Permit (107) CITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT Permit#: MEC2019-00629
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2019
Parcel: 1S134AA02100
Jurisdiction: Tigard
Site address: 10300 SW NIMBUS AVE PB
Project: Saibri Cooper Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: Duct modifications and relocating existing fan.
Contractor: HVAC INC Owner: DIETRICH, NANCY BISHOP
5188 SE INTERNATIONAL WAY ROBINSON, JERRY CHRISTOPHER TRUST
MILWAUKIE, OR 97222 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-462-4822 PHONE: 503-245-7100
FAX: 503-462-6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/27/2019 $495.03
Class of Work: ALT Type of Const: Plan Review 08/27/2019 $123.76
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/27/2019 $59.40
Stories: Info Process/Archiving-Lg$2.00(over 08/27/2019 $6.00
11x17)
Project Valuation: $15,800.00
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:
Appliances
Vent Fans: Vent Systems: Total $684.19
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Exhaust fan
_: _:._
`___ IIuctWork: T
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00•x. Y. may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
: V
Issued By: / Permittee Signature: II ,
Call 503.639.4175 by 7:00 a.m.for the next available inspecti e n d te.
This permit card shall be kept in a conspicuous place on the job site until co • etion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicationRECElVE I FOR OFFICE: I E Oyl.l
CityTigard Received
ofg Date/By: / i �L t� o ./ s
13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 7 2019 Plan Review '
IIIPhone: 503.718.2439 Fax: 503.598.1960 Date/By: "/ jam
IIMM
T 1(_,ARD Inspection Line: 503.639.4175 C iTY OF T I GAR D Date ReadyBy: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIV I S I O Notified/Method: ,3°:,/}.'� -� ill Supplemental Information
Va.=
TYPE OF WORKCOMMERCIAL FEE* SCHEDULE—USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction (zi Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,ov head,and profit.
Value:$ 1 c n
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling jil Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATIONANli
LOCATI N Heating/cooling:
��t [ r` 4( Air conditioning 46.75
Job site address: i �V v�J Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: q c\ `)\ _l S 11 Furnace 100,000+BTU(ducts/vents) 54.91
, Heat pump 61.06
Suite/bldg./apt.no.: I Project name: C'J \'/J (N• v ` /V 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
Subdivision: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
( Flue vent for water heater or gas
t V ) ,c'1 c. AW' 7 1 reA \ `t'�'V) \\,,i f lace 23.32
Log lighter(gas) 23.32
-i--e \ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I 0 TENANT : Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: 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
❑y APPLI (_,/
ANT ❑:CONTACT PERSON Other. 23.32
1 `_ t.„c� Fuel piping:
Business name: i
$14.15 for first four;$4.03 for each additional
Contact name: 1c71A..) Furnace,etc.
1.3 =vkAl
Gas heat pump
Address: \ 1 �� Wall/suspended/unit heater
Phone: :tl `), 7, j Fax::() / LI(0 kO > ')
Fireplace
g / �h Range
E-mail: `-,, ,"� I/`� C�(V t\�,v, l�/,1"t,/✓`, Barbecue
�' CONTRA OR Clothes dryer(gas)
Business name: Other:
1.4\si �'/ t MECHANICAL PERMIT FEES*
Address: WASubtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCBlic.:
V (:'n TOTAL PERMIT FEE
.14.,,/t7� 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 ' ®c1 /) Date: ((
4 3 4400-41 TT 11/02/ M/WEB
I:\Building\Pecmit�C_Parmit pp 0 Ol l ,dce ( )
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description
Fee for all residential systems combined: $75.00 ° IQty. I Each I Total
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.0lto15kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
n Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Vs hr min)
COMMERCIAL WORK ONLY:
ELECTRICAL PERMIT FEES
l
Fee for each commercial system: $75.00 aubtotap eEnteron Page 1):
s Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n B• oiler Controls
n Clock Systems
n D• ata Telecommunication Installation
n Fire Alarm Installation
® HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
I:\Budding\Permits\ELC_PermitApp ELR ERE doe Rev 06/17/2015