Permit (216) CITY OF TIGARD MECHANICAL PERMIT
ii
11 ' COMMUNITY DEVELOPMENT Permit #: MEC2012 -00412
T [ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2012
Parcel: 2S115BA02500
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY X
Project: Marshalls Subdivision: 2004 -015 PARTITION PLAT Lot: 1
Project Description: Hang air handler run lineset. Hook up system
Contractor: A TECH HEATING & AIR Owner: SN PROPERTIES PARTNERSHIP
20170 SW KINNAMAN RD 1121 SW SALMON ST
OR PORTLAND, OR 97205
BEAVERTON, OR 97007
PHONE: 503 - 267 -2557 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/06/2012 $291.51
Class of Work: ALT Type of Const: Plan Review 08/06/2012 $72.88
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 08/06/2012 $34.98
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 08/06/2012 $0.50
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $399.87
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work • not started within 1 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to f• • the rules adopted by a Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-00•0 ou may obtain al op of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
1-0•Ne 4 AS M✓
Call 503.639.4175 by 7:00 a.m. for the next available inspects • n
i f
This permit card shall be kept in a conspicuous place on the job site until co , etion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application '-, 1 FOR OFFICE USE ONLY • City of Tigard i� D ate e /By : g /_( / v ' Permit No.:M6C )01�._O /i
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Y/
.114 q Phone: 503.718.2439 Fax: 503.598.1960 AUG 6 2012 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639 75 Date Ready/By: luris: ® See Page 2 for
Internet: www.tigard- or.gov CITYOFTIGARD Notified/Method: - p, Supplemental Information
BUILDING DIVISI N
OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
/ / / /// 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, IaboQvt:sge,vqd profit
Value: $ i QII// / /1(�vlJ //
CATEGOWOF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling [(i co ommercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: /, ZOO 5 1, 5 C J , (requires site plan showing placement) 46.75
City /State /ZIP: J L / Furnace 100,000 BTU (ducts/vents) 46.75
/ J l I 2 2 Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: i/�-l), ,)(( 5.4 ff,. v Heat pump
i J ' (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
C b ' / Hydronic hot water system 23.32
1 //� �� (J V ,� )Y Residential boiler (radiator or
•
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
I fel Gas fireplace/insert 33.39
1-4..A 1-4..A u✓ f ' 4 . i- /1 A n /� /- A / / / iii ( Flue vent for water heater or gas
'f
/e 4i_ LA/41'
(// 7 • � S , S .` e,, fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name: A , f �C 1.4 A 6» a `,/ v s L - n 1 Fuel piping:
Contact name: G v� ✓ S14.15 for first four; 54.03 for each additional
Address: 2 0 7 7t L 6 .) /Li : ,r ,,,,,, N id Fumace, etc.
7 Gas heat pump
City/State/ZIP: Q�,� ✓�T f .� i ,� �j 7 0 0 7 Wall /suspended/unit heater
Phone: (.5-- u? I J 2 t„,/) . 2 s -75 -- -2 Fax:: -. 0� L1 9 `7, 7 2 Water heater
����]] L / �+ ! ( Fireplace
E- mail:
/f4,ec4 l aI 0 c�,/lL-er. C Q ,-. Range
CONTRACTOR Barbecue
Business name. 4 .- / /'/ G . ) oa J / ,✓ ,„. qc C Clothes dryer (gas) ! 7 Other:
Address: 2-0 / 2 0 S I✓ // r a M A✓� 12 MECHANICAL PERMIT FEES*
City/State /ZIP: 5Qa v t / to c� el .- - y', d 0 Subtotal
Phone: ) Fax: ( ) Minimum permit fee ($90.00)
2 l v _ a 5 _ Plan review (25% of permit fee)
CCB lic.: /959 � � rmit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
F� days after it has been accepted as complete.
Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Permits'MEC- PermitApp.doc 03/07/12 440 -4617T (I 1 /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.
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l:\Building\Pennits\MEC- PermitApp.doc 03/07/12 2
C Building Division
Over- The - Counter (OTC) Mechanical Permit
TIGARD
Check List
-
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: t\-LT Occupancy Group: Type of Construction:
*Type of Use: C 0)U- Oregon Specialty Code: 20
Number of Stories:
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
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm l 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 Dryers Gas Outlets
Woodstove Duct Work _ Gas Fireplace
Fire /Smoke Dampers Other Mechanical Units – Describe:
Total Project Valuation: $ I FEES DUE
$ ( Mechanical Permit Fee 1
$ Plan Review
$ , 12% State Surcharge f
$ Info Proc /Arch, Lg (over 11x17 $2.00)
$ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Misc. Admin Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff:
Date /Time: $ 14 TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
1:\Building\Forms \OTC - MEC.docx 01/13/2011