Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00034
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2016
Parcel: 2S101 BB01500
Jurisdiction: TIGARD
Site address: 12254 SW GARDEN PL
Project: CTA Labs Subdivision: CROW PARK 217 Lot: 3
Project Description: Installing(1)cooling unit in server room.
Contractor: OREGON AIRE INC Owner: ICON OWNER POOL 1 WEST LLC
7715 NE 33RD DR STE A BY RYAN
PORTLAND, OR 97211 PO BOX 460169
HOUSTON,TX 77056
PHONE: 503-335-2222 PHONE:
FAX: 360-423-1978
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/04/2016 $576.31
Class of Work: ALT Type of Const: VB Plan Review 02/04/2016 $144.08
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 02/04/2016 $69.16
Stories: Info Process/Archiving-Sm$0.50(up to 02/04/2016 $2.50
Project Valuation: $18,950.00 11x17)
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $792.05
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: split system
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 of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ermittee ture: --
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 FOR OFFICE USE ONLV
Received City of Tigard te/B ' �j '` Penni[No
13125 SW Hall Blvd.,Tigard,OR 97223 y
n Re
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready y. Juris: ® e Page 2 for
Internet: www.tigard-or.gov AN 1 Z01 Notified/Method: Supplemental Information
Q J1"Lt
TYPE OF WORK V11MME CIAL FEE* SCHEDULE — USE C KLIST
1 -. Mechanical permit fees*are based on the value ofthe work
E]New construction ®Addition/alteration/rBperformed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$18950
CATEGORY OF CONSTRUCTION SIDENTiAL EQUIPMENT/sy§TEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ElMaster builder F1Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 12254 SW Garden Place (requires site plan showing placement) 1 46.75
City/State/ZIP:97223 Furnace 100,000 BTU(ducts/vents) 46.75
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:Park 217 Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site:Hall&99 Duct work 23.32
Hydronic 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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Install small cooling unit in Server Room Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter as23.32
Wood/pellet stove 33.39
Wood fireplace/insert I 1 23.32
® PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 1 23.32
Name: ICON Owner Pool 1 yi est,LLC Environmental exhaust and ventilation:
Address:PO BOX 843959 Range hood/other kitchen
equipment 33.39
City/State/ZIP:Los Angeles,Ca.90084 Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:(503)721 2732 Fax:( ) toilet compartments,utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawls ace fans 23.32
Business name:Oregon-Aire Inc.
Other: 23.32
Fuel piping:
Contact name:David DaCorte $14.15 for first four;$4.03 for each additional
Address:7715 NE 33rd Dr.Suite A Furnace,etc.
Gas heat pump
City/State/ZIP:Portland/Oregon 97211 Wall/suspended/unit heater
Phone:(503)335-2222 Fax::(503-)335-9977 Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name:Same Clothes dryer as
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee($90.00)
Plan review(25%of permit fee)
CCB lic.:64235 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print namri: LY1 m t Q o t Date: l b * Fee methodology set by Tri-County Building Industry Service Board
I:\Building\Permits\MEC-PermitApp.do� __._..12 440-4617T(I 1/02/COM/WEB)