Permit (102) CITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT Permit#: MEC2016-00201
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/31/2016
T "^� � Parcel: 2S102AC00700
Jurisdiction: TIGARD
Site address: 12540 SW MAIN ST 202
Project: Recovery Works Subdivision: BURNHAM TRACT Lot: 1
Project Description: Relocate(1)RTU,install new RTU,ductwork,grilles&gas piping.
Contractor: MILLENNIUM HVAC INC Owner: DOLAN &CO LLC
2723 NE 159TH CIRCLE BY FLORENCE T DOLAN
RIDGEFIELD,WA 98642 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 971-235-3699 PHONE: 503-225-9009
FAX: 360-546-0512
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/31/2016 $589.01
Class of Work: ALT Type of Const: VB Plan Review 03/31/2016 $147.25
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 03/31/2016 $70.68
Info Process/Archiving-Sm$0.50(up to 03/31/2016 $5.00
Stories: 2
11x17)
Project Valuation: $19,450.00
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 $811.94
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 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.33
Issued By: Permittee Signature:
Call 503.•39.4 75 by 7:00 a.m.for the next available inspecti ate.
This permit card shall be kept in a conspicuous place on the job site until c mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application / FOR OFFI( I: I SE 01I.1
UPICity of TigardEIVEP Date/ByReceivea ��`'f /46Permit No.: �LC,dV��`LG/ �
41 13125 SW Hall Blvd..Tigard,O Plan&view
s Phone: 503.718.2439 Fax: 503.598.1960 Date/By: j r/ (--- , Other Permit: /6itr /4, /(
Inspection Line: 503.639.4175
I Ic„�II� MAR 24 ?01G
/ Notified/Method:Date Rea tis: ® See Page 2for
Internet: www.tigard-or.gov U U /
e(,_ i OF Supplemental Information
t ''
.e -•,-•:t'1::?,.:!';',-?;S. ., d-8 lA 1147i oif ift001
9 .i. .p- . ,' t to ' 4mnhit` td . ,,fi'',J1.. Rd+:*`f v,. r'ASP E^#-1 ---t:.
/ % Mechanical permit fees*are based on the value of the work
0 New construction Addi to a to a on�r ac tfi performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: 4 mechanical materials,equipment,labor,overhead,and profit.
x Twp i ! '1rotioiti ' ro,. Value $ 5Q
- - ,-,:''', '-':- -''j.:-'''' - ' ' ' :1,,. ''.'.,, ,..,.., ..,t1A,#.4_41-1101),.: 1..,';,,,,,,4,-t-,':-i'l. ';';:, ..,.:,!? ,': , sT,
0 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
p.
�4 � Heating/cooling:ala, , ,...^n+fi A [�1 : ,. Air conditioning 46.75
Job site address: /.25410 s"k/ /14th SIT. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -77 .,/ � y 7223
Furnace 100,000+BTU(ducts vents) 54.91
Suite/bldg./apt.no.: OProject name:'tJ�'/ � e,K-jX,/ Heat pump 61.06
�
Duct work 23.32 O
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or B
hydronic) 23.32
Unit heaters(fuel-type,not electric), 0C
in-wall,in-duct,suspended,etc. 46.75 v
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: 1 Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
'''REStRIFFTION o, WORK Gas fireplace/insert 33.39
/ Flue vent for water heater or gas
�e t/Ge4'�� OYl r r O �n r 7/ i/fS'�4// „Ic.,.., fireplace 23.32
� ` �j Log lighter(gas) 23.32
�OCY7' e�P Leet t .el S'�4/` rl e C4) ,4f-icILcA-).Y' `
J Wood/pellet stove 33.39
J
yr-r'/(e'S�� tt��ex( cl0),_S r t/0 Wood fireplace/insert 23.32 �}
Chimney/liner/flue/vent 23.32
Other: 23.32
^, PROPERTY OWNER I . ❑.Tl .ci
L. Environmental exhaust and ventilation:
Name: Range hood/other kitchen CZ
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
-)5r.AP41CANT ;cCONTACr PERSON Other: 23.32
,//c� Fuel piping:
/
Business name: 1476444;ciwi by t C l .z,e,J $14.15 for first four;$4.03 for each additional
Contact name: ^T��r •'(� .5�� Furnace,etc.
Gas heat pump
Address: 2_7y . 13 - i.5-?,44- Cr '
t'_., Wall/suspended/unit heater
City/State/ZIP: pe -0/ e._ ,
�•e�el , �� -7g e;„ -- Water heater
Phone:(cj7f ) z3 - 3e,7.7 Fax::(3 i..,0) SL{G (:)S/Z Fireplace
/ `` Range
E-mail: in�I y e?'C 0* i r'h e T X01+'1 Barbecue
I`,2,i,„.3 , ,',,-_,:.:„.,4:1-:„.%.-.4.4v.1.4.,:,,.,, , 4L ,,,, t -.... ,....,.:,:yClothes dryer(gas)
Business name: Other:
Address: S ‘e4'C QS q Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB tic.: 154 log 3(13/i 7 TOTAL PERMIT FEE
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: �J r .tr-(5 Date: 3^24f `l4,
1:�Building,Permits MEC_Permit Ap 040113.doc 440-46I7T(II 02 COM WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I Building Permits MEC_PermitApp 040!13.doc 2