Permit (16) CITY OF TIGARD MECHANICAL PERMIT
IN I COMMUNITY DEVELOPMENT Permit#: MEC2016-00627
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2016
Parcel: 2S102AB01902
Jurisdiction: Tigard
Site address: 9396 SW TIGARD ST
Project: Allred Industrial Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: None
Project Description: Installation of ductless heat pump,2 head
Contractor: CLEAN AIR ACT INC Owner: ALLRED INDUSTRIAL LLC
16582 S CARUS RD. 17902 S HIDDEN LAKE DR
BEAVERCREEK, OR 97004 OREGON CITY, OR 97045
PHONE: 503-632-1563 PHONE:
FAX: 503-632-7158
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/29/2016 $291.51
Class of Work: ALT T Plan Review 08/29/2016 $72.88
ype of Const:
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/29/2016 $34.98
Stories: Info Process/Archiving-Sm$0.50(up to 08/29/2016 $5.00
11x17)
Project Valuation: $8,000.00
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: 1
Appliances
Vent Fans: Vent Systems: Total $404.37
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility • ' -- •• Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or di -ct questions t• •UNC by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: , Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
IN ='City of Tigard �r ''�'ky` i .,` , Received 0 , �� H ao/� oOce 7
' Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 9796 ' J `'°
■ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
T 1 G n R D Inspection Line: 503.639.4175 II ii 2 Date Read Jar s:
Internet: www.tigard-or.gov Q V G +� 2016 Ready/By: See Page 2 for
Notified/Method: S Supplemental Information
1 al
Y9 a 1�.Ya"*I''''' COMMERCIAL TYPE OF*� q ;FEE* SCHEDULE — USE CHECKLIST
� r TAS NTT Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/ t rat"ion/reptacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ SO p(>
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling in Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder
0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
U Air conditioning
Job site address: Z Allred Industrial (requires site plan showing placement) 46.75
City/State/ZIP: Award Presentation Furnace 100,000 BTU(ducts/vents) 46.75
Furnace 100,000+BTU(ducts/vents) 54.91
9396 SW Tigard ST
Suite/bldg./apt.no.: Heat pump
Tigard, OR 97223 (requires site plan showing placement) 61.06
Cross street/direction Duct work 23.32
Hydronic hot water system 23.32
Residential boiler(radiator or
503 706-7530 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
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Id ,/ / / p Gas fireplace/insert 33.39
!/ �'!t" G�/ j� �'L C / "` ^��p Z `l ace/ Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
0 PROPERTY OWNER 0 TENANT Chimney/liner/flue/vent 23.32
Name:
Other: 23.32
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Allred Industrial Clothes dryer exhaust 33.39
Phone: Single-duct exhaust(bathrooms,
( ) Award Presentation toilet compartments,utility rooms) 23.32
0 APPI1 9396 SW Tigrd ST PERSON Attic/crawispace fans 23.32
Business name: Tigard, OR 97223 Other: 23.32
Fuel piping:
Contact name:
$14.15 for first four;$4.03 for each additional
Address: Furnace,etc.
City/State/ZIP:
503 706-7530 Gas heat pump
Wall/suspended/unit heater
Phone:( ) Fax: :( ) Water heater
Fireplace
E-mail:
Range
CONTRACTOR Barbecue
Business name:Clean Air Act Inc Clothes dryer(gas)
Other:
Address:16582 S Carus Rd
MECHANICAL PERMIT FEES*
City/State/ZIP:Beavercreek Or 97004 Subtotal
Phone:(503)632-1563 Fax:(503)632-7158 Minimum permit fee($90.00)
4,423/1$ Plan review(25%of permit fee)
CCB lic.:144650 State surcharge(12%of permit fee)
��J TOTAL PERMIT FEE Aie/37
Authorized signature:/���tel� t— This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: g A d6 z d r-o,,,,,,. Date: ,S'-.2.y -/G * Fee methodology set by Tri-County Building Industry Service Board
I:\Building\Permits\MEC-PermitApp.doc 03/07/12 440-4617T(11/02/COM/WEB)
'Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$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.doc 03/07/12 2