Permit CITY OF TIGARD MECHANICAL PERMIT
2: COMMUNITY DEVELOPMENT Permit#: MEC2016 00784
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/14/2016
TFr4;R- Parcel: 2S112DA01300
Jurisdiction: Tigard
Site address: 6640 SW REDWOOD LN 300
Project: Portland Clinic Subdivision: 1996-048 PARTITION PLAT Lot: 1
Project Description: Relocate ducts for TI
Contractor: HUNTER DAVISSON INC Owner: PACIFIC REALTY ASSOCIATES
1800 SE PERSHING ST ATTN: N PIVEN
PORTLAND, OR 97202 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-542-3628
PHONE: 503-624-6300
FAX: 503-542-3654
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/14/2016 $297.13
Class of Work: ALT Type of Const: Plan Review 11/14/2016 $74.28
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/14/2016 $35.66
Stories: Info Process/Archiving-Lg$2.00(over 11/14/2016 $2.00
11x17)
Project Valuation: $8,130.00
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 $409.07
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notifiatioo_Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may a copy of the rules
or ng 503.232.1987 or 1.800.332.2344.
71
Issuira Byuestions to /by calling permittee Signature: y �'r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
c,� /�
g �R :CEivEn Date/By: t/ r.� ' /GC '/I!'oc7'r
Cityof Tigard PermitNo.:
13125 SW Hall Blvd.,Tigard,OR'
DaPte/By:
Review Other Permit: ,` /
Phone: 503.718.2439 Fax: 503.598.1960 /k if/2s"
TI G A R D Inspection Line: 503.639.4175 NOV 1 4 2 016 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov fVIJ v Notified/Method: Supplemental Information
OMl�RC , . >�-SCHIE0U1 - E� r IST
` f.. r- P. TYP
li � 1 Mechanical permit fees*are based on the value of the work
❑New construction 1Addition a teratron/rep acem`gr performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
.n.�.
Value:$ O . 06
All olt CON lR llu>I'IQ 1
...sn•s✓ ,�:• .. '�' ...`���� �I�IEI!'T ISY'STE+MS TI'+E�'���
❑ 1-and 2-family dwelling X Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
��$.,',' ;•{INA LOCATION Air c Heating/cooling:
Q...
�� Air conditioning _ 46.75
Job site address: i st ,I � ,/ L4nJe Furnace 100,000 BTU(ducts/vents) 46.75
City/State/Z1P: joy ci p� / 7/t a Furnace 100,000+BTU(ducts/vents) 54.91
/ / e Heat pump 61.06
Suite/bldg./apt.no.: £?�� Project name:r tL,1 p/C,1 C I/Ai/C 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
-, .., • Gas fireplace/insert 33.39
- ate ION �` Flue vent for water heater or gas
��
.,00/4 c- (A)4)IN J( m oe/ c4.7¢c)"kc A ei.GcoMMO41,6Afireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
r8 'PKtOP RTyr O AR r -*- ;"" 1lENANT . Other: 23.32
_ 0 -• . , -1' Environmental exhaust and ventilation:
Narne:(',ee) / m u'S F joG✓e /iv c,, Range hood/other kitchen
(( equipment 33.39
Address: 9/1/ /Vie c:2 ` Ave. Clothes dryer exhaust 33.39
City/State/ZIP: �r�"(-,�/ o/(7 '/72/0 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(Slj'-y),,2a8— '2.7/ Fax:( ) Attic/crawlspace fans 23.32
"" .. Other: 23.32
'�:��PLIC+1NT �F , 4,.'���AGT I'E��I
Fuel piping:
Business name: 1-414iir _d9 J,'s.,-,,rll 1, C.
$14.15 for first four;$4.03 for each additional
Contact name: ?c.k C c, / Furnace,etc. _
Address: /FOO / .S'Nt.>J Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: g..,r z„,J d oi&J 717,20ca Water heater
Phone:(S&?) 7.3—` g6. Fax::( ) Fireplace
� Range
E mail:2'7 t e A,,,AI le r e;X If IS.17,1.1.r 0"A A Barbecue
CON�CTOR Clothes dryer as
,...F ry (gas)
Business name: 11“14/�. _ i Other
TtW400,1411 *itS*
Address: Y0c) i?/`$4„1„1 r Subtotal ' �7,J3
Cit /State/ZIP: p' '��- r`s �” l�2C/{. G£ >,�-- m=�p�;it fee__ _(�90 n0) ,p�
y zr z,„tod QQ f / 0�
Plan review(25%of permit fee) 74/..P8'
Phone:(5`A.:7), 7 7..7_ i', -C Fax:( ) State surcharge(12%of permit fee) y -,h 4'
CCB lie.: i/C` TOTAL PERMIT FEE I{el."7
This permit application expires if a permit is not obtained within 180
ri
days after it has been accepted as complete.
Authorized signature: 7,�Jf ,' * Fee methodology set by Tri-County Building Industry Service Board
Print name: z,ti r /In.ie- Date:J/ / /:�
l:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)