Permit CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2016-00532
TIG RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2016
Parcel: 1 S 135 BD01300
Jurisdiction: Tigard
Site address: 10830 SW GREENBURG RD
Project: Washington Square Hotel Subdivision: MEADOW VIEW Lot: 8
Project Description: Installation of mini-split system.
Contractor: AIR COMFORT INC Owner: SCHAEFER, ROBERT M&SALLY J&
16055 SW 74TH AVE SUITE B MILLER,GERALD V
TIGARD, OR 97224 BY SHILO INN-WASHINGTON SQUARE
11600 SW SHILO LN
PORTLAND, OR 97225
PHONE: 503-260-7806 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/08/2016 $319.61
Class of Work: ALT Type of Const: VB Plan Review 08/08/2016 $79.90
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 08/08/2016 $38.35
Stories: Info Process/Archiving-Sm$0.50(up to 08/08/2016 $1.00
11x17)
Project Valuation: $9,000.00
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 $438.86
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: mini split
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N. i• enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir: t questions to OUNC =, C.Ilin. 503.232.1987 or 1.800.332.2344.
s
Iss -d By: ,n / & �1/y2' ,a Lf, Permittee Signature:
AC
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A r FOR OFFICE USE ONL\'
City of Tigard JUl.. 2 b 2016 Received (off�<o t, ee ij/ , 3,'
Date/By:11 Permit No.:.
N . 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.7]8.2439 F Yyg k �l Plan Revretw c,--(( ,
5, c`t Date/B Other Permit:
T I(,A R 1) Inspection Line: 503.639 , i y
Internet: www.ti and- +\!i- ' , 1 '" Date Reay y: //� '��,� Juris: I ® See Page 2 for
g Notified/Method Supplemental Information
t
gi... t - .... Olt' iii4.,: 't~; . , 0,.:1' ' LEE*;$ OilL,EU$ CFEC111100,f
Mechanical permit fees*are based on the value of the work
0 New constructionddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
t v Value:l
n , a, . . ,CA E ' R N.. : ' - - , aP ��e-0E
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
'� '' N Heating/cooling:
� �'INiiN;l �'E?N°' ' ;" T
�. .:; Air conditioning 46.75
Job site address:
t' f;
t.' 5 LA e.. i, (j�_i. /2V Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: '-ri ( len 7)� tit /" 6( 7---2, . , Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: L U I kDuct pump 61.06
/ w� ��'t''S"t- Duct work 23332
Cross street/directions to job site: Hydronic hot water system 23.32
VResidential boiler(radiator or
C))N & )ill &'1:1 f) • 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
x " D1 SCI+IPTION:QFWOR Gas fireplace/insets 33.39
TN Ih�f �� Flue vent for water heater or gas
herr P UH-J P fireplace 23.32
1 /Ni E W e43 cr t Z ,)i m D.ki c, Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
vt,.
, . '.P��P14 �"Y �V�It � r 'pPly ��,n Other: 23.32
N Environmental exhaust and ventilation:
Name: C el,jk (-_e-7--ii pLe)[ f est, -.g c.�J tl7 r .7- Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: -(NiA-A-s---" '- Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax ( ) Attic/crawlspace fans 23.32
APPLI
A 0' NT��°)E'+ fie, 1� t= Other: 23.32
Business name: ,iri el__ U) X./r^�1/U7 A-) Fuel piping:
/ $14.15 for first four;$4.03 for each additional
Contact name: ,:7--, 1� (2.-t' ,177 L' ") Furnace,etc.
Address: GI j „,�L G,` `,I Gas heat pump
3 i ; S y l�(/L J^ 14 S Wall/suspended/unit heater
City/State/ZIP: ipo ,27 G,, ii y r 1) n__ q 2--2 2-t1 Water heater
Phone:( ) /ti ,' _-26e,
' e- -7 �6' Fax: :( ) Fireplace
E-mail: Range
, l'qCC) Barbecue
W °£ '' rte x t.tt 1e `. , -"i ' '1 Clothes dryer(gas)
Business name: �n� Other
t a I/'C�/Zri �'e�J� - 3t R NIC ,PERM T FEES* --
Address: 60 J s O_) y/ 111 `' .�.
to v� It L/ Subtotal
City/State/ZIP: lot / 7-7 1-ro , b q Minimum permit fee($90.00)
Phone:(i15) 2. 6 e0 79.0 Fax:( ) ---- Plan review(25%of permit fee)
D %� State surcharge(12%of permit fee)
J
CCB lie.: 5-e 8 �" TOTAL PERMIT FEE
g This permit application expires if a permit is not obtained within 180
C days after it has been accepted as complete.
Authorized signature: Fee methodology set by Tri-County Building Industry Service Board
r
Print name: 4-
, 1 G . /2._)t})0 r Date: 6114 4:,
1:/Building/Permits\MEC_PermitApp_040113.doc 440-4617T(I I/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi Family Fee Schedule:
$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:ABuilding\Pennits\MEC_PennitAPP_0401 1 3.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10830 SW GREENBURG RD, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2016-00532
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor