Permit (110) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPINMENT Permit#: MEC2017 00918
Date Issued: 11/20/2017
-[GAty D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 20/201 0300
Jurisdiction: Tigard
Site address: 9735 SW SHADY LN 201
Project: Whole Body Health Physical Therapy Subdivision: None Lot: None
Project Description: Dryer vent for medical clinic TI.
Contractor: HUNTER DAVISSON INC Owner: TIGARD MEDICAL MALL LLC
1800 SE PERSHING ST PO BOX 98
PORTLAND, OR 97202 POULSBO,WA 98370
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Specifics: Description Date Amount
Permit Fee 11/20/2017 $84.41
Type of Use: COM Plan Review 11/20/2017 $21.10
Class of Work: ALT Type of Const:
12%State Surcharge-Mechanical 11/20/2017 $10.13
Occupancy Grp: Occupancy Load:
Info Process/Archiving-Sm$0.50(up to 11/20/2017 $1.00
Stories: 11x17)
Project Valuation: $1,000.00
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: Vent Systems: Total $116.64
Hoods: Comm Incinerators: Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: 1 Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions t OUNC by c4ing 503.232.1987 or 1.800.332.2344.
Issued By: ,(/
. 0.! Permittee Signature: /4•r'f
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicaRWcEl‘IED
FOR OFFICE LSE ONLI
Cityof TigardPI
Permit No. - O �]
Received 0 V 2 Date/By: SIL i�/� Il
111 111 13125 SW Hall Blvd.,Tigard,OR 9722 0 2017 Plan Review
Phone: 503.718.2439 Fax: 503.598 1260, Other Permit:Date/By: ♦;,
T I G A R D Inspection Line: 503.639.4175 BU(` 'r' e l;+ =?F3 Date Ready/By: Juris 0 See Page 2 for
r Internet: www.tigard-or.gov !L lt`JG D(ViSION Notified/Method: Supplemental Information
`,F,---- 4,c,: . . .(iiiiiiCAIFE�* Cl1 w1EEC14 S*
' Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ /ooc , 00
, :., A"TEGORX O CONSTI U:,. - . Wi N`I'I a;I QI!'IWR1 ST5 EES*
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family Master builder 0 Other: Description Qty. Ea. Total
OB SittIN ORM4I'IO T-AN 1* r Heating/cooling:
., Air conditioning 46.75
Job site address: �� �i c `_! Cck/Je Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Gjc Df T7,2. Furnace 100,000+BTU(ducts/vents) 54.91
//,, Heat pump 61.06
Suite/bldg./apt.no.: Project name. ,__ A s ,R / r - Duct work 23.32
Cross street/directions to job site: ,,f�,r a®/ Hydronic hot water system 23.32
`I Residential boiler(radiator or
t
W 4oI L_ 4.- bLealik 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
• -i`i Gas fireplace/insert 33.39
: f I 1i (i " �'"� Flue vent for water heater or gas
'"•
S1-a I L �/4 r vel fireplace 23.32
�1 C` a 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
NM I"R •' � � 1 Vis• '' Environmental exhaust and ventilation:
",i'•' ') t 7 - Q —/— Range hood/other kitchen
Name: �/CQ Er ! �� C /�`inC�/ 1 J1`I equipment 33.39
Address:ypjc) S s7 ir4c±v^Ie1,/ VV Clothes dryer exhaust 33.39
City/State/ZIP: l Of r7 Single-duct exhaust(bathrooms,
(�/e1 i/�/\te. sL gift? Clothes
compartments,utility rooms) 23.32
Phone:(5-o3) 35 70 a Fax:( ) Attic/crawlspace fans 23.32
Other: 23.32
��,. ''/_-'
,• `' Fuel piping:
Business name: mAti f"t`_,,„�r p”) aM�- $14.15 for first four;$4.03 for each additional
Contact name: Co CSI L r
�� Furnace,etc.
a Gas heat pump
Address: /8() /,S'� �rs- I/J Wall/suspended/unit heater
City/State/ZIP: "tlt�tPtd I'�RJ F7D20,2 Water heater
Phone: 3) Li
/ jc c Fax::( ) Fireplace
t Range
E-mail: G ru tiN7 r a ,v/S ,eC.) Barbecue
4 4- RACf"OI „,,•',2,4!--',,,,,07,-,:',
cClothes dryer(gas)
Other.
Business name: 54”R., 4$- 4)ite, AtitnOili I i#tt4J f 'Xkisem.
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.: /41� TOTAL PERMIT FEE tit,,t' i
This permit application expires if a permit is not obtained within 1 0
days after it has been accepted as complete.
Authorized signature: 6, * Fee methodology set by Tri-County Building Industry Service Board
40/.Z.
Print name: Co rey Date: `/—°/Q—/2
l Building\Permits\MEC_PermttApp_040113.doc 440-4617T(11/02/COM/WEB)
A
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9735 SW SHADY LN 201 , TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-00918
Inspection Type: Inspector:
699 Mechanical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor