Permit CITY OF TIGARD MECHANICAL PERMIT
IN C COMMUNITY DEVELOPMENT Permit #: MEC2012 -00088
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/01/2012
T 1 G ARD Parcel: 2S102CB03200
Jurisdiction: Tigard
Site address: 9975 SW FREWING ST 140
Project: Adeo Home Care Subdivision: FREWING'S ORCHARD TRACTS Lot: 21
Project Description: Mechanical modification for new tenant.
Contractor: ULTIMATE COMFORT Owner: BY PICOCO
5946 SE LLOYD ST MASSIH LLC
MILWAUKIE, OR 97222 4343 VON KARMAN AVE 3RD FL
NEWPORT BEACH, CA 92660
PHONE: 503 - 786 -0494 PHONE:
FAX: 503 - 821 -7423
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/01/2012 $266.22
Class of Work: ALT Type of Const: Vg Plan Review 03/01/2012 $66.56
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/01/2012 $31.95
Stories: 2 Info Process /Archiving - Lg $2.00 (over 03/01/2012 $4.00
11x17)
Project Valuation: $7,001.00 Info Process /Archiving - Sm $0.50 (up to 03/01/2012 $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: 1
Appliances
Vent Fans: Vent Systems: Total $369.23
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 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 obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: • - mittee Signature:
Call 50 - : by 7:00 a.m. for the next available inspection dat .
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 ApplicatioRECEIVED FOlt t)rrlcl.: usr (:)N1,\
City of Tigard Date/By: i /5 / I ,I Permit No.: Mg /a—/ //: •
1 ° 13125 SW HaII Blvd., Tigard,OR 97223
C . Phone: 503.718.2439 Fax: 503.598.1960 FEB 1 5 201 Plan Review �
Date/By: �-& L -7 ■ er Permit:
T 1 G A R D Inspection Line: 503.639 Date Ready °y: rwie: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: ♦, ," Supplemental Information
BUILDING DIVISION /
TYPE OF WORK t gtRCIAL 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 rofit
Value: $ 71 cod. 5o
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling E ' 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: tic 1 S 3W PR E W I N („ ST ii I Li 0 (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: ,- r w/ J , „R._
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: � Project name: 4 (J t 0 11 G evi a C t Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 'a i i C Hwy � g...0 W % ( 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 23.32
/ Gas fireplace 33.39
- f F. NP 1 � 7 IM P E O V � M 1 N T--- Flue vent for water heater or gas
,1 L fireplace 23.32
NEW AI I't, I+f1 E k. / H L. 4 1 PUMP CP�a F Log lighter (gas) 23.32
' AlaJ Su PP LV t f_f 7 u 12A1 ID V C 7 I AJ GI 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: $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
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Dki ENTERPRIS INK' - ULTIM,CtlF CoM.6RZ �thesdryer (gas)
Address: bc, 46, S LLO' 0 ST MECHANICAL PERMIT FEES'
City /State /ZIP: MI LW P U IKI6 ink. &. q 1'7 7L-1-. Z. Subtotal
I Minimum permit fee ($90.00)
Phone:
(543) 1g6 r 01.4q(4 Fax: ( SO3 ) gZ t • 147,3 Plan review (25% of permit fee)
CCB lic.: /)/ /) -- 1 pe L/ r 1 P State surcharge (12% of permit fee)
I YL TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature:
/ dlit __ days after it has been accepted as complete.
Print name: � Date: ' ----- r1 • Fee methodology set by Tri -County Building Industry Service Board
i
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1:\Building\Permits\MEC -Pe ,,Rrpp.doc 09/09/10 perry l� A „ f ic' lfi h 440 -4617T (11/ l2/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. •
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