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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00174 Date Issued: 04/21/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S102AA04100 Jurisdiction: TIGARD Site address: 12230 SW MAIN ST 120 Project: Live Laugh Love Glass Studio Subdivision: Lot: 0 Project Description: Replacing B vent and gas line for glass heater. Contractor: AZURE HEATING & AIR CONDITIONING INC Owner: 3DM HOLDINGS INC PO BOX 62 12230 SW MAIN ST STE C GLADSTONE, OR 97027 TIGARD, OR 97223 PHONE: 503 - 706 -2568 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 04/21/2011 $78.27 Class of Work: ALT Type of Const: Plan Review 04/21/2011 $19.57 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 04/21/2011 $9.39 Stories: Project Valuation: $800.00 Fuel Air Handlers Fuel Types: Natural Gas 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 $107.23 • Hoods: Comm Incinerators: Required Items and Reports (Conditions) Woodstoves: Gas Fireplaces: 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 - 1 -0090. You ma obtain a copy of the rules or direct questions to 0 • C by calling 503.4987 + Issued By �. — Permittee Signature: Call 503.63 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. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Date/ Permit No.: 131 SW Hall Blvd., Tigard, OR 97223 '' ,, O�� Date/B L/ �` AL.- ,, / I Z Er ci, Plan Review Phone: 503.718.2439 Fax: 503.598.1960 ' '" 1 � Date/By: Other Permit: IA W/ ` —di , ��d Inspection Line: 503.639 . \ TIG II ate Ready B ® y: 7uris. See Page 2 for Internet: www.tigard- or.gov Q� C .(��� G , Notified/Method: % Supplemental Information TYPE OF WORK Cr. (t\-- COMMERCIAL FEE* SCHEDULE - USE CHECKLIST \`���,�?' Mechanical permit fees* are based on the value of the work ❑ New construction Addition/alteration/rep�fement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead" and profit. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling "Commercial /industrial ❑ Accessory building For special information use check list. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: 2 � C; t.� �� I + `) d I G ' J' tr (� ( requires site plan showing placement) 46.75 � City /State /ZIP: (� I Furnace 100,000 BTU ( ducts/vents) 46.75 li Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: I t/'L l � Heat pump tot, "Y �� f 'r' `s` l C (requires site plan showing placement) 61.06 Cross street/directions to job site: 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 1 23.32 + Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 23.32 1 Gas fireplace 33.39 Q v e}C \- — Q..`T 1 (N e\ Flue vent for water heater or gas 1 ptis \ r• fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32 Other. 23.32 Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment , 33.39 City/State /ZIP: Clothes dryer exhaust 33.39 Fax: Single -duct exhaust (bathrooms, Phone: ( ) ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact name: S14.15 for first four; $4.03 for each additional Address: Furnace, etc. • Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater E -mail: Fireplace Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: v �Q ,Q � \ I Other: 1c' s � / Address • 0 t (X le MECHANICAL PERMIT FEES* City /State /ZIP: ^ © ` C /\ Q.. C) - `l ! O)) Subtotal _ • Phone: (s (s -7 0 6'j 'V -!; (Q % Fax: ( ) Minimum permit fee ($90.00) ��, - 7 Plan review (25% of permit fee) 14 ..-- CCB lic.: 1 ` 1 LA 5 } State surcharge (12% of permit fee) 3 I TOTAL PERMIT FEE (p d---..3 1 Authorized sign ( 0.../-41. This permit application expires if a permit is not obtat ed within 180 days after it has been accepted as complete. Print name: C� i G is , n Date: L I Z k- ` Z d ) ' Fee methodology set by Tri -County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440- 4617T (I1 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation: Permit Fee: $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.doc 09/09/10 2