Permit (45) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2018 00265
13125 SW Hall Blvd.,Ti Date Issued: 05/09/2018
Tits LFt. and OR 97223 503.718.2439 9
Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 130
Project: Bridgeport Family Medicine Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: (1)new fan powered terminal unit,(2)ceiling exhaust fans for restrooms,and duct work modifications.
Contractor: OREGON HEATING&AIR CONDITIONING LLC Owner: G&S FC LLC
19300 SW 118TH AVE 16083 SW UPPER BOONES FERRY RD,
TUALATIN, OR 97062 STE
TIGARD, OR 97224
PHONE: 503-691-9699 PHONE:
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/09/2018 $723.63
Class of Work: ALT Type of Const: VB Plan Review 05/09/2018 $180.91
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 05/09/2018 $86.84
Stories: Info Process/Archiving-Lg$2.00(over 05/09/2018 $2.00
11x17)
Project Valuation: $24,800.00 Info Process/Archiving-Sm$0.50(up to 05/09/2018 $27.50
11x17)
Fuel Air Handlers
Fuel Types: Units<10000 cfm: 1
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: 2 Vent Systems: Total $1,020.88
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 ou may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: a Permittee Signature:
,,,, ,)
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application ,_., FOR OFFICE USE ONLI
III City of Tigard ' . i' %'Received
Date/By: Permit No.: � /��
?#:,
OlIr /'�y hfXrG '• 13125 SW Hall Bivd.,Tigard,OR 97223.° vii,Plan ReviewPhone: 503.718.2439 Fax: 503.598.1960y Other Permit: , Li
Date/By: 1— ! etc
NF1 l:v L t
TI ,ARD Inspection Line: 503.639.4175 lip R 1 '4 /�}i. Date Ready/By: _ Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: S / / �� Supplemental Information
:ri
TYPE OF WOR� tr -N1 d'j i IS-It COMMERCIAL-FEES'trflll1(fULE— USE CHECKLIST
r Mechanical permit fees*are based on the value of the work
❑New construction grAddition/alteratiol7/'replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CA'T'EGORY OF CONS11(UCTION Value:$ 2,4-6, BUD
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 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
JOB SITE.TNNFORMATION AND LOCATION Heating/cooling:
l ( Air conditioning 46.75
Job site address: /t0 c �: 6L-) a v 1,6,....01,6,....0,„,,,,I0,„, w,yy e & Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: T' yr f di -1 72ZG' Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I7(� Project name: Heat pump 61.06
,6v`1cle�Jt)�i �cw+"�b •/`2tEilcti.v� Duct work 23.32
Cross street/directions to job site: uJ `/ Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unitheaters(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
DESCRIPTION OF WORK Gas fireplace/insert 33.39
BP
Flue vent for water heater or gas
iUu TY 5 — f B 1` 1 � O(S N`',L.GI'11 CSC h b l/`j `, fireplace 23.32
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 PROPERTY OWNER I 0 TENANT `
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
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 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: �../‘ ( `'��—`J
$14.15 for first four;$4.03 for each additional
Contact name:Gtr in L�n*e,� Furnace,etc.
Address:
13(x) S/..6 ( 1 iA Gas heat pump
�' Wall/suspended/unit heater
l l.�
City/State/ZIP: c. 1 c, hc- r (3‹.....
Ql "1 a� Water heater
Phone:( r)3)?c/c/ ,F l t c,. Fax::( ) Fireplace
, Range
E-mail: n — (N`ey✓1C k-,,, „ - ��` Barbecue
CONTRACTOR J Clothes dryer(gas)
Business name:dr C KI- Other:
MECHANICAL PERMIT FEES*
,,,s---6,,Address: i I 30 ( ( s-t-b �ve Subtotal
City/State/ZIP: 17A( (--C ) C 6 C Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(50y) 7, ((,, Fax:( ) State surcharge(12%of permit fee)
CCB lic.: /"3.--/(o 53 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized Signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:) Se.„vtc -k-Z` Date: Lt—13-1
1:\Building\Permits\MEC_PermitApp_0401I3.doc 440-4617T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16083 SW UPPER BOONES FERRY RD 130,
TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Mechanical MEC2018-00265
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor