Permit i l l . CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00120
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/22/2011
Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 130
Project: State Farm Subdivision: Lot: 0
Project Description: Registers and grills.
Contractor: JNB MECHANICAL INC Owner: G &S FC LLC
1304 NE 125TH AVE 516 SE MORRISON #100
VANCOUVER, WA 98684 PORTLAND, OR 97214
PHONE: 360 - 433 -9067 PHONE:
FAX: 360 - 433 -9439
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/22/2011 $328.04
Class of Work: ALT Type of Const: Plan Review 03/22/2011 $82.01
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/22/2011 $39.36
Stories: Info Process /Archiving - Lg Sheet (over 03/22/2011 $2.00
11x17)
Project Valuation: $9,237.00
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 $451.41
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
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 OUN calling 503.232.1 • e : .: • r
Issued By: 1 , Permittee Signal f
I
Call 503. • 9 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.
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Mechanical Permit Application . FOR OFFI( 1.1 l SF: 0\1.)
City of Tigard
Received
Date/By: No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �" ` .6 eAl.
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Date/By:
Inspection Line: 503.639.4175
TIC ,4}ZD Date Ready/By: ]uric: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK a;'N l ei � l'''')' '1 , . 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.
Value: $ L3?
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SS F.EI*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 16083 SW UPPER BOONES FERRY ROAD (requires site plan showing placement) 46.75
City/State /ZIP: TIGARD, OR 97224 Furnace 100,000 BTU ( ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: #130 Project name: STATE FARM TI-AIISEIECYS Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: RIGHT OFF UPPER BOONES FERRY ROAD Duct work 23.32
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
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 2332
1 l l L Gas fireplace 33.39
,S. h1'b o% J, 1111 -r gyp Vi/!'/ 7k is p.,•pk �„t �, Gt. T Flue vent for water heater or gas
rkt, -41, +, v x C i S . 5 A al t&4 r , 6,4- on I,. ()L fireplace 23.32
/ Log lighter (gas) 23.32
\2_A - Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER J ) TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: STATE FARM TI Environmental exhaust and ventilation:
Address: 16083 SW UPPER BOONES FERRY ROAD Range hood/other kitchen
equipment 33.39
City/State /ZIP: TIGARD, OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
el APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 23.32
Business name: JNB MECHANICAL, INC Other: 23.32
Fuel piping:
Contact name: JASON ELLIS $14.15 for first four; $4.03 for each additional
Address: 3315 NE 112 AVE SUITE A 40 -41 Furnace, etc.
Gas heat pump
City/ State/ZIP: VANCOUVER, WA 98682 Wall/suspended/unit heater
Phone: (360) 433 -9067 Fax: : (360) 433 -9439 Water heater
Fireplace
E -mail: JASON@JNBMECH.COM Range
CONTRACTOR Barbecue
Business name: JNB MECHANICAL, INC
Clothes dryer (gas)
Other:
Address: 3315 NE 112 AVE SUITE A 40-41 MECHANICAL PERMIT FEES*
City/State/ZIP: VANCOUVER, WA 98682 Subtotal
Minimum permit fee ($90.00)
Phone: (360) 433 -9067 Fax: (360) 433 -9439
Plan review (25% of permit fee)
CCB lie.: 176150 State surcharge (12% of permit fee)
TOTAL PERMIT FEE ills! II Authorized signature: This permit application expires ifs permit is not obtai within 180
days after it has been accepted as complete.
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