Permit (159) CITY OF TIGARD MECHANICAL PERMIT
11114
1 ' ' COMMUNITY DEVELOPMENT Permit#: MEC2019-00200
Date Issued: 04/24/2019
r i G.1 R f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 134BC00401
Jurisdiction: Tigard
Site address: 12442 SW SCHOLLS FERRY RD 100
Project: Providence Medical Group Subdivision: None Lot: None
Project Description: New ductwork and gills for TI.
Contractor: HARDER MECHANICAL Owner: PROVIDENCE HEALTH&SERVICES-ORE
2148 NE MLK BLVD. ATTN: REAL ESTATE&CONSTRUCTION
PORTLAND, OR 97208 4400 NE HALSEY BLDG 2 STE 190
PORTLAND, OR 97213
PHONE: 503-764-6434 PHONE:
FAX: 503-287-5284
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/16/2019 $182.65
Class of Work: ALT Type of Const: VB Plan Review 04/16/2019 $45.66
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 04/16/2019 $21.92
Stories: Info Process/Archiving-Lg$2.00(over 04/16/2019 $2.00
11x17)
Project Valuation: $4,200.00
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 Fumaces: 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 $252.23
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. 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: 64'-Permittee Signature:
riit‘
Call 503.639.4175 by 7:00 a.m.for the next available insp, tion date. /K-7)1344417c.'1\11P(
This permit card shall be kept in a conspicuous place on the job site un it completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic 1-1 E+EwED FOR OFFICE USE ONLY
City of Tigard LL._w Received
�� /1 A dag-Q), A -
Date-By:
;IN 13125 SW Hall Blvd..Tigard,OR 97221p 2019 Plan Review �ty J+�
Phone: 503.718.2439 Fax: 503.598.19 Date.By: s i C-y9 1� 0W9 iC/
T I G R D Inspection Line: 503.639.4175
CITY OF TIGARD Date Ready y; I ® Sec Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified�Method /7. Supplemental Information
TYPE OF WORK COMME IAL FEE*SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction ® 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.
Value:$$4,200.00
CATEGORY OF CONSTRUCTION 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 Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:12442 SW Scholls Ferry Foad Furnace 100,000 BTU(ducts'vents) 46.75
City/State/ZIP:Tigard,Oregon,97223 Furnace 100,000+BTU(duets.vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:100 1 Project name:Diagnostic Imaging-X-ray Duct work 23.32
Cross street/directions to job site:217 take exit 4B to SW Cascade Hydronic hot water system 23.32
Residential boiler(radiator or
Turn right on SW Scholls Ferry Rd.,turn right on SW North Dakota hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent fbrany of above 23.32 ,
Subdivision: 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: 1 S134BC00401 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
• .. e, fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Akt-.) title, elGe3ot K0( r'6L/S - 7Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
:
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12442 SW SCHOLLS FERRY RD 100, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2019-00200
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12442 SW SCHOLLS FERRY RD 100, TIGARD, June 6, 2019 at 12:19:47 PM
OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2019-00200
Inspection Type: Inspector:
699 Mechanical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor