Permit CITY OF TIGARD MECHANICAL PERMIT
.
_ • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00156
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/27/2012
Parcel: 25101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 460
Project: State Farm Subdivision: VARNS ACRES Lot: 9
Project Description: Relocate (29) supply diffusers, relocate (17) return grilles, add (10) new supply ducts and diffusers, and add (19)
new return air grilles for Ti.
Contractor: AMERICAN HEATING INC Owner: GK TRIANGLE CORPORATE PARK III L
1339 SE GIDEON ST BY THOMSON REUTERS INC
PORTLAND, OR 97202 ATTN: MEGAN DOWLING
PO BOX 130174
CARLSBAD, CA 92013
PHONE: 503 - 239 -4600 PHONE: 503 - 221 -1900
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/27/2012 $660.13
Class of Work: ALT Type of Const: Plan Review 03/27/2012 $165.03
Occupancy Grp: Occupancy Load: 12% State Surcharge, Mechanical 03/27/2012 $79.22
Stories:
Project Valuation: $22,224.00
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: Vent Systems: Total $904.38
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
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 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 0 j Ann 3 2.2344.
Issued By: Permittee Signature: RC ci /14.6.01C+ S C
�/J
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 Application FOR OFFICE USE ONLY
Cit
Tigard Ti and 3 27 y • - .t No ,p
`J Date /By: i i - ��iZ �(/Q /s .
° 13125 S W Hall Blvd., Tigard, OR 972
°14 C . Phone: 503.718.2439 Fax: 503.598.1 6 Plan Rev Other Prmit
er e '' p
Date /By: >Or t / o2.0/ — etoori Q
T l G A R D Inspection Line: 503.639.4175 MAR 2 7 2012 Date Ready /By: kris: ® See Page 2 for
Internet: www.tigard- or.gov It �y Notified/Method: 7/6.--- Supplemental Information
CITY OF TIGAP,D
TYPE OF giiFDING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
M echanical 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.
Value: $ $22,224.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® 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: 13221 sw 68 parkway (requires site plan showing placement) 46.75
City/ State/ZIP: Tigard OR 97223 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: State Form 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:
DESCRIPTION OF WORK Water heater 23.32
relocate 29 supply diffusers Gas fireplace/insert 33.39
Flue vent for water heater or gas
relocate 17 return grilles fireplace 23.32
Log lighter (gas) 23.32
add 10 new supply ducts and diffusers Wood/pellet stove 33.39
add 19 new return air grilles Wood fireplace/insert 23.32
❑ 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
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
0 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: American Heating Other: 23.32
Fuel piping:
Contact name: Brad Manchester $14.15 for first four; $4.03 for each additional
Address: 1339 SE Gideon Street Furnace, etc.
Gas heat pump
City/State/ZIP: Portland OR 97202 Wall/suspended/unit heater
Phone: (503) 239 -4600 Fax: : (503) 239 -7038 Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Brad Manchester Clothes dryer (gas)
Other:
Address: 1339 SE Gideon St MECHANICAL PERMIT FEES*
City/State/ZIP: Portland OR 97202 Subtotal , 6 0 , 4 j
Phone: (503) 239 -4600 Fax: (503) 239 -7038 Minimum permit fee ($90.00) f
Plan review (25% of permit fee) /(p 5. 03
ii/ CCB lie.: 33135 Stat q
e surcharge (12% of permit fee) , ,2.2
J � �G v �j� s 4-.‘ TOTAL PERMIT FEE 1 i, 38
f' (.. /!
Authorized signature: ( This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: Brad Manchester I Date: 3/26/2012 • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permits\MEC- PermitApp.doc 03/07/12 440-4617T (I i /02 /COM/WEB)