Permit (82) CITY OF TIGARD MECHANICAL PERMIT
g . COMMUNITY DEVELOPMENT Permit#: MEC2016 00186
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/29/2016
Parcel: 1S135BA00102
Jurisdiction: Tigard
Site address: 10140 SW WASHINGTON SQUARE RD
Project: Spec Space Subdivision: OAKBURG Lot: 9
Project Description: New gas line,landlord work. TI by others
Contractor: MODERN PLUMBING Owner: PPR SQUARE TOO LLC
11120 SW INDUSTRIAL WAY PO BOX 847
TUALATIN, OR 97062 CARLSBAD, CA 92018
PHONE: 503-691-6166 PHONE:
FAX: 503-691-6771
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/29/2016 $182.65
Class of Work: ALT Type of Const: VB Plan Review 03/29/2016 $45.66
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 03/29/2016 $21.92
Stories: 1 Info Process/Archiving-Sm$0.50(up to 03/29/2016 $1.00
Project Valuation: $4,200.00 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: Vent Systems: Total $251.23
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Noti enter. Those rules are set forth in OAR 952-001-0010 through OA q59- 01-0090. You may obtain a copy of the rules
or dire questions to O► C • - in. 503.232.1987 or 1.800.332.2344.
Issue. By: I /, Permittee Si ature: ItAllire_40-4.1.---r-
Call 503.639.4175 by 7:00 a.m.for the next available insp= ion date.
This permit card shall be kept in a conspicuous place on the job site •ntil completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard
Date/By:
Permit No.: / • )��
IIIII il 13125 SW Hall Blvd.,Tigard,OR 97223 V
. ``' Plan'y to r ( ISI 1�.. i _ _
Phone: 5017182439 Fax: 503.59 V DateB ili: Other Permit: 6
T 1G A R D Inspection Line: 503.639.4175la ��� G Date Rea kris: '4 See Page 2 for �,
Internet: www.tigard-or.gov t `L��U O Notified/Method: / (0
Supplemental Information
.^ 4`174 M-11�'A ik # v z s s yy"t'/"5- 1c�7. i rI .ti s' "4\' .� -10r * kk$ t.z Y,?.S N.-.90.,-; Tat .. w `..,.a"- T,
" i Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/al •`` t� 'ment performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: Vv mechanical materials,equipment,labor,overhead,and profit.
" , ;. �tw: Value $ y�3� b
u"'t-'-,` a 41 v s bo y`t'i'1 1 iA:4 i',ii-Ori ri z t_�'�r .'4. z., '" 5^ ` j iii E.(t.— I-''', -.R,s r'E''`'. ti' "`l n',
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
mow. �. 4 i Heating/cooling:
, . r,�r. °k Y 7-' 4C RMA7�O sl I t ' 'I(�N i''''''''�,.')' ; k
� '°"�'� Air conditioning 46.75
Job site address:10140 SW Washington Square Road 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.:BO1A Project name4ct=pl.-landlord work 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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRH'TIOI't OF WORK' Gas fireplace/insert, 33.39
Flue vent for water heater or gas
Install approximately MP feet of 1 1/14"black steel gas line from meter to fireplace 23.32
2SO Log lighter(gas) 23.32
space —
_ f3/� Wood/pellet stove 33.39
ew
t l0c/eV/ j' y k' _ I I , OfkevS Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 _
❑ PROPERTY OWNER. ❑ TENANT 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/crawlspace fans 23.32
® APPLICA "k+' `5 0 CONTACT PERSON Other: 23.32
Business name:Modern Plumbing Co. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Don George Furnace,etc. _
Address: 11120 SW Industrial Way,Bldg.9-3 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Tualatin,OR 97062 Water heater
Phone:(503)691-6166 Fax::(503)691-6771 Fireplace
Range
E-mail:deborah@modernplumbing.us Barbecue
z =` v4 co Ta i.� r� : �._ - Clothes dryer(gas)
Business name:Modern Plumbing Co. Other`jam Ye *oweOK
::',)*15'':-<- 14IECHANI P$RMTI'FEE + : 'rte'` r F"
Address:11120 SW Industrial Way,Bldg.9-3 Subtotal
City/State/ZIP:Tualatin,OR 97062 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)691-6166 Fax:(503)691-6771
State surcharge(12%of permit fee)
CCB lic.:87906 TOTAL PERMIT FEE 57.'13
This permit application expires if a permit is not obtained within 180
days atter it has been accepted as complete.
Authorized signature: �'��� Fee methodology set by Tri-County Building Industry Service Board
Print name: I .... •".• -1• Am,'"4 ate,,,,,_ Date:3/16/16
I:\nuilding\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WI?13)