Permit (63) CITY OF TIGARD MECHANICAL PERMIT
712 COMMUNITY DEVELOPMENT Permit#: MEC2016 00504
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 08/03/2016
V14F�T7 9
Parcel: 2$101 BD00100
Jurisdiction: Tigard
Site address: 7650 SW BEVELAND RD 200
Project: Womens Healthcare Associates Subdivision: None Lot: None
Project Description: Add or relocate duct work and grilles,and add(1)Mitsubishi ductless split system for TI.
Contractor: AMERICAN HEATING INC Owner: PNWP LLC#2
5035 SE 24TH AVE PO BOX 2206
PORTLAND, OR 97202-4765 BEAVERTON,OR 97075
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/03/2016 $368.03
Class of Work: ALT Type of Const: VB Plan Review 08/03/2016 $92.01
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 08/03/2016 $44.16
Stories: 2 Info Process/Archiving-Lg$2.00(over 08/03/2016 $2.00
11x17)
Project Valuation: $10,800.00 Info Process/Archiving-Sm$0.50(up to 08/03/2016 $1.50
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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $507.70
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: ductless split
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 C by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' M „...c.,—.7 / ..„...„...7-,---
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 FOR OFFICE USE ONLY
CI Of Tigard Received
A -�
g Date/By: 7 Permit No.: /y� ��ry
13125 SW Hall Blvd.,Tigard,OR 97223 / /" 'kms 9.0 CI cc, ii
7` Plan Revrew"""
Phone: 503.718.2439 Fax: 503.598.1960 '' e pate/By: % P �'� " + Other Permit }
Inspection Line: 503.639.4175 e `'r e Page
Lf�L' ' ) r
T I GARD `Date ReadyB , Juris: See Page 2 for
Internet: www.tigard-or.gov Notified/Method���/✓ ' Supplemental Information
V *. ' � - `::. COli** RCLIL FEE* HEI)tTLE '-USE IWC LIST
may: 11 O+1"�U4y3R q, `
" `' ' Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
NValue:$$10,800 00yCA ORE F QIRIUClt01, s . GOiESi3�NTIAIEQUIPMENT lSYT
EMS
F�*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessorybuilding
For special information use checklist.
❑Multi-family 0 Master builder ❑Other: DescriptionQh'• Ea. Total
... Yi"`5 1 E„_,I1VF r- ,,t,LO - -,,o
Heating/cooling:
od W Air conditioning 46.75
Job site address:7650 SW Beveland 2 floor Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump
Suite/bldg./apt.no.:2°d f Project name:Womens Healthcare Lab 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
I)I cRIPTION Ui WOi .0 AtGas fireplace/insert 33.39
Flue vent for water heater or gas
Add or relocate Duct work and Grilles fireplace 23.32
Add(1)mitsubishi ductless split Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32l31iRoPER .0 � tz Other:
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
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
jr 146., G0I4-? .GT pERSO' ?�,. Other: 23.32
Business name:American Heating Inc.
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Brandon Hutchinson Furnace,etc.
Address:5035 SE 24th Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland,OR,97202 Water heater
Phone:(503)239-4600 Fax::(503)239-7038 Fireplace
Range
E-mail:b.hutchinson@americanheating.net Barbecue
ert
>•:n:. '�:._" ��,. ,;.. g� � �: ' �� Clothes dryer(gas)
Business name:American Heating Inc. Other:
Address:5035 SE 24th Ave Subtotal
City/State/ZIP:Portland,OR.,97202 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)239-4600 Fax:(503)239-7038 State surcharge(12%of permit fee)
CCB lie.:33135 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: i`� * Fee methodology set by Tri-County Building Industry Service Board
Print name:Brandon Hutchinson Date: — .•
' I:iBuilding\Permits\MEC_PermitApp_040113.doc 440-4617T(i l/02/COM/WEB)