechanical for TI:Installing(8)exhaust fans,and replacing(1)RTU with duct work.
Contractor: JET INDUSTRIES INC Owner: BELANICH, ROGER M
1935 SILVERTON RD NE 22020 17TH AVE SE#200
SALEM, OR 97303 BOTHELL,WA 98021
PHONE: 503-363-2334 PHONE:
FAX: 503-363-2622
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/11/2016 $1,513.11
Class of Work: ADU Type of Const: VB Plan Review -, 01/11/2016 $378.28
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 01/11/2016 $181.57
Stories: Info Process/Archiving-Lg$2.00(over 01/11/2016 $4.00
11x17)
Project Valuation: $56,000.00 Info Process/Archiving-Sm$0.50(up to 01/11/2016 $9.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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: 8 Vent Systems: Total $2,086.46
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 Other Desc:
Duct Work: 1
Fire/Smoke Dampers: 12
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct ions UNC by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application K91 Wel 0 0 10 a WI WHO
Received
City Of Tigard Received
PermitNo.: i
lu
13125 SW Hall Blvd.,Tigard,OR 97223 _"k
Plan R _
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: 7nh
._ Date/13 ,t j Z.� —
Inspection Line: 503.639.4175
Internet: www.ti and-or. ov .`tv'^may Date Rea Juris: See Page 2 for
g g n Notified/Method:/ I/ Supplemental Information
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Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alterati
€i performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition El Other: \ mechanical materials,equipment,labor,overhead,and profit.
Value:$
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
;x,; E tUN1�iD I.i)CATHeating/cooling:
Air conditioning 46.75
Job site address:10763 SW Greenburg Rd. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
��
Suite/bldg./apt.no.: OT 1 Project named Heat pump 61.06
+ 9tR Ductwork 23.32
Cross street/directions to job site: H dronic hot waters stem 23.32
Residential boiler(radiator or
h dronic) 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
Ij :t y Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
ks 4c' Log lighter as 23.32
r ' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
4 „ Other: 23.32
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/crawls ace fans 23.32
.. Other: 23.32
Fuel piping:
Business name:Jet Industries,Inc.
$14.15 for first four;$4.03 for each additional
Contact name:Tina Torres Furnace,etc.
Address:1935 Silverton Rd.NE Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Salem,OR 97301 Water heater
Phone:(503)363-2334 Fax::(503-)363-2611 Fireplace
Range
E-mail:Tina.t@jetindustries.net Barbecue
Clothes dryer(gas)
Business name:Jet Industries,Inc.
Other
Address:1935 Silverton Rd.NE Subtotal
City/State/ZIP:Salem,OR 97301 Minimum permit fee($90.00)
Plan review(25%of permit fee) j
Phone:(503)363-2334 Fax:(503)363-2622 State surcharge(12%ofpermit fee) j 1,
CCB lic.:3944 TOTAL PERMIT FEE �e;' £
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:Tina Torres Date:12/21/15
I:\Buildmg\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/CAM/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
10763 SW GREENBURG RD 100, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00020
Jeff Grove
Violation Summary:
Inspector Contractor