Permit (66) CITY OF TIGARD MECHANICAL PERMIT
; to , . COMMUNITY DEVELOPMENT Permit#: MEC2017-00689
Date Issued: 09/11/2017
T[+GA L 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102AC00900
Jurisdiction: Tigard
Site address: 12571 SW MAIN ST
Project: Ayes Labs Subdivision: None Lot: None
Project Description: Replacing existing gas furnace,duct work,and NC unit due to fire damage.
Contractor: WOLCOTT PLUMBING Owner: ADAM, FAZILAH
1075 W HISTORIC COLUMBIA RIVER HWY CIMENT, GARY
TROUTDALE, OR 97060 12571 SW MAIN ST
TIGARD, OR 97223
PHONE: 503-667-1781 PHONE:
FAX: 503-667-9891
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/11/2017 $398.51
Class of Work: ALT Type of Const: Plan Review 09/11/2017 $99.63
12%State Surcharge-Mechanical 09/11/2017 $47.82
Occupancy Grp: Occupancy Load:
Info Process/Archiving-Lg$2.00(over 09/11/2017 $2.00
Stories: 11x17)
Project Valuation: $12,000.00
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 1 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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $547.96
Hoods: Comm Incinerators: Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work wit be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ` //1
fr
Call 503.639.4175 by 7:00 a.m.for the next available inspecti•n date.
This permit card shall be kept in a conspicuous place on the job site until completio of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICL LSE O\L\
City of Tigard Received I��
Permit No.:
a r Date/By: `11 • L/ _ i /w s, A.
13125 SW Hall Blvd.,Tigard,OR 97223 pian Review
a Phone: 503.718.2439 Fax: 503.598.1960 I .�A�` Other Permit:
Date/By: X _ ,
T I C A R D Inspection Line: 503.639.4175 Date Ready/By: gl See Page 2 for
Internet: www.tigard-or.govy ��� Notified/Method: IffliSupplemental Information
SEP i
TYPE-OF WOI ^l/ l ty I�gA)Fi COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
1 I r 4 I f Mechanical permit fees*are based on the value of the work
❑New construction �,'Addition/alteraft-�Ir �; N performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: 1
mechanical materials,equipment,labor,overhead,and profit.
Value:$ /2 obi.;
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/tSYSTEMS FEES*
❑ 1-and 2-family dwelling in 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 conditioning46.75
Job site address: r'�t,1 S W 1A c„,,,, \s Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: °r` G►/J 1 o .,c,j a, a13 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: eL� r �.. t 1 Lb..., 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 I 23.32
Subdivision: I Lot no.: Other: - 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
.. ,.v" ` Gas fireplace/insert 33.39
R, ,... 1ZOA1 OI?.WORK_ ,:' ..
gper/ r ` ,n Flue vent for water heater or gas
o I''\o1,V'•CJ R-60cu,e �j'�(, S n. fireplace 23.32
Cac Q c e 1 k a c�)\„ or(- Log lighter(gas) 23.32
� J 1 Iv , Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0P 'ERTY OVI BR 0 TES 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
. ... :s . Other: 23.32
0 APPLICANT �C/]��G((�)(N',TpA(`CT=PESQ�1
r.,,,,_ ,1 I 1 1l� Fuel piping:
Business name: $14.15 for first tour;$4.03 for each additional
Contact name: \yy\e(l e2 Furnace,etc.
Address: `Oi 5 Y V 1, s-A- L IPApr Gas heat pump
� 'j(� Wall/suspended/unit heater
City/State/ZIP: 1-i(U 'd O . G� O ` ,.`.'A Water heater
Phone:(53 Act\, -4giFax::( ) Fireplace
p �7 \n r(,1 C/� L ` �/1n�y 1n �M Range
E-mail: h% ,rn`JI lC` V�1 v`W�'\'(C���lJ1 r`ioi 1 '(, c(�1 1 ' Barbecue
J CONTRACTOR 1 Clothes dryer(gas)
Business name: [ � �n N 1nv\f lidos(-0Other:
`�✓ t 1 MECHANICAL PERMIT FEES*
Address: 1,0-"I ‘-15\--- 0)` �r num91 Subtota�„�}{ ,,City/State/ZIP:M W�G1 aJ-10 'c Jpc2_ on 0� ✓/ Minimum pernut fee($90.00) j rjw` ► Plan review(25%of permit fee) 'ij.(3
Phone:( I - 4 t4 ax:( ) State surcharge(12%of permit fee) :17 D..
CCB lic.: 0:1.2.2.0TOTAL PERMIT FEE .1 £1(
This permit application expires if a permit is not obtained witilin 180
e days after it has been accepted as complete.
Authorized signature: / ' • Fee methodology set by Tri-County Building Industry Service Board
Print name: 1 `' ' C 7 Date: 9 n \ 11
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\Pennits\MEC_PermitApp_040113.doc 2
City of Tigard
11111 111
n COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R D Building Permit Review — Commercial - No Land U s e
Building Permit #: ,l+reC 42()/7--
Site Address: 2J( SVS( ilj t v j ( - Suite/Bldg#:
Project Name: e;diY reShOl±l L--
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: V fl {,V11Ca,Q
Existing Business Activity: N ` P- r 1 U -- riTtrA.C.1 latOkG4Ace ? P�vpri aitt)
Proposed Business Activity: �J J
Verify site address/suite#exists and active in permit system.
61 River Terrace Neighborhood: ❑ Yes No
Zoning: M c )
A–Permitted Use:(J(A ❑ Yes ❑ No ❑ Spec Space
AC Confirm no land use required.
Business License:
Exists: A- Yes ❑ No,applicant notified to obtain business license
Notes: p a[.P \N\ 2JCGl( sivat _ ACX \ t9\A l ittn nc V IS l -
no 1nhUErc I UIr
Approved by Planning: Ay'J/) 4t.4Date:lit C
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: /kit/t 7
Site Plans: # �:7
Building Plans: #
Building Permit#: C—�1'E,,nt uilding permit#above.
Workflow Routing: 'Planning 't Coordinator iii ng
Workflow Sign-off5�755v-off for Planning(include notes from planning review)
Route Application Documents: L�Building original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: At 107)1, 0041 yr.„44r ! dt c
By Permit Technician: - Date: fia/i
I:\Building\Forms\BldgPermitRvwCOM NoLandUse 060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
7
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
;6OK to Issue Permit
proved byPermit Coordinator: /1�e: 40/ i�_
I:\Building\Fonns\BldgPermitRvw_COM NoLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12571 SW MAIN ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-00689
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor