Permit CITY TIGARD MECHANICAL PERMIT
k DEVELOPMENT SERVICES PERMIT #: MEC2003 -00473
I ' I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/7/03
PARCEL: 2S 112DC -01500
SITE ADDRESS: 15757 SW 74TH AVE BLD D
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 006 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of vent fan for new restroom.
Owner: FEES
74TH AVENUE INDUSTRIAL PARK LL Description Date Amount
8100 SW DURHAM RD
TIGARD, OR 97224 [MECH] Permit Fee 8/7/03 $72.50
[TAX] 8% StateTax 8/7/03 $5.80
Total $78.30
Phone:
Contractor:
A J VENTURES OF OREGON LLC
8100 SW DURHAM RD
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503
Final Inspection
Reg #: LIC 156242
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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 -00
Issued y:_ ` ` �� �� � Permittee Signature.
Call (503) 639 -4175 by 7:00 P.M. for inspections need:„. the next business day
Mechanical Permit Application FOR OFFICE USE ONLY
N Received Mechanical , r
Date/By: Permit No.: Nye �po)9.,00 T 7 3
City Of Tl�rand Planning Approval Building
b Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Aa Post - Review Land Use
dl �� � ' I i Date/By: No.:
Internet: www.ci.tigard.or.us ° e .� I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 W ' Name/Method: Supplemental Information.
02 tM..# � :.. #t. iTYPE OF NF'ORK a`, ,COIV MERCIA0FEE. SCHEDUI E;= USE=CfIECIMST . kla
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
teag' W e � �s , �;', mechanical materials, equipment, labor, overhead and profit.
C AT'rEGQR�Y rOF CONSTRUCTION;; „
❑ 1 & 2- Family dwelling ❑ Commercial /Industrial value: $ See Page 2 for Fee Schedule
ask; RESI!DENPA IEQUIPMENTIS,YSTEIVisTE *; SCHED.ULE i
El Accessory Building ❑ Multi- Family ea.
Description Qty 1 Fee ( ) Total
❑ Master Builder 0 Other:
Heati ng/Coolin g °
` JOB;SITE INEQ RMATION and LOCATION , sr Furnace - add -on air conditioning ** 14.00
Job
site address: /575? j ? 6 " 7 .1/r /i/ Gas heat pump 14.00
Suite #: 1 Bldg. /Apt. #: Duct work 14.00
Project Name: „ $/6/1 - 4 z d'et,,g Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Repair
Lot #: p units 12.15
Subdivision: , ' Other FuelApplianc k '
Tax map /parcel #: Water heater 10.00
" Zi n,r.DESCRIiP;TIONTOF WORKeS: =tom.•., < Gas fireplace 10.00
Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
v Other 10 00
�PR®pERT°�YrOWNER_ ,,,�. . �
.Q .TENANT _� ..� ,.. �..� �?
Name: r e Ill e5 CGS /We „ =,:,,, , , ,,EilAiiinmentaI Exhausti &:Ventilation' ;
n � Range hood/other kitchen equipment 10.00
Address: 'r16 Sr.� ,QU,• / lr4fi > cx Clothes dryer exhaust 10.00
City /State /Zip: r i ff 9 - 27 !/ Single duct exhaust
Phone:/7- 7/ 7 2 / 2 FaX $2 625 i -- C: 0 (bathrooms, toilet compartments, APP // d
LICANTa, £.:N CONT PER
ACTSON_:',3 utility rooms) • / 6.80 tP "
Name: Attic /crawl space fans 10.00
Other: 10.00
Address: m . ,u- , , ; ",'Fuel °Piping i.;' & ,. .
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Furnace, etc. **
Phone: Fax: Gas heat pump **
E-mail: Wall /suspended/unit heater **
n CONTRACTOR
`' t "" Water heater **
Business Name: - jJr.o7//r'S d ►e, ci.e_ Fireplace **
Address: Range ** _
/OCR Su / Ai/40w? „ BBQ **
City /State /Zip: ' j / fiJ, d' A-€._ Clothes dryer (gas) **
Phone: 67 q -4'2/- 72/ Fax: 50.3 -,3 /y -4 ,./-2 Other: **
CCB Lic. #: . Total
s „!Mechanical Permit Fee .
Authorized �//� Subtotal $ r}
Signature: �' ��s'Date: /'�G� Minimum Permit Fee $72.50 $ !v A 0
Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ .5- 8v
TOTAL PERMIT FEE $ 1', 50
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Permit Fee_,
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
•2Assuined,ValuationsPer Appliance •
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656 •
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1 -4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION: a'
is \Dsts\Permit Forms\MecPermitAppPg2.doc 01/03