Permit (77) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Permit#: MEC2018-00915
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/28/2018
TIGARD 9 Parcel: 2S115AB01400
Jurisdiction: Tigard
Site address: 16297 SW 113TH AVE
Project: Willow Brook,Lot 19 Subdivision: Lot: 19
Project Description: Installing mini split for temporary sales office located in the garage.
Contractor: PACIFIC LIFESTYLE HOMES Owner: MISSION HOMES NW LLC
11815 NE 99TH ST#1200 PO BOX 1689
VANCOUVER,WA 98682 LAKE OSWEGO, OR 97035
PHONE: 360-213-0813 PHONE:
FAX: 360-574-6401
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/28/2018 $191.86
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 11/28/2018 $23.02
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $4,500.00
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 $214.88
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 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 0 NC by calling 50��32.1987 or 1.800.332.2344.
Issued By: A( & fdir Permittee Signature: - t:
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 Applicat' ECEIVED FOR OFFICE USE ONE)
City of Tigard Receive ` /� te'1.;,_� C //6.
III 13125 SW Hall Blvd.,Tigard,OR 97223 2018 Date/By:nR
C Plan Review
Phone: 503.718.2439 Fax: 503.598.1960NOV 2 Date/By: i d L!'
Inspection Line: 503.639.4175 y ��
T I G!�R D Date ed/ a Ready/By: See Page r
Internet: www.tigard-or.gov CITY OF i�ICwARD Notified/Method: Supplementalhill Information
BUILDING DIVISION
y, s* TYPE}OE WC)i COMMERCIAL l EE* SdIEDIJLE-4 5E CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit.
Value: 6®0
CATEGORY OF CONSTRJCTION ID ,
Ews 4
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
• V:!::!.:4
- Heating/cooling:
z
�'� JOB,.S1TE�i1gF® 3{�NI AND �'�� '° �J t ;
. -...• -,..,-..,. :?.. t. r. Air conditioning 46.75
Job site address: \ ([2:5‘' IN \\'3 I\1NQ, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -,c- c r _ d 9 -7 2Z 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump / 61.06
Suite/bldg./apt.no.: Ld - \a Project name: W-,\\up\,',1 pJ'rD K 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
Other: 23.32
Subdivision: Lot no.: / Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
t y 4-. .tf; _, DES i7.. o ^',,,t
F.'",-.4'-'' .,,,,,..„,11,'"
QI .1 r s' . tr' Gas fireplace/insert 33.39
/4\
` ` Flue vent for water heater or gas
/"\ C Vo.An`.c ca\ �-t r I.....,V .c v- i :v.', s r 1,� fireplace 23.32
S 1/S _ w� 1 Log lighter(gas) 23.32
F-K Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
f , , ,rw s v4. Other: 23.32
4 o- ® ° `_ • Th.- Environmental exhaust and ventilation:
Name: o- ; C \c c.--e 4 j l R c via S Range hood/other kitchen
Address: 1\\C\[' 9 ei S--1- equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: V cr,v,CGU y .,(- 9 $ . g Z Single duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( () _,'t % 0 8 1 c Fax:( ) Attic/crawlspace fans 23.32
4:41"
41 t AP Other: 23.32
�t� �.�x.:. ® �. . l�'+CONTAGTiI<'�= � : E
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: I\,r\ ` rl o cc.(1 Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Q-v, .714- ---& GO k 1 PL-I- . co v„, Barbecue
CONTRA t! ``Y Clothes dryer(gas)
Other:
Business name: A,1,,,,„,S `� Y� 4 :, MECHANIICALPi*T ., : ;
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.: \-1 1 ZL\ 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: Date:
I:\Building\Permits\MEC_PermitApp 040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuata
�.� 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_040113.doc 2