Permit (39) irolCITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2017 00444
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/26/2017
Parcel: 1 S 135BA00102
Jurisdiction: Tigard
Site address: 10104 SW WASHINGTON SQUARE RD
Project: Visionworks Subdivision: OAKBURG Lot: 9
Project Description: Like for like RTU replacement,duct distribution,ductless mini-split install.
Contractor: ARCTIC HEATING&REFRIGERATION Owner: PPR SQUARE TOO LLC
5809 SE JOHNSON CREEK BLVD PO BOX 847
MILWAUKIE, OR 97222 CARLSBAD, CA 92018
PHONE: 503-735-2808 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/26/2017 $1,058.91
Class of Work: ALT Type of Const: VB Plan Review 06/26/2017 $264.73
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 06/26/2017 $127.07
Stories: Info Process/Archiving-Lg$2.00(over 06/26/2017 $6.00
11x17)
Project Valuation: $38,000.00
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: 3 Vent Systems: Total $1,456.71
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: 2 split
Duct Work: systems
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit otification t ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or rect questions to O allin. 503.232.1987 or 1.800.332.2344.
Iss ed By: / /�'�/ ;1 Permittee Signature: 4.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit AppyITEIVEI) FOR orr1CL CSEoNLI"
Received
City of Tigard Date/By: ,ATM�1 Permit No.: 17-ee IN
II
® 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re w �t.
' -
Phone: 503.718.2439 Fax: 503.598}UN 1 9 ?017 Date/By: (�(, �� Other Permit: P 7 �1
TI G A R D Inspection Line: 503.639.4175 Date Rea�' : Juris: El See Page 2 for �C
Internet: www.tigard-or.gov c Ty
of,•TaGA Day Notified/Method: Supplemental Information
Ty� DIVISION COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction %Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 3 e,pq p
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 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:
Job site address: �,�/ 1 J -Sr � AirFurnaceconditioning, 00 (ducts/vents) 46.75
�d��`� �L� l�i� 7`�'l r�1� 100,000 BTU46.75
City/State/ZIP: /e907... CZ��/ ()� /. /?,. 2..2.2 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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: Other: 23.32
Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
EScRIPTiON OR,WORK Gasfireplace/insert 33.39
/ Flue vent for water heater or gas
Li .9 74x1 // ,7 / ,---,x-,,,,,.,,tZ._r'JZi../ c."-Ac-74fireplace
-
23.32
l Log lighter(gas) 23.32
c.--7",%5'71:-/�[.i `cm / t / 74/ s S .177.1%71 yo h'7`' i37S14c l/ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY 'e Other: 23.32
� TENANT
- ::, ,,. 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
0 APPLICANT ;.v 0 CONTAC"I' PERSON Other: 23.32
Business name: � Fuel piping:
X13rc:./G or
r �"4:4� V'' �+'f' $14.15 for first four;$4.03 for each additional
Contact name: d/j ,/zji-a-e7 Furnace,etc.
Address: /01,15c- et Gas heat pump
bU SF G e J E Wall/suspended/unit heater
City/State/ZIP: j u/ �, 6 k9 �2,2 > s.9' Water heater
Phone:(5Z 3 ) 7.:75--•_Z Eri ] Fax::( ) „...,471- 1-7.45:-...5 ��(� Fireplace
_ Range
E-mail: Com' /rc �'� /'7Sh. Cc /e'r/.e vi1 �' rr?cx�/c....-.,Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: �' Other:
^� �.J� L A s 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.: v"?.yami_,(//ir7 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: Xl - * Fee methodology set by Tri-County Building Industry Service Board
Print name: ;;';J ,41/47- Date: 6/?/' 7`
I:\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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10104 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-00444
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor