Permit •
CITY OF TIGARD MECHANICAL PERMIT
111 11 a.: COMMUNITY DEVELOPMENT Permit #: MEC2012 -00299
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9530 SW WASHINGTON SQUARE RD H10
Project: Apple Subdivision: Lot:
Project Description: Relocate ducts, grilles, return /supply and demo in break room.
Contractor: GREY WOLF HVAC INC. Owner: PPR WASHINGTON SQUARE LLC
7306 NE 37TH AVE BY THOMSON PROPERTY TAX SERVICES
VANCOUVER, WA 98665 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 360 - 588 -3207 PHONE:
FAX: 360- 326 -8506
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/06/2012 $161.16
Class of Work: ALT Type of Const: Plan Review 06/06/2012 $40.29
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 06/06/2012 $19.34
Stories:
Project Valuation: $3,500.00
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 $220.79
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 obtain a copy of the rules
or direct questions t OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available Inspectio d • j
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
Received /lb /� -jt n�
City of Tigard RECEIVE" Date/By: t 5 6 /,2 ; „ Permit No oC •
III 13125 SW Hall Blvd., Tigard, OR 97223
2
: ` JUN 0 6 2012 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Perml
Inspection Line: 503.639.4175 Date Ready/By: Juris: Se g e Page DD / �
TIGARD Y Y g
Internet: www.tigard- or.gov cITY OF
p Notified/Method: 7/: Supplemental Information
WORK DIVISION
OF WOR 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.
Value: $ 3) SOO
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: 9530 SW Washington Square Rd. (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.: 1410 Project name: Apple 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),
s) 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 23.32
/�� Water heater
Air Distribution, VAV /2. L. 0 C4-7 ,(�u C7 6 /g/ L LES Gas fireplace/insert f o r w ater 33.39
Flue vent for water heater or gas
2 E-ru.4..✓ / /s-,..<_/ `7 ( ArE!`jo fireplace 23.32
Log lighter (gas) 23.32
//v a_/L et /2.017/1' Wood /pellet stove 33.39
Wood fireplace /insert 23.32
12 PROPERTY OWNER El 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: Grey Wolf HVAC, Inc. Other: 23.32
Fuel piping:
Contact name: Darrell Osborne $14.15 for first four; $4.03 for each additional • Address: 7306 NE 37 Ave. Furnace, etc.
Gas heat pump
City /State /ZIP: Vancouver, WA 98665 Wall /suspended/unit heater
Phone: (360) 635 -6117 Fax: : (360) 326 -8506 Water heater
Fireplace
E -mail: dosborne @greywolfhvac.com • Range
. CONTRACTOR Barbecue
Business name: Grey Wolf HVAC, Inc. Clothes dryer (gas)
Other:
Address: 7306 NE 37 Ave. • MECHANICAL PERMIT FEES*
City /State/ZIP: Vancouver, WA 98665 Subtotal
Phone: (360) 635 -6117 F ax: (360) 326 -8506 Minimum permit fee ($90.00)
L Plan review (25% of permit fee)
CCB lic.: 1651 State surcharge (12% of permit fee)
i TOTAL PERMIT FEE 22 1, 2y
Authorized signature. ,
�, r �v:I t �� This permit application expires if a permit is not obtained within 180
lip, �j _ days after it has been accepted as complete.
Print name: Darrell Osborne Date: 6/5/12 I • Fee methodology set by Tri County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 03/07/12 4404617T(II /02/COM/WEB)