Permit (40) INCITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00830
T f 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/09/2017
GARD.
Parcel: 251136000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services Subdivision: None Lot: None
Project Description: Replacing existing duct work and associated pipe supports.
Contractor: STETTLER SUPPLY COMPANY Owner: BURLINGTON NORTHERN INC
1810 LANA AVE NE PROPERTY TAX DEPT
SALEM, OR 97303-3198 PO BOX 961089
FORT WORTH, TX 76161
PHONE: 503-585-5550 PHONE:
FAX: 503-581-6799
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/03/2017 $4,068.71
Class of Work: ALT Type of Const: VB Plan Review 01/03/2017 $1,017.18
Occupancy Grp: F-2 Occupancy Load: 12%State Surcharge-Mechanical 01/03/2017 $488.25
Stories: Info Process/Archiving-Sm$0.50(up to 01/03/2017 $50.00
11x17)
Project Valuation: $150,000.00
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 $5,624.14
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: seismic
Duct Work: bracing
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questionsnsto
OUNC by calling 503.232.1987 or 1.800.332.2344. (2+_
Issued By: /,i Permittee Signature: /1 e I/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
FOR OFFICE I;SE ONE
City of Tigard eived
13125 SW Hall Blvd.,Tigard,OR 97223 /By' / /�I
Permit No.:
Phone: 503.718.2439 Fax: 503.598.1960
':n Review "� 1
�
Inspection Line: 503.639.4175 Date By: / • Other Permit: I f
TIGARD p Date Read
Internet: www.tigard-or.gov r (� c y °yd See Page 2 for
{�Iel` �Q�U Notified/Method: / 3 iINE
I Supplemental Information
TYPE OF WORK �� Y CIF2COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
❑New construction F,I Addition/alteration e G DIVISIONMechanical permit fees*are based on the value of the work
� a performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ SO 00C,
❑ 1-and 2-family dwelling Commercial/industrialRESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 Accessory building For special information use checklist.
❑Multi-family Master builder
❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 0S � T(� Air conditioning 46.75
SL s.s .__.. t Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: TV/42_0 e),(.2._ e?7 2_E. i Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name:bu Q..tji jHeat pump 61.06
Duct work 23.32
Cross street/directions to job site:
favii 2#L41(2--
l L/ k;1 1" � 124'4"1-1-Hydronic hot water system 23.32
b RD SResidential boiler radiator or
�t41 q'� �� 4s 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
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
DESCRIPTION„OF WORIC-' .:r Gas fireplace/insert 33.39
Flue vent for water heater or gas
eda eL4 0 0,-..,,yt D iAc� a K -/4 b S JC t(i-�b� fireplace 23.32
,e t�(�v(Lr S Log lighter(gas) 23.32
- Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY�OWI'ER,
[ D TENANTOther: 23.32
� : �'
Name: C! Environmental exhaust and ventilation:
`?l2 v 'q S -Q1/41ic-C S Range hood/other kitchen
Address: a SK's r n' equipment 33.39
S >`N� Clothes dryer exhaust 33.39
City/State/ZIP:TIG*LO - A `'t 72 z - Single-duct exhaust(bathrooms,
Phone:(�jv31 !� ��� ax:(��- ) toilet compartments,utility rooms) 23.32
47 Attic/crawlspace fans 23.32
0 APPLICANT
CONTATPERSON. Other: 23.32
Business name: Fuel piping:
Contact name: —
y� $14.15 for first four;$4.03 for each additional
1., A,i/C Furnace,etc.
Address: (G G c, c„....,,,, (i.e., Th /9-41_ Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
&!111-� CJ r'l ' 7z 4-
Phone: _ Water heater
(Sts )�U j L�-E Cl Z I Fax::( ) tj �Yt."� Fireplace
Range
E-mail: ;ek
.._C rttyCS -, ,Ad:CJz,-`,. ni2--7. Barbecue
CONTRACTOR ( Clothes dryer(gas)
Business name: /tom Other:
Address: / �,,G� ( QI^.evi
�C �l��' MECHANICAL PERMIT FEES*
`1��0 Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) ' r C !, Fax:( ) Plan review(25%of permit fee)
./ State surcharge(12%ofpennit fee)
CCB lic.:
--3, a, TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized Si tore: days after it has been accepted as complete.
ki 0 ALL C /Q/1..- * Fee methodology set by Tri-County Building Industry Service Board
Print name: -d C O I Date: I 122-G
1.\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/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_040113.doc 2