Permit CITY OF TIGARD MECHANICAL PERMIT
e Permit
' #: MEC2017-00964
a: COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2017
T F ' '' Parcel: 25101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE#100
Project: Conduent Xerox TI Subdivision: VARNS ACRES Lot: 9
Project Description: Relocating(1)supply grill and adding(4)return grills for TI.
Contractor: HUNTER DAVISSON INC Owner: TRIANGLE POINTE TWO LLC
1800 SE PERSHING ST 901 NE GLISAN ST, STE 100
PORTLAND, OR 97202 PORTLAND, OR 97232
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/06/2017 $84.41
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 12/06/2017 $10.13
Occupancy Grp: Occupancy Load:
Stories:
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 $94.54
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: Permittee Signature: PIj%,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE I SE ONE\
• City of Tigard R�� Received ��� �� _
DaDate/By: t� Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review L 7^U'r 'i
' = Phone: 503.718.2439 Fax: 503.598.1960 DEC C 2017 By: Other Permit&Z Al/,
A
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov C V Y J) :;,n r D Notified/Method: Supplemental Information
BUJ...0114G ID.iVi s11 N
T i `' itn � R1 U.1 -t S CIZ 1US1r ,. ' -
Mechanical permit fees*are based on the value of the work
❑New construction J Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
' WValuTtf �$, /C1 C).OC)
, .,. . .�.,.., , �St�tl(l 'FAAL;' Q NT/SYSTEMS S' EM )ES*
❑ 1-and 2-family dwelling IJ Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description p Qty. Ea. Total
'; Heating/cooling:
��$, SI'i° ,1(1�)F'0� , Qk�l r�N�;c0c
/ ; Air conditioning 46.75
lob site address:/3 3 3 3 Sa fi^�eugk w Bsitl� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
Sal i Heat pump 61.06
Suite/bldg./apt.no.. /o 0 Project name: CSN e/tl+ -77,2-
1/4 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
J mf r -' ., R0. �' t, I[>� t i ';VvoiRac - Gas fireplace/insert 33.39
-••••:3-•,', '
/4/�� / / / ,/ Flue vent for water heater or gas
ve / 5H//21 �jti!/@' �t)r%r Q�K V re1tJ N fireplace 23.32
Jcillex fo ct C OM MOC/ i L /, 2,
Loger(gas) 23.32
�� �` Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
,,� Other: 23.32
,t.,,. l,' P 'tY;OWI ',_ , , T _ ventilation:
Environmental exhaust andven'a ion:
Name: ( y,) ct �ee. CaNSItol01O/v Range hood/other kitchen
Address: 427. e../ Lo0t,S7t .5 -' equipment 33.39
�/J Clothes dryer exhaust 33.39
City/State/ZIP: 5$ LvvtiS /'r C3'/Q,' Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
` � Ti SO
r. „ • ., �,: ROther: 23.32
Business name: 1 f Fuel piping:
44 n/fe., —4,5)1//'‘IA/J 7--77" $14.15 for first four;$4.03 for each additional
Contact name: �.C)r12. � Furnace,etc.
Address: �O o U �s er /rn Gas heat pump
'�`.'./J Wall/suspended/unit heater
City/State/ZIP: �j/ � � a2 717 p
f J Water heater
Phone: 73 ) fff6j Fax::( ) Fireplace
E-mail: // Range
ral.Yle vIN7,f ,,x,,„,-roN • r`-OM Barbecue
� QR ! ; Clothes dryer(gas)k4,, �s,,,,, . ,_ , _• j ;„, ' Other:Business name:
Address: �;. )iN[ /t.L: �”ly>�O* .1::''''.-„,!)-',-,
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.: / TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized SlgnatUCe', /0-9p7,410,0 * Fee methodology set by Tri-County Building Industry Service Board
Print name: Date: /aZ•--')Q:,I t)
- 1L, s
1:\Building\Permits\MEC_Per tApp_040113.doc 440-4617T(11/02/COM/WEB)