Permit : �u '- , ; ; . MECHANICAL PERMIT
•
CITY OF TIGARD .I.,1 f '',, .4. :
1111 ° :•' COMMUNITY DEVELOPMENT lereiriya Permit #: MEC2011 -00608
Date Issued: 03/23/2012
T t G A R l? 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1 S136DCO2504
Jurisdiction: Tigard
Site address: 7275 SW DARTMOUTH ST 180
Project: Tigard Triangle Smiles Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: Mechanical for TI. 4/19/12, reprinted to add suite number, 180.
Contractor: ARJAE SHEET METAL CO, INC. Owner: AMERICAN INDUSTRIES INC
5510 SE MCLOUGHLIN BLVD. 1750 NW FRONT AVE STE #106
PORTLAND, OR 97202 PORTLAND, OR 97209
PHONE: 503 - 231 -7717 PHONE:
FAX: 503 - 230 -4888
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/23/2012 $319.61,
Class of Work: ALT Type of Const: VB Plan Review 03/23/2012 $79.90
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/23/2012 $38.35
Stories: 1
Project Valuation: $9,000.00
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: 1 50 or Greater HP : . .
Air Conditioning: •
Heat Pump: • . .
Appliances •
Vent Fans: 3 Vent Systems: Total $437.86
Hoods: Comm Incinerators: .
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: clothes dryer
Duct Work: duct
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 C_____ enter. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dirs to s' .y calling 503.232.1987 or 1.800.332.2344.
Issue • 4 / / tL _ , • - , Permittee SIgpature: I `_ % J
Call 503.639.4175 by 7:00 a.m. for the next available inspecti. date.
This permit card shall be kept in a conspicuous place on the job site unt' completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
v CITY OF TIGARD MECHANICAL PERMIT
.111 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00608
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/23/2012
Parcel: 1 S136DCO2504
Jurisdiction: Tigard
Site address: 7275 SW DARTMOUTH ST
Project: Tigard Triangle Smiles Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: Mechanical for TI.
Contractor: ARJAE SHEET METAL CO, INC. Owner: AMERICAN INDUSTRIES INC
5510 SE MCLOUGHLIN BLVD. 1750 NW FRONT AVE STE #106
PORTLAND, OR 97202 PORTLAND, OR 97209
PHONE: 503 - 231 -7717 PHONE:
FAX: 503 - 230 -4888
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/23/2012 $319.61
Class of Work: ALT Type of Const: VB Plan Review 03/23/2012 $79.90
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/23/2012 $38.35
•
Stories: 1
Project Valuation: $9,000.00
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: 1 50 or Greater HP:
Air Conditioning:
Heat Pump:
•
Appliances
Vent Fans: 3 Vent Systems: Total $437.86
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: clothes dryer
Duct Work: duct
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 per x pire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law r- = u to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through ir r , + • • • u may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: P ermitteeSign• �i
....cilizaferg..._______ 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 6 ' FOR OFFICE USE ONLY
Cl of Tigard %\i\ Received permit
a `J g an DateDate/By: V/ II 41 No.: ac-9.6 1) -(f :f
13125 SW Hall Blvd. Tigard, OR 97223 L ��
an Review 1
C
Phone: 503.718.2439 Fax: 503.598.1960 Q� ,`lC). I Date /By: 7 • � Other Permit: 6 , ,
TI G A R D Inspection Line: 503.639 C ,V l i � Date Ready By • Sutss: n See Page 2 for
Internet: www.tigard or.gov C S ,,�`C Notified/Method: Yt0 Supplemental Information
TYPE OF WORK �� `` COMMERCIAL 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 profit.
CATEGORY OF CONSTRUCTION Value: $ , O t70. 0
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling rkommercial/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 / 56%) /q4]- a>"111 5 (requires site plan showing placement) 46.75
City/State /ZIP: ' J • Furnace 100,000 BTU (ducts/vents) 46.75
° 1Ar0 ( iZ_ Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name:' \ 11 �' , � Heat pump
( �� �2 r Ali (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 1 23.32
Gas
-�_� >> l 1 fireplace 33.39
N •' � t vx ON s�2, ? t 1\ P - 1 / 7 eis/V . I1F') Flue vent for water heater or gas
1 J Aft/C. 'PPIa A, I d p4 4 - I " / ,J, C 7 fireplace \ 23.32
U 1 Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER TENANT
Chimney/liner/flue/vent 23.32
Other. 23.32
Name: ,9'6,{ (4 L- 0 l . 1A
Environmental exhaust and ventilation:
Address: e (op / 04. ' ts-714, Range hood/other kitchen
equipment 33.39
City/State/ZIP: l 4'01Nt� (() t 24, DC, Clothes dryer exhaust r 33.39
�ry
Single -duct exhaust (bathrooms,
Phone: 0/11 )1 4,,,,, 1 , ,, r> Fax: f'1)'1 ) .ti,- 0 7:' 0 toilet compartments, utility rooms) 23.32
ppt PPLICANT jCONTACT PERSON Attic/crawlspace fans 23.32
Business name: 3 . 1 .. c .. (el f L Q� f�t ( 7 .� �C Other. 23.32
J Fuel piping:
Contact name: Lit I M /t .(1 ai $14.15 for first four; $4.03 for each additional
Address: 2014 Li I �tA fN //-C Furnace, etc.
Gas heat pump
City/State/ZIP: / (9/ CO 9 1 e g / Wall/suspended/unit heater
Phone: ( 9 ) 5 (7^t'L, CJ Lj Fax: : ( ) 3 � ..' q S j Water heater
)� / Fireplace
E -mail: 014 Ci (-> hb./V.. co Range
CONTRA TOR Barbecue
Business name: ,14e S'�Le A/C' -L Clothes dryer (gas)
Other:
Address: . 55/d 5�� ,5-6.-- MECHANICAL PERMIT FEES*
City/State/ZIP: An4, N � 1. 7 - 4_ 9 /,' ad,z, Subtotal
Minimum permit fee ($90.00)
Phone: 6-,3) as/ 7, 7 Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 6,0 e 11 State surcharge (12% of permit fee)
I TOTAL PERMIT FEE
Authorized signature: '' This p ermit application expires if a permit Is not obtained within 180
days after It has been accepted as complete.
Print name: AZ ( C/r,„ J e-4-)A--.N.) Date: Z..5 �ik_v_. v/-, • Fee methodology set by Tri -County Building Industry Service Board
1: \ Building \ Permits \MEC- PermitApp.doc 09/09/10 440-4617T(I1 /02/COM/WEB)