Permit (24) CITY OF TIGARD MECHANICAL PERMIT
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2.-.,
COMMUNITY DEVELOPMENT Permit#: MEC2017 00254
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/12/2017
TIGARD Parcel: 2S101AA00100
Jurisdiction: Tigard
Site address: 12300 SW 68TH AVE
Project: Landmark Ford Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Relocating gas line due to new elevator.
Contractor: ARJAE SHEET METAL CO, INC. Owner: CORLISS, JAMES L&CORA K
8545 SE MCLOUGHLIN BLVD. PO BOX 23970
PORTLAND, OR 97222 TIGARD, OR 97281
PHONE: 503-231-7717 PHONE:
FAX: 503-230-4888
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/12/2017 $115.11
Class of Work: ALT Type of Const: Plan Review 04/12/2017 $28.78
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 04/12/2017 $13.81
Stories: Info Process/Archiving-Sm$0.50(up to 04/12/2017 $0.50
11x17)
Project Valuation: $2,000.00
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 $158.20
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 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 1.800.332.2344.
r
Issued By: g '-.----7 Permittee Signature: ,_
.1----
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
City of Tigard
GG /
��' ® Received
111 Date/By: itZ Permit No.:u - A
.,
Al.13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
a Phone: 503.718.2439 Fax: 503.598.1960 ®p 1 0 2 17 DateB • MEIN Other Permit:104 A it ' , ..w `r'F'
Al
I WARD Inspection Line: 503.639.4175 Q1 I� 1 Date Ready/By: H See Page 2 for ,
Internet: www.tigard-or.gov p�,t T'U'A' Ts ,tifed/Method: IffliSupplemental Information
TYPE OF Wo L �Gl� I9 '
COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
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
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$2 16
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT J SYSTEMS FEES*
0 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 122-04 6 LsJ t fo&t k Ave. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: .71-,,,,,..3.I 91223 Furnace
100,000+BTU(ducts/vents) 54.91
H�tPu P W
Suite/bldg./apt.no.:
Project name:Laic MOA-K Fc rrk 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: I,ot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK 7 Gas fireplace/insert 33.39
Flue vent for water heater or gas
Rei616`44 4-A Illoti Py P)65,+,,t1 Jars l,/IP .- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
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
'APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: 4c)- 0,
si_,,,,,,+._ "G' $14.15 for first four;$4.03 for each additional
Contact name: I ve ( f�O4 Furnace,etc.
Address: t� '/`Vl ^I I I-p gJ,u Gas heat pump
d5 /c mi. /i Ili) Wall/suspended/unit heater
City/State/ZIP: AR i,„1,,,�Ki't " ,Q '1ZtZ Water heater
f UU Fireplace
Phone:(50 )-tnS 1-170 Fax::( )
Range
E-mail: JYl114e 4( ,..fa t(y Barbecue
L`J� �' CONTRACTOR Clothes dryer(gas)
Business name: Other:
Darn P ' 5(a4 J t MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.:Cod 335' TOTAL PERMIT FEE /S7 AO This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature;-.- ,��,K / �� * Fee methodology set by Tri-County Building Industry Service Board
Print name:NIA Ike Cv chi Date:i-11, 2 V 1 1
I:ABuildingVPermits\MEC_PermitApp_0401 I 3.doc 440-461(I I/02/COM/WEB)
III City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC) Building & Fire Protection System Permit
i(, R 11 Appointment Checklist
Permit Record#:
Contact Name: 07 ` Phone #: 5O -a/3- O l`l 7
Business Name: QJ, v.rt. ��¢,�.{� i1 Appt. Date/Time: 4//A et) /p:e 471/Site Address: �a�o ai,,J Q9' 4Bldg/Suite #:
Project Name: ^-- �,Peg-/
Project Description: oueyle-C j
Existing Use: p New Use:
MMD Required: ❑ Yes `! o Related Record #:
GENERAL INFORMATION
Class of Work: Occupancy Group: Type of Construction:
Type of Use: Occupancy Load: Oregon Specialty Code:
SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback—Left Sideyard Setback—Front
Sideyard Setback—Right Sideyard Setback—Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access.Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $
vhA. ix..» -
$ DC Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2016) $ 12%State Surcharge
Project Valuation $ Plan Review,Structural
Up to$4,999 $0.00 $ Plan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $224.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $357.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ !fig. AD TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070116.docx
City of Tigard • BUILDING DIVISION
N ' Over-The-Counter (OTC) Mechanical Permit
l G A R D Appointment Checklist
Permit Record#: /41 -C-c20(-7 - 064
Contact Name: Phone #:
Business Name: Appointment Date:
Site Address: Bldg/Suite #:
Project Name:
Project Description:
Related Record #:
GENERAL INFORMATION
*Class of Work: , Occupancy Group: Type of Construction:
*Type of Use: c.m w+ Oregon Specialty Code:
Number of Stories:
FUEL FURNACES
Type: Furnace< 100K BTU Furnaces>= 100K BTU
Gas Pressure: Roof Top Unit(RTU) Tons
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler(BTUs) Vent Fans Gas Line
Solid Fuel Fireplace/ Clothes D ers Gas Outlets
Woodstove Duct Work Gas Fireplace
Fire/Smoke Dampers Other Mechanical Units—Describe:
Total Project Valuation: $ I P ,. .``� „
$x Mechanical Permit Fee
$ Plan Review
$ 12%State Surcharge
$ • Info Proc/Arch,Lg(over 11x17 $2.00)
$ --()„3'd Info Proc/Arch,Sm (up to 11x17 $0.50)
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other:
Building Staff:
Date/Time: $ Or.)43 TOTAL FEES DUE
I:\Building\Forms\OTC_MEC_021116.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12300 SW 68TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-00254
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor