Permit ^ v
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00420
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/12/2008
PARCEL: 2S 102AC -00700
SITE ADDRESS: 12550 SW MAIN ST ZONING: CBD
SUBDIVISION: DOLAN BUILDING LOT: 001 JURISDICTION: TIG
PROJECT: A -BOY
Project Description: Replacing 7.5 ton RTU unit with 12.5 ton unit and modifying supply duct and grilles. Valuation:
$13,000.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: 1 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
DOLAN + CO LLC Description Date Amount
BY FLORENCE T DOLAN
4025 SE BROOKLYN [MECH] Permit Fee 8/12/200E $272.00
PORTLAND, OR 97202 [MECPLN] Plan Rev 8/12/200E $68.00
[TAX] 12% State Surch 8/12/200E $32.64
Phone: Total $372.64
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
_MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 462 -4822
FAX 503- 462 -6555
Reg #: LIC 50897
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: j / L/ �/ Permittee Signature: , f gym
C -. 39.4175 by 7:00 a.m. for inspections that business day.
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 Applica ' C
NNIED FOR OFFICE USE ONLY
r
C
City o Received Tigard D'ateiv : Permit No.:
• 13125 SW Hall Blvd., Tigard, OR 97223 52-
Pl Review ��� y I "" : �' � ` . • , 0.
Ph one: 503 .639.4171 Fax: 503.598.1960 WS Other Permit:
T I G Ii D Inspection Line: 503.639 < T,Gp� D Date/By:
ate Ready/By: El See Page 2 for
Internet: www.tigard-or.gov
C. V 0 otified/Method: En Supplemental Information
01 1 Iv� n
TYPE OF W COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
El New construction EgAddition/alteratio eplacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CAe F CONSTRUCTION value: $ 13 pp p , ciD
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
El I- and 2- family dwelling mmercia h.)ustrial El Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address:
? 550 cc , QC.V) s4... Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: I v� rJ 6Y1 Furnace 100,000 BTU (ducts/vents) 14.00
J 1 1 Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Pro t name: q S 1 ii(e_. Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.:
Flue/vent for any of above 6.80
Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
rep 16,@, 75 fl-TV u.7/ 1 ? . 5 1bn (t, D /Lc noY
^ l llrz r, Flue vent for water heater or gas
G, fireplace 10.00
° , d 3 o t ( e-s Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
[PROPERTY OWNER I , TENANT Chimney/liner /flue /vent 10.00
Other. 10.00
Name: A - g l Environmental exhaust and ventilation _
Address: Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
cil APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: 1,..1,q / e_., Fuel piping
Contact name: et
ll ) _:I _ I) $5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
. . f 1 c J Clothes dryer (gas)
�I
Business name: V /'�, Other:
Address: 5 [ � SE i- ttk
City/State /ZIP: dkuCul kJ) I ii (.n1 Subtotal PERMIT FEES* Subtotal ,°,j,ry - �
Phone: (5 pJ (R W . ) ..... \_ . ( Fa d 1(� (0� _ /.. S55 Minimum (25% fee rmit fee) J' lU Plan review (25% of permit fee) (psfi. OD
CCB lic.: 5O ' 7 State surcharge (12% of permit fee) 3 &,1
c Ck:LAAA ji__.) �� TOTAL PERMIT FEE�r
This permit application expires if a permit is not obtained within 180
Authorized signature:
l/l/VJ�� days after it has been accepted as complete.
Print name: , �41 P a e_ b �Sa..,,-t I Date: 511 6 1 o 1 • Fee methodology set by Tri-County Building Industry Service Board
1 :\ Building \Permits\MEC- PermitApp.doc 01/19/07 4404617T(1I/02/COM/WEB)
•
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00. •
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
I:\Building\Permits MEC- PermitApp.doc 01/19/07 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200B -00420
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2008
Phone: (503) 639 -4171 U°4/44,4;4 I
. �.
Inspection Requests (24 Hrs.): (503) 639 -4175 '.!:.
INSPECTION WORKSHEET FOR DATE: 9/16/2! TIME: 7:01AM PAGE: 4
SITE ADDRESS: 12550 SW MAIN ST CLASS OF WORK:
SUBDIVISION: DOLAN BUILDING LOT #: 001 TYPE OF USE:
PROJECT NAME: A -BOY
DESCRIPTION: Replacing 7.5 ton RTU unit with 12.5 ton unit and modifying supply duct arid grilles. Valuation:
$13,000.00
OWNER: DOLAN + CO LLC, PHONE #:
CONTRACTOR: HVAC INC PHONE #: 603.462 -4822
Inspection Request Scheduled For: Date: 9/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 075519-02 971 -322 -6353 411P ill
1
,!o PI`A
Corrections /Comments/ Instructions:
--
•
C s., ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IN FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718- Z-CW