Permit (142) CITY OF TIGARD MECHANICAL PERMIT
��! A " COMMUNITY DEVELOPMENT Permit#: MEC2019-00640
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2019
Parcel: 2S101 DC03900
Jurisdiction: Tigard
Site address: 7150 SW SANDBURG ST
Project: Immunology Consultants Laboratory(ICL) Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Adding(3)walk-in coolers for TI.
Contractor: AMERICAN REFRIGERATION INC Owner: LESLIE SANDBURG LLC
575 MARKET ST ATTN: JOHN G LESLIE
EUGENE, OR 97402 14056 GOODALL RD
LAKE OSWEGO, OR 97034
PHONE: 541-688-0939 PHONE:
FAX: 541-431-0251
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/23/2019 $3,426.31
Class of Work: ALT Type of Const: VB Plan Review 09/23/2019 $856.58
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 09/23/2019 $411.16
Stories: Info Process/Archiving-Lg$2.00(over 09/23/2019 $18.00
11x17)
Project Valuation: $128,000.00 Info Process/Archiving-Sm$0.50(up to 09/23/2019 $10.50
11x17)
Fuel Air Handlers
Fuel Types: Electricity 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 $4,722.55
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
1 Special Inspection(see plans)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: walk in
Duct Work: coolers
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / irrmittee Signature:
L�'��'�SCG_-• ���"""
C 1503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
?al B ' = /
Mechanical Permit Application FOR OFFICE
USE ONLY
.1City of Tigard Received tDateivy h, �. c7,'"
>/9 v6
,��13125 SW Flail Blvd.,Tigard,OR 97223 Plan 1edy1 M Phone: 503.718.2439 Fax: 503.598.1 0 Date/By: � -•,. i . 46rEp/ i - 4.0TIGARD Inspection Line: 503.639.4175 ECEIVE Date Ready/By:
oris: ® See Page or
Internet: www.tigard-or.gov otified/Metho.. qA°' Supplemental Information
l I� WUII"CC a, .° IALP1II* . U:LE.-I CI#ECKLIST
�1�b�TjQA�" `" u. Mechanical permit fees*are based on the value of the work
o New construction Addition/alteethiEtiMeesi0N performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overheadand profit.
Value:$ /.2, r crate
+CA'#`EGO;RY Eli*" CONSTRUCTION . RESIDENTIAL EQUIPMENT IISY TEMSFEES*
❑ 1-and 2-family dwelling , Commercial/industrial 0 Accessory building For s ecial information use checklist.
0 Multi-family 0 Master builder El Other: Description e.v` Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling: 6
, - Air conditioning 46.75
Job site address: 70-69 5c v SG% ,J e Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: I _� ^' 7 S. Furnace 100,000+BTU(ducts vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project nam
`l1,itleu Ptt5 C.t.AASlriiget.2 Duct work 23.32
Cross street/directions to job site: („0t(4 > 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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: _Water heater 23.32
DE RIPT'ION OF Wow. Gas fireplace/insert 33.39
Flue vent for water heater or gas
qel-d- 3 £ l2J( L CB,04,-e.�, fireplace 23.32
���"""""" Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
OPEItT OWNER ❑ E ANI Environmental exhaust and ventilation:
Name: T�v../)o/J l G) er s+l-D/J ,( Range hood/other kitchen
V��_"r ,
equipment 33.39
Address: (/- !
7/60 5 to 5 a3 97 Clothes dryer exhaust 33.39
City/State/ZIP: � Single-duct exhaust(bathrooms,
y /t' toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
APPLICANT I unta.A+ I PEIZS(7N` ',
Other: 23.32
: Fuel piping:
Business name: *M,.,..;Cp•-� /k),,.f ll _eA � $14.15 for first four;$4.03 for each additional
Contact name: �j 9,,��`� "r��/9 Furnace,etc.
I'"" * .tJr/_ 5 Gas heat pump
Address: c5".7-5ttk-
AA-
heater
-- -City/State/ZIPS-- __4&,,,,..*„._ �., .
Phone:(SW Cpm 6g3 of I Fax::( ) Fireplace
Range
E-mail: CU e441-(-061724I-. Gp. Barbecue
4ER-..'' 7. Clothes dryer(gas)
Other:
Business name:
<f11r,:/, .1.5- ct Sift MECIIANICAL?EItMIT,F.E * ,
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 lie.: //)'2)1 '5---(o -0
l)--1TOTAL 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: 1� j ic4J ,�� Date: y' -/
I:\Building\Permits\MEC PermitApp040113.doc ( 440-4617T(11/02/COM/WEB)
II
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Pee:
$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