Permit (68) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00837
'
Date Issued: 10/25/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S101AB03100
Jurisdiction: Tigard
Site address: 12115 SW 70TH AVE 201
Project: Advanced Endodontics Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Installing new ducting,grills,and(6)bathroom exhaust fans.
Contractor: ARJAE SHEET METAL CO, INC. Owner: TIGARD TRIANGLE PARTNERS LLC
8545 SE MCLOUGHLIN BLVD. 18187 SIERA DR
PORTLAND, OR 97222 LAKE OSWEGO, OR 97034
PHONE: 503-231-7717 PHONE:
FAX: 503-230-4888
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/25/2017 $855.71
Class of Work: ALT Type of Const: Plan Review 10/25/2017 $213.93
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/25/2017 $102.69
Stories: Info Process/Archiving-Lg$2.00(over 10/25/2017 $2.00
11x17)
Project Valuation: $30,000.00
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: 6 Vent Systems: Total $1,174.33
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OU C by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicattECEIVEP FOR OFFICE USE ONLY
City of Tigard Received
in 13125 SW Hall Blvd.,Tigard,OR 97223 Date By: / �' Permit No.: Ln r2 z5 ,
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review (/
1 I( A R I) Inspection Line: 503.639.4175 OF Date/By: Other Permit:Au ,x, -42,Internet: www.tigard-or.gov
CITY
Date Ready/By: Juris ® See Page 2 for
1 Notified/Method: Supplemental Information
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition Other: mechanical materials,equipment,labor,overhead,and profit
V; � �* ' 77U1 Value.$ $O OGO
." . .� 4, r. `" I " E 1[ 11 *,
0 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist
0 Multi family 0 Master builder
❑Other: Descriptiont
Qty. 1 Ea. I Total
-' : t c 10 Heating/cooling:
��/ �^ Air conditioning 46.75
/
Job site address: ( l T'�/
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: '1 tat- , OR q -2Z3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: r Project name: /� / Heat pump 61.06
'10` 4�V jgi TZYbi{Or Ort CG5 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 2332
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 Lot no.: Other: 23.32
Tax map/parcel no.:
Other fuel appliances:
Water heater 23.32
a = ' ,,8 . ',l' i,,,, ..„,„ i " 1.4 4th
, , _.- , .r ,, Gas fireplace/insert 33.39
A�( " Flue vent for water heater or gas
UC'�1 $1 —c t C6, fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
'*R .'iza A N '` Other:
.f� ® �. ( �,,. � � �; 23.32
Name:
Environmental exhaust and ventilation:
p% curry Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
Phone: toilet compartments,utility rooms) 23.32
( ) " Fax Attic/crawlspace) crawlspace fans 23.32
`` �I 1''',"-,6,.,',.,:-:: ITA T X S " ` Other:
23.32
Business name: Ar4m, `? Fuel piping:
Contact name: /2
$14.15 for first four;$4.03 for each additional
`'� Furnace,etc.
Address: q q Ado (! e /u a r. Gas heat pump
City/State/ZIP: � ` Wall/suspended/unit heater
M.i i wliv !G
7��7 Water heater
Phone:(SOS) Z.73
1 � 77,�� Fax::( ) Fireplace
E-mail: 4, v,-v, .*6.. "te rRange
Barbecue
-.
-,,.
CONT OR
�s ro v
Clothes dryer(gas)
Business name: ) G out, 4.5 eyr Other:
MECHANICAL PERNITFEES*Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.: /� F3� /� f
�nTOTAL PERMIT FEE
( This permit application expires if a permit is not obtained within 180
Authorized signature: 1/
/Q
I//� days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: pA06 % 'I,_ 'fCc*jANI N1 I Date: 'Q,/z. (
I\Building\Permits\MECPermitApp_040)13.doc �1 �'V l 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
$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