Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00301
T f GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2012
Parcel: 25101 DCO3800
Jurisdiction: Tigard
Site address: 7180 SW SANDBURG ST 100
Project: Bioject Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Add 3 ton ductless mini split system to service room
Contractor: ARROW MECHANICAL Owner: MCCORMACK PROPERTIES LP
10330 SW TUALATIN RD 7190 SW SANDBURG ST
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 -692 -1565 PHONE:
FAX: 503 - 691 -1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/06/2012 $173.44
Class of Work: ALT Type of Const: Plan Review 06/06/2012 $43.36
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 06/06/2012 $20.81
Stories: Info Process /Archiving - Sm $0.50 (up to 06/06/2012 $2.50
11x17)
Project Valuation: $3,835.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: .
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Fumaces < 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 $240.11
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 or 1.800.332.2344.
Issued By: Permittee Signature:
__
Call 503.639.4175 by 7:00 a.m. for the next available ins tion 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.
•chanical Permit Applica'i o isCM/ED FOR OFFICE USE O LV
City of Tigard Received PecmitN
13125 SW Hall Blvd., Tigard, OR 972231- Date/By: y��' Ob
•
' a Phone: 503.7182439 Fax: 503.598.1960U �s 2��2 Date/By: Other Permi
Inspection Line: 503.639.4175 �r:I! Q P�►a" D004 r
El T I G n I: D Internet: www.tigardor.gov CITY OF 1 y�l't�RD Notified/Method: Supplemental Information
BUILDING DIVISION
.TYPE. OF .WORK :. ' COMMERCIAL FEE* SCHEI)[JLE - USE CHECKLIST
❑ New construction (� Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
P performed. Indicate the value (rounded to the nearest dollar)of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY :OF • CONSTRUCITON Value: $ 5, 35, O o
' RESIDENTIALEQUIPME'NT / SYMMS FEES*
❑ 1- and 2- family dwelling 'i Commercial mdustrial ❑ Accessory building For spedal Information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INOYtMATiON AND L Heating/cooling: OCATION Air conditioning
Job site address: 71 go S,/ 5a1.) O 6 vt2 i s 1 ,, (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State/ZIP: - 1 - t d Any b le_ q 72'13 Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg./apt. no.: J I Project name: $ +o c- Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: • Duct work 2332
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: I Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
'DFSCRIPIIION: OF . WORK : Water heater 2332
Gas fireplace 33.39
Apo 3 pvr_TId'Sc, /s►1M1 51 c,yy e-,- To Ene,veac "OOC+•. Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
. . Y OWNER- - - ®
Chimney/liner/flue/vent 23.32
. ❑ PROPERTY
I Other: 23.32
Name: S D �- `T
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
7 i So X 1/4 4 . ?A MO Bt 4 S'T equipment 33.39
City /State/ZIP: Tt r, A R.12 o a- q"I2,ir 3 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( 471 ) 2 2,1- Co o 6 Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICAiVT ' . , ' :';`.:: . ; . =I . CONTACT `PERSON- Attic/crawlspace fans 23.32
Other: . 23.32
Business name: A 4 1/4., nom, 61.,.. rt 4.L AI Fuel r m .
PP g:
Contact name: t -6.-r M51A $14.15 for first four; $4.03 for each additional
Address: 1 0330 �a.t Tu x ign, .t teal . Gas hea etc.
Gas heat pump
City/State/ZIP: `r' A 'Ail 0 ie Q76 t; Z Wall/suspended/unit heater
Phone: (6.63) 6 e l2 - t5 65 - I Fax:: ( 6 1 -/ 6 Water heater
E -mail:
Fireplace
C ONTR ACT O R Barbecue
Clothes dryer (gas)
Business name:
AesclA/ /rL15'LN-AnI.fLAI Other.
Address: 1d3o ...4 - 11:01 IATr.4 'CI. . '• - MF:CHANICAI.PERMIEFEES•a•
City/State/ZIP: Tli nl.. • n, , , bit 4742- Subtotal
Minimum permit fee ($90.00)
Phone: (C 3) VIZ-1515- I Fax: (6 ) 4 71-) 87 q Plan review (25% of permit fee) .
CCB tic.: S q 3 State surcharge (12% of permit fee)
� TOTAL PERMIT FEE S 'tO .1%
Authorized signature: yf 7 . . dapplication s fter it has been a as complete. ISO
I n...: - . ..•. 12 im / Ark l TN..... 6 -/ 2i / 2;j, i 7. I • Fen meihMnl.ov get by Trt(nuuniv Rnldinv inch, ry Servine Ananl