Permit CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00392
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/25/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY, STE# 010
Project: National American University Subdivision: VARNS ACRES Lot: 9
Project Description: Installation of ductwork not covered under MEC2012 -00327 by HVAC, Inc
Contractor: VERTEX MECHANICAL LLC Owner: TRIANGLE POINTE LLC
111 SW 5TH AVE STE #1850 901 NE GLISAN ST, #100
PORTLAND, OR 97204 PORTLAND, OR 97232
PHONE: 503 - 963 -4732 PHONE: 503 - 297 -8791
FAX: 503 - 963 -4730
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/25/2012 $652.51
Class of Work: ALT Type of Const: Plan Review 07/25/2012 $163.13
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 07/25/2012 $78.30
Stories: •
Project Valuation: $22,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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 $893.94
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 i'cation Cen - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or di ct questions to OUNC . • ling 503.232.1987 or 1.800.332.2344.
Iss d By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspectio 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 Applica "+i��i _ rt)R 01:1:1( ► s►: u'►.■•
Re c eived
City of Tigard .s., . 7 / Permit No.: d&l ,,,.DO 39d
• r
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
11 Phone: 503.718.2439 Fax: 503.598.1960J UL 2O Z Date/By. °tberPermit tits edoll -ea,.
.1. i G R n Inspection Line: 503.639.4175 Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard-or.gov CITY CF T CARD Notified/Method: Supplemental Information
BJtLO far D ifIRIO )
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Addition/alteration/replacement
Mechanical permit
the are based on the the of r the work
iStNew construction
❑ rep performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 0 ,2 � e) 40. O o
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling ZCommercial/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 Heatng/cooling:
Air conditioning
Job site address: ) 3 7 7 3 Sw 6? Pt- W y (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/ State/ZIP: P o r ( - - ( , . . , . / O r C ! 1 - /
o Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt.no.: Project name: pclt/o,. / Arlerica+ CAavt: -./- HeatPump
(requires site plan show 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 Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other Owl appliances:
DESCRIPTION OF WORK Water heater 23.32
Foy Gas fireplace/insert 33.39
- ylt,
die/ ' I r , ° X' -' r j Flue vent for water heater or gas
V4 V b., i c, > P 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood Sreplacefmsert 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
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other:
Business name: 23.32
Fuel piping:
Contact name: $14.13 for first four, $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/tmit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: e - kx /" .tc .r 4 / C4 / i 1, G Clothes dryer (gas)
V
/ // JA- 7 i - f� / f5 c Other:
Address: MECHANICAL PERMIT FEES*
City/ State/ZIP: ri - /a "J Z- q7' 720 9 Subtotal
Minimum permit fee ($90.00)
Phone: ( 3) 96 7 - 4'13i. Fax: (50) ) 9G3 y 7 3 b Plan review (25% of permit fee)
CCB lic.: 1 g9 C/ (/ A/5/ / / State surcharge (12% of permit fee)
TOTAL PERMIT FEE $7 g Y3•
Authorized This permit application expires a permit Is not obtained within 180
/� if
after it has been accepted as complete.
(i
Print name: 474.1 6 D 1L.- l Date: 7/74. , • Fee methodology set by Tri-County Building Industry Service Board
I: 1Buildmg /Pcnmits\MEC-PcsmiitApp.doc 03/07/12 MW61 % 11 /02COnf/w1e)