Permit , CITY OF TIGARD MECHANICAL PERMIT
'` - C COMMUNITY DEVELOPMENT Permit #: MEC2012 -00581
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/07/2012
Parcel: 1 S 135DC0o200
•
Jurisdiction: Tigard
Site address: 11825 SW GREENBURG RD
Project: Greenburg Business Park Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: Installation of 2 furnaces, (2) ground mount a/c units, associated gas piping ,,
J P O O9 i 9 PP 9 and duct work. Work is in the
common areas of 1st and 2nd floors. ,
Contractor: GENERAL CONSTRUCTION SERVICES Owner: TWO G'S REAL ESTATE LLC
• 18395 WOOD THRUSH ST 18395 WOOD THRUSH LLC
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503 - 684 -0550 PHONE: 503 - 684 -0550
FAX:
FEES
Specifics: . Description Date Amount
Type of Use: COM Permit Fee ' 11/07/2012 $207.21
Class of Work: ALT Type of Const: Plan Review 11/07/2012 $51.80
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/07/2012 $24.87
Stories: 2
Project Valuation: $5,000.00 .
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 2 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $283.88
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Co .es and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if ork is net starte. 'thin 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to . low the les ad** ed by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-00** You r - obtain copy of the rules
or direct qu ons to Ob C by - ing 503.232.1987 or 1.800.332.2344. •
Issued B : = /At / / Permittee Signature: Pii1i f
' i i
Call 503.639.4175 by 7:00 a.m. for the next available inspection dal v _
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 Applicatioq, FoR OFFICE USE ONLY
Cl Of Tind K1t,EIVED Received
Permit No.:
City Date/By: / / ,,,, _
° 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review
' C . }y g Q 7 , Phone: 503.718.2439 Fax: 503.598.9 2012 Other Permit: •
• i
�� Date/By:
I' I G n 1i U Inspection Line: 503.639 Date Ready/By: lurk: El See Page 2 for
Internet: www.tigard or.gov CITYOFTIGARD Notified/Method: Supplemental Information
TYPE YORK DIVISION 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
mechanical materials, equipment, la r, overhead, and profit.
El Demolition ❑ Other:
Value: $ ,dG °
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling 12 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 /1�
Job site address: 11 �zs we P4p a1Mt G,, %/4. (requires site plan showing placement) ` 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State /ZIP: , , ted n t, 2.,`Z3 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. o.: No-2.). Project name: Heat pump
g t. �' (requires site plan showing placement) 61.06
Cross street/directions to job site:e.„,t,` p. ..e. C v A 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
Gas fireplace/insert 33.39
c 2 104.- c QLiP. L-t Z.AN_ S 1 Nv L ta.>Q! - \\V IN ` Flue vent for water heater or gas
Nn! AS �Nr'A C--- fireplace 23.32
Log lighter (gas) 23.32
c LLY., , `pNAQZ \q %%43..0 .ati se1� . r. Z Wood/pellet stove 33.39
Wood fireplace /insert 23.32
.® PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name
v C � ,r_v, Lc_cj■q �"` V, )t C--- Environmental exhaust and ventilation:
Range hood/other kitchen
Address:
Nttiggi �j- "1M110 p ) r�41� ST equipment 33.39
City /State /ZIP: Lipa,t2ss,6lNte_ew-b f U Isz. Gil 7 /3 S Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone:g5p? )---c&C p Fax: 603)/,Zo SS63 toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name:C. Other: 23.32
L�
` ` Fuel piping:
Contact name: 5�SS �\ O $14.15 for first four; $4.03 for each additional
Address: ` O,l � 0 9-Tc‘te.v 5NiS Furnace, etc.
Gas heat pump
City /State /ZIP: , .L.o 'blCz. A)c7O� Wall /suspended/unit heater
Phone: (5v3 )j A. - -DS G j Fax: : 6,6 )4Rb - SS c3 Water heater
Fireplace
E S,Sop �G� .Ta o� O . C_, 0tr..
Range
CONTRACTOR Barbecue
Business name: �''S Clothes dryer (gas)
--- e;\" Other:
Addressst,Ql[ �v d am - -��, , 4 S MECHANICAL PERMIT FEES*
City /State /ZIP: �Vy,C,z j 2. •7O� Subtotal 7 .P/
) .� F;11-- )) Minimum permit fee ($90.00)
Phone:
�3 foE6 S ;43 Plan review (25% of permit fee) 51. so
CCB Iic.: •6, ) State surcharge (12% of permit fee) AL/ .17
4 0 TOTAL PERMIT FEE 9 3. S If
Authorized signat This permit application expires if a permit is not obtained within 180
P� d ays a fter it has been accepted as complete.
Print name:�� Date: ) .. • Fee methodology set by Tn -County Building Industry Service Board
1:\ Building \PermitsUMEC- PermitApp.doc 03/07/12 440-4617T (11 /02/COM/WEB)
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.
1:\ Building \Permits\MEC -PermitApp.doc 03/07/12 2
Building Division
Over- The - Counter (OTC) Mechanical Permit
TIGARD Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: Oregon Specialty Code:
Number of Stories:
FUEL FURNACES
Type: Furnace < 100K BTU Furnaces >= 100K BTU
Gas Pressure: Roof Top Unit (RTU) Tons
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler (BTUs) Vent Fans Gas Line (00 t
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work t Gas Fireplace
Fire /Smoke Dampers Other Mechanical Units — Describe:
•
Total Project Valuation: $ FEES DUE
$ Mechanical Permit Fee
$ Plan Review
$ 12% State Surcharge
$ Info Proc /Arch, Lg (over 11x17 $2.00)
$ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Misc. Admin Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff:
Date /Time: $ TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
END = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
1:\Building\Forms \OTC - MEC.docx 01/13/2011