Permit (20) CITY OF TIGARD MECHANICAL PERMIT
.71 . COMMUNITY DEVELOPMENT Permit#: MEC2017-00438
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/15/2017
4 G' B° Parcel: 1 S 136AD04100
Jurisdiction: Tigard
Site address: 11501 SW PACIFIC HWY 201
Project: CJAM Subdivision: VILLA RIDGE Lot: 2
Project Description: HVAC modifications for TI: replace supply registers and add(7)returns.
Contractor: WILLAMETTE HVAC LLC Owner: CJAM LLC
3075 SW 234TH AVE.#206 10200 SW GREENBURG RD STE 340
HILLSBORO, OR 97123 PORTLAND, OR 97223
PHONE: 503-259-3200 PHONE: 503-688-5106
FAX: 503-848-2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/15/2017 $215.64
Class of Work: ALT Type of Const: Plan Review 06/15/2017 $53.91
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 06/15/2017 $25.88
Stories: Info Process/Archiving-Lg$2.00(over 06/15/2017 $2.00
11x17)
Project Valuation: $5,300.00
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 $297.43
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
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 Noti •ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 —You may obtain a copy of the rules
or dire.. questions to OU • b -fling 503.232.1987 or 1.800.332.2344.
Issu d By: I, ' A = Permittee Signature: v. 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 Rseceived �j� FOR OFFICE ISE ONLY
City of Tigard FIEEIV h:ate/By: &14 , Permit No.: ¢C?OI Z VG y ,�
114 11 • 13125 SW Hall Blvd.,Tigard,OR 97223 �A @+ 1 an Review /tw/�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: f /1 / q'
T I G A R D Inspection Line: 503.639.4175 JUN 201/ Date Ready/By: Juris. ® See Page 2 for
Internet: www.tigard-or.govITY Notified/Method: Supplemental Information nF ricl
t�
TYPE OF DI G D j COMMERCIAL FEE SCHEDULE— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$5,300.00
CATEGORY`OF G(INSTiIUG PION RESIDENTIAL EQUIPMENT/SYS ILMS FEES*
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
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 11501 SW Pacific Hwy (requires site plan showing placement) 46.75
n Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 0-1u
Fumace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:201 Project name: 01 Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insertreplace supply registers and add 7 returns to accommodate new office layout 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑,PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 23.32
El APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name:same as below
Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Address: Furnace,etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( ) Fax::( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name:Willamette HVAC,LLC Clothes dryer(gas)
Other:
Address:3075 SE Century Blvd Suite 206 MECHANICAL PERMIT PEES*
City/State/ZIP:Hillsboro,OR 97123 Subtotal _
Minimum permit fee($90.00)
Phone:(503)259.3200 Fax:(503)848.2597 —
Plan review(25%of permit fee)
CCB lic.:56951 State surcharge(12%of permit fee) 12
TOTAL PERMIT FEE $ .,(41Q 7
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name:michael malstrom Date:6/13/17
* Fee methodology set by Tri-County Building Industry Service Board
I:ABuilding VPermits\MEC-PermitApp.doe 03/07/12 440-4617T(11/02/COM/WEB)