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Permit CITY OF TIGARD MECHANICAL PERMIT RIR COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00278 ____ TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007 PARCEL: 2S 110DC -02300 SITE ADDRESS: 11525 SW DURHAM RD D -3 ZONING: C -G SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT: JURISDICTION: TIG PROJECT: PACIFIC BREEZE Project Description: Remove 10' class and replace with 15' ub hood only. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: 1 FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES HIP WILLOWBROOK LLC Description Date Amount PO BOX 2708 PORTLAND, OR 97208 [MECH] Permit Fee 5/15/2007 $130.00 [TAX] 8% State Surcha 5/15/2007 $10.40 Total $140.40 Phone: Contractor: DAN CO CONSTRUCTION 55695 VIEWCREST PL WARREN, OR 97053 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 997 -3744 FAX 503 -366 -0405 Reg #: LIC 110448 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ` /tipn /a-3 tog Permittee Signature: 4 , � Call 503.639.4175 by 7:00 a.m. for inspections that business day. 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. r— ' • ;( k ' w i t ant pr * , rowt'�c3cgon 't^'S�SL,cF',�dS'iS?lr^+ a e +; t t t Mechanical Permit Application )� IMM aFOR Tro OFFIC,E�USEtON, �r EWSP �'°; MIN W �t x4 CI of Tigard Received Permit No.: _ r Ct^ ae }� t ° � 1 `J g Date/By: IS 0„, r _ G _ i CO (. p4, t ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 12!� s i a .J( / Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: Date/By: + i X0) Inspection Line: 503.639.4175 Date ReadyB ma :' i � I , GiVR'D y: ® See Page2for I 4t Internet: www.tigard - or.gov Notified/Method. 'n e- Supplemental Information . TYPE 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, labor, overhead, and profit. :. CATEGORY OF, CONSTRUCTION Value: $ f e)(1 RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. Ea. 1 Total JOB SITE INFORMATION AND LOCATION : . Heating/cooling Air conditioning or heat pump Job site address: /71;2 j-- �, litl _ /�/ /� / /y 2 (requires site plan showing placement) 14.00 City /State /ZIP: Q, �/ Furnace 100,000 BTU (ducts/vents) 14.00 �� (-- / / Furnace 100,000+ BTU (ducts/vents) 17.90 v Suite/bldg. /apt. no.: (/ Project name: T 4 •/ � /��e Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances ., DESCRL! TION OF WORK . ',.' ,.. - Water heater 10.00 Gas fireplace 10.00 ,,,4% /y) oli (, //2 ' C 44 `J �j�2 r)2 Flue vent for water heater or gas fireplace 10.00 ,,LL Log lighter (gas) 10.00 / .�' p.1 ___„,--1 � l -!A 5 � i e'�� �c Wood/pellet stove 10.00 Wood fireplace /insert 10.00 0,U �y .:I . ❑ OPERTY OWNER Chimney liner /flue /vent 10.00 ❑ TENANT ` Other: 10.00 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen A equipment X 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: l 7 4 Fuel piping Contact name: ' t ' - - $5.40 for first four; $1.00 for each additional Address: l Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater Phone: ( ) 9/V9 s c' Q Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR - . . Barbecue Clothes dryer (gas) Business name: ,,'".,0,1_,, — C 6 Other Address: t <-- < , - /) 7 Gtv G/<' P..S /2/ , MECHANICAL PERMIT FEES* City /State /ZIP: t!� ?r� /�.f' / / �x ZJ ! 20.1..7 Subtotal J'50. 0O Phone: ( ) / ' 2 v(--/ Fax: ( ) 2'6 0 VO_ Minimum permit fee r it fee) Plan review (25% of permit ) CCB lic.: /7o (/5i F . 12 /f.5 / s State surcharge (8% of permit fee) 110. 0 f O TOTAL PERMIT FEE 14-1 ©, G} 0 Authorized signature:�� / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: / '1 D e: r, ' Fee methodology set by Tri- County Building Industry Service Board 1\ Building 'Permits\MEC- PermitApp.doc 04 /06/06 440- 46t7T(1I /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: ' Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. l:\ Building \Permits\MEC -PermitApp.doc 12/30/05 2