Permit (38) CITY OF TIGARD MECHANICAL PERMIT
v COMMUNITY DEVELOPMENT
IN
Permit#: MEC2017-00743
Date Issued: 10/17/2017
-i-f GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S102CB03101
Jurisdiction: Tigard
Site address: 12950 SW PACIFIC HWY 245
Project: Charis Bible College Subdivision: FREWING'S ORCHARD TRACTS Lot: 21
Project Description: Replace existing RTU and gas piping.
Contractor: OREGON HEATING&AIR CONDITIONING LLC Owner: HUDSON PLAZA LLC
19300 SW 118TH AVE 11795 SW KATHERINE ST
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503-691-9699 PHONE.
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/17/2017 $347.71
Class of Work: ALT Type of Const: Plan Review 10/17/2017 $86.93
Occupancy Grp: E Occupancy Load: 12%State Surcharge-Mechanical 10/17/2017 $41.73
Info Process/Archiving-Sm$0.50(up to 10/17/2017 $6.00
Stories: 11x17)
Project Valuation: $10,000.00
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 $482.37
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules .re set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to 0 by cal' g 50 i 2.1987 or 1.800.332.2344.
Issued By: 4 Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE ISE O1L\
City of Tigard �: �i' r Received ` , d /7 - Permit No/y&.---4,20/7100 7`f3
11 13125 SW Hall Blvd.,Tigard,OR i . )l&-" Plan Review'' II Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Date/By:
T I G^,11 17 Inspection Line: 503.639.4175 °E-e 2 S (_511 Date Readt �`� l Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Meth_od: r L/// /4i I Supplemental Information
<''i -s : w A ''r ', ;,y COMMERCIAL FEE** SCHEDULE- USE', HEC LIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ J 0POO
r CATEGOI1,,:OF CONSTRUCTION , .i
x��. ;. . RES��TIAL Nt3iPMENT 1 SYSTEIfi F>;ES
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
OB SITE INORMATION AND LOCATION Heating/cooling:
�('►� Air conditioning 46.75
Job site address: 1215 0 SIA) '�4 Llge___ 1.4.4,_..7 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 90,,,4-14tio(l d(Z 7 7 Z Z3 Furnace 100,000+BTU(ducts/vents) 54.91
,l Heat pump 61.06
Suite/bldg./apt.no.: Z7 Project name: • Duct work 23.32
Cross street/directions to job site: ( 't Y7.5 d
l 1 Z aO L�� Hydronic hot water system 23.32
fa* " 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTIO1+lF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
1(a_ cs in h� R-T')A l 54 e5 �t� fireplace 23.32
�-�/� t '� Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0
'ROPERTY OWNER 0 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
❑ APPLICANT QCONTACT PERSON Other: 23.32
Fuel piping:
Business name: Of,t IA"W.Da $14.15 for first four;$4.03 for each additional
Contact name: (j .I.1.- L..6 ,,'- Furnace,etc.
Address: 19 3 D O S`J 1 1 5u+- Ave_ Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:17A 4'4 i� t Alt, - ?7O Z Water heater
Phone:(50 ) l trp-*f 6,Z Fax::( ) Fireplace_
33 Range
E-mail:34,1 citi_ a„el I.),EL Niko t 6.0.4., Barbecue
ONTRACTOR" Clothes dryer(gas)
Other:
Business name: a
rtsbn ftQS 1.1'�) MECHANICAL PERMIT FEES*
Address: l515Ob 5 co /,g- . Avc Subtotal
City/State/ZIP: T. 1 �1 h 2 ' ' . Z Minimum permit fee($90.00)
1 "t�► '� / Plan review(25%of permit fee)
Phone:(503 )West Z Fax:( ) State surcharge(12%of permit fee)
CCB lic.:t 3.47f5 3TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: i /i .";R� _ - * Fee methodology set by Tri-County Building Industry Service Board
Print name: ��c c 4 r'6,4,-1-- Date:' -V7-11
I.\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)