Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT ®�/ Permit #: MEC2011 -00583
TIGARD 13125 SW HaII Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/16/2011
Parcel: 2S 101 AB00100
Jurisdiction: TIGARD
Site address: 12005 SW 70TH AVE
Project: Acupuncture Clinic Subdivision: Lot:
Project Description: Duct work, restroom exhaust and gas piping for fireplace. 4/10/12, adding fireplace.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: RED ROCK BUSINESS ASSOCIATES LLC
PO BOX 241 23077 SW NEWLAND RD
DUNDEE, OR 97115 WILSONVILLE, OR 97070
• PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/16/2011 $500.11
Class of Work: ALT Type of Const: Plan Review 12/16/2011 $125.03
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/16/2011 $60.01
Stories: Info Process /Archiving - Lg $2.00 (over 12/16/2011 $2.00
11x17)
Project Valuation: $16,000.00 Info Process /Archiving - Sm $0.50 (up to 12/16/2011 $0.50
11x17)
Fuel Air Handlers Additional Plan Review 04 /11/2012 $90.00
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Fumaces >= 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 $777.65
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces: 1
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 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 estions . OUNC by calling 503.232.1987 or 1.800.332.2344. �, r
Issued y: ac, P e r m i t t e e Signatur ~ , . ice/ /'_ A
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.
it CITY OF TIGARD MECHANICAL PERMIT
17 1 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00583
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/16/2011
Parcel: 2S101AB00100
Jurisdiction: TIGARD
Site address: 12005 SW 70TH AVE
Project: Acupuncture Clinic Subdivision: Lot:
Project Description: Duct work, restroom exhaust and gas piping for fireplace.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: RED ROCK BUSINESS ASSOCIATES LLC
PO BOX 241 23077 SW NEWLAND RD
DUNDEE, OR 97115 WILSONVILLE, OR 97070
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 -691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/16/2011 $500.11
Class of Work: ALT Type of Const: Plan Review 12/16/2011 $125.03
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/16/2011 $60.01
Stories: Info Process /Archiving - Lg $2.00 (over 12/16/2011 $2.00
11x17)
Project Valuation: $16,000.00 Info Process /Archiving - Sm $0.50 (up to 12/16/2011 $0.50
11x17)
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 $687.65
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces: 1
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 Farted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rul adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. V. may obtain a copy of the rules
or direct questions to • - by calling 503.232.1987 or 1.800.332.2344.
•
Issued By • Permittee Signature:
C . 39.4175 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 Application FOR OFFICE USE ONLY
City of Tigard Received
�� Date /B_ M 'ermitNo.: <j 1 1—co
13125 SW Hall Blvd., Tigard,OR 97223
fI'�I
Phone: 503.718.2439 Fax: 503.598.196 r�j Date/By: Plan Review /i � ralll el Other Permit: p . -
Inspection Line: 503.639.4175 �/ �,
T [ G A R D p �O Date Re. dy a� See Page 2 for
Internet: www.tigard- or.gov 6 Notified/Method: J Supplemental Information
VCIV Stn
TYPE OF WORK 0 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
� �
�+� t en Mechanical permit fees* are based on the value of the work
11 New construction Addition/alteration/?ttent 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*
El 1 -and 2- family dwelling Commercial /industrial ❑Accessory building For special information use checklist.
El Multi - family //" Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: / ) t! S 5 -Li 7d-1 (requires site plan showing placement) 46.75
� /f Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP:
4 , l ' l 4 Y ) Or- Furnace 100,000+ BTU (ducts /vents) 54.91
1/ dd
Suite/bldg. /apt. no.: p , Pr ject name: n, 1 e Heat pump
P
!^' (requires site plan showing placement) 61.06
Cross street/directions to job site: j Duct work 23.32
Hydronic hot water system 23.32 gel
�Q' ✓4 ) 111 2 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 23.32
d N- i1 l / _ / Gas fireplace 33.39
C� '79' //) (f� u /-7 ,-)'1 Flue vent for water heater or gas
fireplace 23.32
4' i fad Log lighter (gas) 23.32
�
/ `q � �ute , 6/�� (4l l-�/ Wood/pellet stove 33.39
' I 1 v Wood fireplace /insert 23.32
El PROPERTY OWNER ❑ 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
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
e ki APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: (2J Y l Other: 23.32
�r l9? Fuel piping:
Contact name:
!!/` ) i tit._ & 1A- $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: (St7) qii 9 rllpv Fax: : ( ) Water heater
/ ,y,,� Range Fireplace
E -mail:
Cl/ l ✓�-� / a ,��J %C 447) , (.0 "
CONTRACT Barbecue
Business name:
Clothes dryer (gas)
� L�
�& `-' Othe
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: O 11 AZ:te-e � v - 7 /) J Subtotal '
Phone: (ie� 0 [ I ?/ o, Fax: ( ) Minimum permit fee ($90.00)
(O ! Plan review (25% of permit fee)
CCB lic.: I 2-1 "2--60, State surcharge (12% of permit fee)
r7 TOTAL PERMIT FEE
Authorized signatureC This permit application expires h if a permit is ot obtained within 180
days after it has been accepted as s complete.
�LL
Print name: I , ut (- T J , Date: f z— J c, /I, * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC - PermitApp.doc 09/09/10 440- 617T (11/ 2 /COM/WEB)
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard •
Buildin g Division • TIGARD
TRANSMITTAL LETTER
TO: IQ 'w DATE CEIVED:
DEPT: BUILDING DIVISION
RECEIVED
APR 5 2012
FROM: C L vV j1 f ►'`sblVp..._
CITY OF TIGARD
COMPANY: a k,ACi BUILDING DIVISION
PHONE: (-,}
Vt/- By.
RE: 005 ` 7 () 4v -t- / C 20/ l O'DcU-
(Site Address) (Permit Number)
/4644 0/f7‘i 46,1Ad4•U ' -
(Project name or subdivision name and lot number,
ATTACHED ARE THE FOLLOWING ITEMS •
Copies: Description: I Copies: I Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
— Other (explain):
REMARKS: 6y1 bz- 1 add/ 41) .C1.� ,, Cam, -V.
•
FOR 0 FIC USE ONLY
Routed to Permi Technician: Date ' (p
Fees Due: M Yes ❑ No Fee JD escription: • ount Due:
.. tTl R ) vi ,c.) ( 'Q • 00)
$
$
Special
Instructions:
• Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: frey Date: G/ Initials: 4f T
I:\Buildin \TransmittalLetter - Revisions.doc 02/08/2011
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.
1:\ Building \Permits\MEC - PermitApp.doc 09/09/10 2