Permit CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00418
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/08/2012
Parcel: 2S 101 DA00101
Jurisdiction: TIGARD
Site address: 13190 SW 68TH PKWY 110
Project: Steams Lending Subdivision: VARNS ACRES Lot: 9
Project Description: Relocate (8) existing return /supply grilles, add (6) new return /supply grilles to connect to existing ductwork.
Contractor: ACCURATE HEATING INC Owner: PACIFIC NW PROPERTIES LIMITED PA
19450 SW MOHAVE CT STERN FAMILY LIMITED PARTNERSHIP
TUALATIN, OR 97062 STERN, HELEN R REVOCABLE TRUST
6600 SW 105TH AVE #175
BEAVERTON, OR 97008
PHONE: 503 - 650 -1229 PHONE:
FAX: 503 - 650 -4845
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/08/2012 $212.83
Class of Work: ALT Type of Const: Plan Review 08/08/2012 $53.21
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 08/08/2012 $25.54
Stories:
Project Valuation: $5,150.00
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 $291.58
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
issu. • .r i " suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
ity Notification Center. Those ules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You may ob ain a • • • .use rules
•r direct questions to OUNC b - • 50 232.1987 or 1.800.332.2344.
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Issued By: k /` /I � /✓ 4 _ Permittee Signet
4 ,940
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Call 503.639.4175 by 7:00 a.m. for the next availab = - pe tion date.
This permit card shall be kept in a conspicuous place on the Job site until completlo • of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic .1 't ; kdin,i I' t, . FoR OFFICE: USE ONLY
City of Tigard QUG 0 8 2012 D React eeBy: g i , ,l Permit No.: WO /V_60 f
II ° 13125 SW Hall Blvd., Tigard, OR 97223
C Plan Review
Phone: 503.718.2439 Fax: 503.59 Other Permit: BQ
Inspection Line: 503.639.4175 yt'" df"�
Ti G A R D p -� ;, • r ^rl r Date Ready/By: J ur i s: S ee Pa g e 2 for
Internet: www.tigard - or.gov B!J6L'�l r % [ylt� dStOF' Notified/Method: 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.
Value: $ $5,150.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- 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: 13190 SW 68 Parkway (requires site plan showing placement) 46.75
City /State /ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Stern Lending 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 (8) existing return / supply grilles, Add return/supply grilles
Gas fireplace /insert 33.39
() g pp y 6 g (6) new return /su pp y g Flue vent for water heater or gas
to connect to existin g ductwork and modify as per plans fireplace 23.32
. 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: Stern Lending Environmental exhaust and ventilation:
Address: 13190 SW 68 Parkway Range hood/other kitchen
equipment 33.39
City/State /ZIP: Tigard, Oregon 97223 Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Accurate Heating, Inc. Other: 23.32
Fuel piping:
Contact name: Kim Williams $14.15 for first four; $4.03 for each additional
Address: 19450 SW Mohave Court Fumace, etc.
Gas heat pump
City/State /ZIP: Tualatin, Oregon 97062 Wall /suspended/unit heater
Phone: (503) 650.1229 Fax: : (503) 650.4845 Water heater
Fireplace
E -mail: kwilliams @accurateheating.com Range
CONTRACTOR Barbecue
Business name: Accurate Heating, Inc. Clothes dryer (gas)
Other:
Address: 19450 SW Mohave Court MECHANICAL PERMIT FEES*
City /State /ZIP: Tualatin, Oregon 97062 Subtotal
Phone: (503) 650.1229 Fax: (503) 650.4845 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 88423 State surcharge (12% of permit fee)
TOTAL PERMIT FEE 0'91.1$
Authorized si a / /. This permit application expires if a permit is not obtained within 180
�� days after it has been accepted as complete.
Print name: Kim Wtt la t t s Date: 08.06.12 • Fee methodology set by Tri- County Building Industry Service Board
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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