Permit �� CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00544
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011
Parcel: 2S102AA00602
Jurisdiction: Tigard
Site address: 11960 SW PACIFIC HVVY
Project: Tendercare Dental Subdivision: TIGARD HIGHWAY TRACTS Lot: 12
Project Description: Modifications to duct work due to new tenant, install (3) exhaust fans.
Contractor: WILLAMETTE HVAC Owner: AMAN, WALTER S CREDIT SHELTER TR
3075 SW 234TH AVE. #206 19217 SW 119TH AVE
HILLSBORO, OR 97123 TUALATIN, OR 97062
PHONE: 503 - 628 -6841 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/30/2011 $538.21
Class of Work: ALT Type of Const: Plan Review 11/30/2011 $134.55
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/30/2011 $64.59
Stories:
Project Valuation: $17,500.00
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: 3 Vent Systems: Total $737.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 hin 180 days of
issuance, • ' • k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopt•,: i by the Oregon
Utility • ification Ce -r. These rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain . copy of the rules
or dire t questions to OU c.Hlin• 03.232.1987 or 1.800.332.2344. '
Issue. By: 0 i o/ / Permittee Signature:
/
Call 503.639.4175 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.
Mechanical Permit Applitca a)m FOR OFFICE USE ONLY �"
City of Tigard GElUED Date /B / l 1 yt`/
Date/By. / ? Perm No.: /'C /liC/
II
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review e/
. Phone: 503.718.2439 Fax: 503.598.19k OV 3 O 2011 Date /By Other Permit: /614. Pgo // D4.2/7
Inspection Line: 503.639.4175
TIGARD Date Ready /By luris: ® See Page 2 for
• Internet: www.tigard- or.gov CITY OF TIGARD Notified /Method: Supplemental Information
BUILDING _...- ;. ' x i COMMERCIAL FEE* SC HEDULE . [7S E CH E GICLS7 ' r
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""' 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.
m iii, ,,-• ,,,,, CATEG :OF. ;,,.. >'s¢`
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a� - -- ,. < -� :, ORY �` ;, r .RESIDEN- I'AI�tE FI R1VIENT%S,YSTENIS.FEE *44
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist. •
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
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..- ° ; - - . . ,, CE f , , ',,,,, NFORMATION "AND'
A n
Air conditioning
Job site address: 11960 SW Pacific Hwy (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: tigard or 97223
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Tender Care Dental Heat pump
(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 23.32 _
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
.,,.. DE "" T ; F ° „ Water heater 23.32
, ,� ;,. .. -_= SCRIP ONO !'VO[ZK ",���:: ,
,.:;� .. �.� ��•. ;, «.-- � .,.:�.: ,,.��,., . � �•', R H ..... :e, `
„., >; Gas fireplace 33.39
install duct work to accommodate new office. Install return duct work off three Flue vent for water heater or gas
furnances. Install three exhaust fans. fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
:::..:,,,.;•, fi r, R : . � E Chimney/liner/flue/vent .
23 32
, . . -, .. .'tg N„ r
❑.� Ai V ' I`
z , ._ q._, -- Other:
Name: Environmental exhaust and ventilation:
Range hood /other kitchen
Address: equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
APEI ICANT�' "� R: CONTACT Attic /crawlspace fans 23.32
Business name: same as below Other: 23.32
Fuel piping:
Contact name: $14.15 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
Fireplace
E -mail:
Range
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, - ;, :,..- :., r, � °s' '�a Barbecue
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Business name: Willamette HVAC, LLC
Clothes dryer (gas)
Other:
Address: 3075 SW 234 Ave Suite 206 - -'z i `�_- ": 7.g ""
's ' x":-1VIECfIA1VICAUPERMITFEES * =' ``
City /State /ZIP: Hillsboro OR 97123 Subtotal ,..9 5g .
Minimum permit fee ($90.00) —
Phone: (503) 628.6841 Fax: (503) 848.2597 Plan review (25% of permit fee) /' . �
CCB lie.: 56951 State surcharge (12% of permit fee) _ / Lr. 5
--- TOTAL PERMIT FEE 737.35-
1 I This permit application expires if a permit is not obtained within 180
Authorized signature:! days after it has been accepted as complete.
Print name: michael malstrom Date: 11/29/11 * Fee methodology set by Tri- County Building Industry Service Board
I \Building \Permits \MEC- PermitApp doc 09/09/10 440 -4617T (11/02 /COM/WEB)