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Permit (61) • Mechanical Permit Applicati FOR OFFICE USE ONLY City of Tigard n Received / / !, 7 7 + Date/By: t/� �!�� i�� ermit NojJ� s��/7^!/r� D°J 13125 SW Hall Blvd.,Tigard,OR 97223 No V 6 7 plan Review ///C L / O Phone: 503.718.2439 Fax: 503.598.1960 201/ Date/By: I)' h J Other Permit: T I GA RD Inspection Line. 503.639.4175 . y c,;, Date Ready/By: Juris: El See Page 2 for Internet: www.tigard-or.govNotified Method: BUILDING ry _ Supplemental Information i.-1\lr-eiON „ *{” t ' r'i i:. int,_ u r _ ur i a tiY F , Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑New construction �Addition/alteration/replacement mechanical materials,equipment,labor,overhead,and profit. ❑Demolition El Other: Value $18,417 ' 4414 C11-and 2-family dwelling OCommercial/industrial DAccessory building For special information use checklist ❑Multi family ❑Master builder ❑Other _ Description Qty. Ea. Total s S ,, J IB� t *:41. II) C4`IOO$ " W - _ �a - Heating/cooling: Job site address: 12254 SW Garden PI Air conditioning 46.75 City/State/ZIP: Tigard,OR 97223 Furnace 100,000 BTU(ducts/vents) 46.75 Suite/bldg./apt.no.: Project name: Furnace 100,000+BTU(ducts/vents) 54.91 Cross street/directions to job site: Heat pump 61.06 Duct work 23.32 Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), Subdivision: Lot no.: in-wall,in-duct,suspended,etc. 46.75 Tax map/parcel no.: Flue/vent for any of above 23.32 : t z `n *1 ;f. . :I .` Other: 23.32 �a Disconnect ducting to Curtis'office&conference room Other fuel appliances: New duct run to freezer&mechanical room Water heater 23.32 Gas fireplace/insert 33.39 Install ventilation system in chemical room&freezer area Flue vent for water heater or gas Install 2-zone ductless heat pump to Curtis'office&conference room fireplace 23.32 A� © �°ht* 6 `^-��? N�-�"�_" � i '� �� ❑ ' a v Log lighter(gas) 23.32 Name:CTA Lab Wood/pellet stove 33.39 Address:12254 SW Garden PI Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 City/State/ZIP:Tigard,OR 97223 Other: 23.32 Phone:( ) Fax:( ) �.�P Environmental exhaust and ventilation: r _ L^[ IarN , t ;❑ ON *!:*Z*1 1t 1 Range hood/other kitchen Business name:Revival Energy,LLC equipment 33.39 Clothes dryer exhaust 33.39 Contact name:Jim Ballman Single-duct exhaust(bathrooms, Address:10013 NE Hazel Dell Ave#401 toilet compartments,utility rooms) 23.32 Attic/crawlspace fans 23.32 City/State/ZIP:Vancouver,WA 98685 Other: 23.32 Phone:(503)893-8243 Fax::( ) Fuel piping: Emailjim@revivalenergygroup.com $14.15 for first four;$4.03 for each additional n _.,. ^: ' - Furnace,etc. Business name:Revival Energy,LLC Gas heat pump Address:same as applicant Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax:( ) Fireplace CCB lic.: 196723 ‘4 7).4.//r- /� Range 0,,„f - Barbecue Authorized signature: - Clothes dryer(gas) Print name:Jim Bailin. Date: 11/2/2017 Other: ME i:ArisRc >!**::**_ 7PA I:\Building\Permits\MEC_PermitApp 040113.doc 440-4617T(11/02/COM/WEB) w Subtotal 563.61 Minimum permit fee($90.00) Plan review(25%of permit fee) 140.90 State surcharge(12%of permit fee) 84.54 TOTAL PERMIT FEE 789.05 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board I:\Building\Permits\MEC_PermitApp_040113.doc 2 Mechanical Permit Application - City of Tigard Page 2- Supplemental Information • Commercial& Multi-Family Fee Schedule: 'LAUgatftttIL'Z'„ rmt $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 or14 17 1, 3 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 0 fraction thereof,to and including5 JP— $50,000.00. 4 I $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 re 5.1 :2.5 4) 3 6 fraction thereof,to and including $100,000.00. 1 • la $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or _ r fraction thereof. ,9_50 • 4/ (2,4Yo Note: All All new commercial buildings require 2 sets of plans. 1 5 I:\BuildingTermits\MEC_PermitAPP_040113 doc 3 EllCity of Tigard • BUILDING DIVISION Over-The-Counter (OTC) Mechanical Permit Appointment Checklist Permit Record#: A4j CAU/2—i>e.i R7J Contact Name: T PSee&Li&y Phone #: 5V3 Business Name: � �� -Z.2.47:5 1Prvf'v� / eii,-,rte Lie' Appointment Date: //lG(17 Site Address: la-2-5-4i Sw (J`•A✓e--6- 1'74 - Bldg/Suite #: Project Name: n-771--- L-465 Project Description: ZHs .l/i s, (Jr , of � S ‘,,r jH e.4?A.?, .^vo),_., dye oCZ•�, Relate cord#: pv . A„c (k -Ytel-e✓' .f' titre c,,,i Cg7 m44_1 . IIMIIIIMIIIIMIIMIMIIIBIIIIIIIIMMMIIIIIIIIIIMIIMEEEIINNNI GENERAL INFORMATION *Class of Work: A' 7 Occupancy Group: 0 Type of Construction: J f)— 8 *Type of Use: Oregon Specialty Code: p Number of Stories: ) 1 V•• FUEL FURNACES Type: Furnace< 100K BTU Furnaces>= 100K BTU Gas Pressure: Roof Top Unit(RTU) Tons Floor Furnaces Unit Heaters Vents without Appliances Air Conditioning 14/(/‘ ' Heat Pump AIR HANDLERS HOODS Units<= 10000 cfm Type 1 Hood Type 2 Hood Units> 10000 cfm Grease Duct 1 Hour Shaft Fire Wrap APPLIANCES Boiler(BTUs) Vent Fans Gas Line Solid Fuel Fireplace/ Clothes D ers Gas Outlets Woodstove Duct Work Gas Fireplace Fire/Smoke Dampers Other Mechanical Units—Describe: Total Project Valuation: $ 1 g,L} )"7 $ ' 6 3 . 6 1 Mecha al Permit Fee $ ) 4. 0 .9 O Plan Review $ 4 7 . C3 12%State Surcharge $ Info Proc/Arch,Lg(over 11x17$2.00) $ a,— Info Proc/Arch,Sm(up to 11x17$0.50) $ Hourly Rate Fee $ Hourly Rate State Surcharge $ Misc.Admin Fee $ Other: $ Other: Building Staff: Date/Time: $ 7 7 LI-. ) TOTAL FEES DUE I:\Building\Forms\OTC_MEC_021116.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12254 SW GARDEN PL, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Mechanical MEC2017-00873 Inspection Type: Inspector: 699 Mechanical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor